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Remote Utilization Review Jobs in Seattle, WA (NOW HIRING)

CHPW

Utilization Management Coordinator I

Seattle, WA · On-site +1

$21 - $28.98/hr

The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and ...

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing and reimbursement Remote in Washington State only Posted wage ranges represent the ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing and reimbursement Remote in Washington State only Posted wage ranges represent the ...

Karius

Clinical Sales Manager (Seattle)

Seattle, WA · On-site +1

... and utilization review. • Secure contracts and agreements, where necessary or optimal, to ... remote and in-person, and manage follow-up. • Collaborate with Customer Success to onboard new ...

Karius

Clinical Sales Manager (Seattle)

Seattle, WA · Remote

$118K - $177K/yr

... and utilization review. • Secure contracts and agreements, where necessary or optimal, to ... remote and in-person, and manage follow-up. • Collaborate with Customer Success to onboard new ...

Proliance Surgeons

Remote Coder (CPC)

Seattle, WA · On-site +1

$24.70 - $44.46/hr

Reviews/audits and interprets medical record documentation to identify pertinent diagnosis ... Demonstrates appropriate utilization of coding software and coding reference material. * Follow up ...

CHPW

State Hospital Liaison

Seattle, WA · On-site +1

$41.05 - $64.45/hr

This position is remote. However, the candidate will need to reside in Washington State in order to ... Review requests for Behavioral Health Wraparound Care (BHWC). * Review requests and create ...

Dura Digital

VP, Delivery & Customer Success

Seattle, WA · Remote

$157K - $202K/yr

Conduct ongoing reviews, retrospectives, and feedback loops to continuously strengthen customer ... Own delivery financials, including project profitability, margin targets, utilization, forecasting ...

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Remote Utilization Review information

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$24

$48

$78

How much do remote utilization review jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for remote utilization review in Seattle, WA is $48.12, according to ZipRecruiter salary data. Most workers in this role earn between $38.03 and $55.24 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

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 does a typical day look like for someone in a Remote Utilization Review role?

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 is a Remote Utilization Review job?

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 are the most commonly searched types of Utilization Review jobs in Seattle, WA? The most popular types of Utilization Review jobs in Seattle, WA are:
What are popular job titles related to Remote Utilization Review jobs in Seattle, WA? For Remote Utilization Review jobs in Seattle, WA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Seattle, WA look for? The top searched job categories for Remote Utilization Review jobs in Seattle, WA are:
What cities near Seattle, WA are hiring for Remote Utilization Review jobs? Cities near Seattle, WA with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Seattle, WA as of July 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 100% Remote job distribution, with an average salary of $100,085 per year, or $48.1 per hour.

Utilization Review Nurse

Virginia Mason Medical Center

Seattle, WA • On-site, Remote

$52.03 - $101.24/hr

Other

Posted yesterday

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Job description

Where You'll Work
Virginia Mason Franciscan Health brings together two award winning health systems in Washington state - CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.
Job Summary and Responsibilities
As our Utilization Review Nurse, you will ensure the medical necessity and appropriateness of care for all hospitalized patients, promoting fiscal responsibility and optimal patient outcomes. You will leverage specialized utilization review criteria, technologies, and tools to verify the correct level of care throughout their acute stay.
Every day you will perform meticulous clinical assessments, identify and coordinate cost-effective alternatives, and proactively support provider decision-making. You will collaborate with the healthcare team, patients, families, and both internal/external customers to achieve optimal outcomes efficiently and ethically, ensuring compliance with payer guidelines and regulatory standards.
To be successful in this role you will have strong analytical skills, persuasive communication, and a steadfast commitment to patient advocacy. Fiscal stewardship is crucial for navigating complex clinical and financial landscapes, ensuring appropriate resource utilization.
Job Requirements
Required
  • Bachelor's degree in Nursing and 3 years of professional nursing experience in a hospital setting.
  • Experience in utilization review.
  • Demonstrated ability to work collaboratively with all members of the care team (CNLs, MSWs, MDs) in conveyance of information that affects patient care.
  • An understanding of variable payor rules and regulations is also required.

Preferred
  • Knowledge of core insurance coverage guidelines and financial principles.
  • Acute care nursing experience.

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