ZipRecruiter

Log In

2

Remote Utilization Review Jobs in Portland, OR (NOW HIRING)

next page

Showing results 1-20

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Portland, OR

Remote Utilization Review information

See Portland, OR salary details

$22

$44

$73

How much do remote utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for remote utilization review in Portland, OR is $44.84, according to ZipRecruiter salary data. Most workers in this role earn between $35.43 and $51.49 per hour, depending on experience, location, and employer.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What are the most commonly searched types of Utilization Review jobs in Portland, OR?

The most popular types of Utilization Review jobs in Portland, OR are:

What are popular job titles related to Remote Utilization Review jobs in Portland, OR?

For Remote Utilization Review jobs in Portland, OR, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review jobs in Portland, OR look for?

The top searched job categories for Remote Utilization Review jobs in Portland, OR are:

What cities near Portland, OR are hiring for Remote Utilization Review jobs?

Cities near Portland, OR with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Portland, OR as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $93,268 per year, or $44.8 per hour.

RN Utilization Management Reviewer - Remote (OR, WA, AK)

PeaceHealth

Vancouver, WA • On-site, Remote

$48.52 - $72.78/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New

PeaceHealth rating

7.7

Company rating: 7.7 out of 10

Based on 175 frontline employees who took The Breakroom Quiz

160th of 891 rated healthcare providers

Job description

Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are.
PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization Management (UM) Reviewer to join our dedicated team in a Full Time, Day Shift (1.0 FTE) role. If you enjoy analytical work and are energized by helping ensure patients receive the right care at the right time, this remote opportunity may be the perfect next step in your nursing career.
Why You'll Love This Role
As a Utilization Management Reviewer at PeaceHealth, you will play a key part in supporting safe, high-quality, and efficient patient care across our healthcare system. This position centers on concurrent and retrospective UM reviews, leveraging clinical expertise, payer policy knowledge, and technology tools to guide patient status determinations and promote appropriate utilization of hospital resources.
You'll work fully remote*, with PeaceHealth-provided computer equipment-empowered by a collaborative team, supportive leadership, and a strong organizational commitment to diversity, cultural humility, and caregiver well-being.
*Must reside in Washington, Oregon, or Alaska. PeaceHealth will provide the caregiver with necessary computer equipment. It is the responsibility of the caregiver to provide Internet access.
PeaceHealth's Total Rewards package supports your physical, emotional, financial, social, and spiritual wellbeing. Benefits include:
  • Pay Range: $48.52 - $72.78/hour
  • Full medical, dental, and vision coverage
  • 403(b) retirement plan with employer base and matching contributions
  • Paid time off and paid disability & life insurance (with buy-up options)
  • Tuition reimbursement and continuing education support
  • Robust wellness benefits, EAP, and expanded mental health programs
  • A culture grounded in Inclusivity, Respect for Diversity, and Cultural Humility

What You'll Do
  • Coordinate accurate patient status identification and documentation
  • Ensure correct admission status and reimbursement through certification and clinical review
  • Gather additional clinical documentation to validate treatment plans and level of care
  • Collaborate closely with physicians, clinicians, and multidisciplinary teams
  • Apply UM criteria using the Xsolis Dragonfly™ platform and PeaceHealth Care Level Score tools
  • Conduct pre-admission status reviews in the ED, patient access areas, and elective settings
  • Communicate with third-party payers regarding medical necessity and discharge progress
  • Support denial and appeal processes; refer cases for physician advisor review when appropriate
  • Participate in UM Committee work, quality initiatives, and performance improvement
  • Identify DRGs with complications/comorbidities and recommend documentation improvements
  • Promote responsible hospital resource utilization, length-of-stay optimization, and care efficiency
  • Perform other duties as needed to support UM and organizational goals

What You Bring
Education
  • Required: Bachelor of Science in Nursing (BSN)
  • Preferred: Master of Science in Nursing (MSN)

Experience
  • 3+ years of acute care hospital experience with strong clinical knowledge
  • In-depth understanding of Medicare/Medicaid UM regulations, RAC, QIO, MAC, and denial/appeals processes
  • Preferred: Prior experience in utilization management or case management

Credentials
  • Active RN license in your state of residence (WA, OR, or AK)

Ready to Make a Meaningful Impact?
Bring your clinical expertise, attention to detail, and passion for patient advocacy to a mission-driven healthcare system that believes in caring for caregivers as much as patients.
For full consideration, please attach a current resume with your application.
PeaceHealth is an EEO Affirmative Action Employer/Veterans/Disabled following all applicable state, local, and federal laws.

What PeaceHealth employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

PeaceHealth logo

About PeaceHealth

Sourced by ZipRecruiter

PeaceHealth, based in Vancouver, WA, is a not-for-profit Catholic health system employing approximately 16,000 caregivers, a multi-specialty medical group practice with more than 1,200 providers and 10 medical centers serving both urban and rural communities in Washington, Oregon, Alaska. In 1890, the Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, the legacy of its founding Sisters continues with a spirit of respect, stewardship, collaboration and social justice in fulfilling its Mission. Get a feeling for the Spirit of PeaceHealth through this three-minute video, and visit us on Facebook or LinkedIn! We offer competitive compensation, a robust benefitspackage and a collaborative, Mission-driven work environment! To learn more please visit: jobs.peacehealth.org. Questions? Review our Employment FAQor email Recruitment@peacehealth.org. Please note this email does not accept resumes or applications.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Vancouver, WA, US

Year founded

1890

Social media

FacebookTwitter

View All PeaceHealth Jobs

Apply