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Remote Weekend Utilization Review Jobs (NOW HIRING)

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks ...

Village Care

Utilization Review Nurse

Manhattan, NY · Remote

$95K - $105K/yr

RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is ...

Medix

Utilization Review Nurse - Remote

Tempe, AZ · On-site +1

$40 - $45/hr

Job Summary Our client is seeking a Utilization Review Nurse to perform frequent case reviews ... weekend day (either Saturday or Sunday). * Training schedule: M-F 8:30-5pm, usually lasting 6-8 ...

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Remote Weekend Utilization Review information

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How much do remote weekend utilization review jobs pay per hour?

As of Jun 24, 2026, the average hourly pay for remote weekend utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Remote Weekend Utilization Review vs Remote Weekday Utilization Review?

AspectRemote Weekend Utilization ReviewRemote Weekday Utilization Review
CredentialsTypically requires a healthcare professional license and utilization review certificationSame as weekend role, healthcare license and utilization review certification
Work EnvironmentRemote, weekend hours, often part-time or flexibleRemote, weekday hours, standard business hours
Employer & IndustryHealth insurance companies, third-party administratorsSame as weekend role, health insurance industry
Work SchedulePrimarily weekends, possibly eveningsWeekdays, regular business hours

Remote Weekend Utilization Review and Remote Weekday Utilization Review roles are similar in credentials and industry but differ mainly in work schedule. Weekend roles focus on reviewing cases during weekends, offering flexibility, while weekday roles follow standard business hours. Both positions require healthcare licensing and utilization review certification, serving health insurance companies and third-party administrators.

What cities are hiring for Remote Weekend Utilization Review jobs? Cities with the most Remote Weekend Utilization Review job openings:
What are the most commonly searched types of Weekend Utilization Review jobs? The most popular types of Weekend Utilization Review jobs are:
What states have the most Remote Weekend Utilization Review jobs? States with the most job openings for Remote Weekend Utilization Review jobs include:
Remote Weekend Utilization Review jobs near you
Utilization Review Physician

Utilization Review Physician

Dane Street, LLC

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

Overview
We are seeking a high-performing Physician Reviewer to join our Group Health division. The role is responsible for delivering timely, defensible utilization review determinations across a high-volume, fast-paced environment. Reviews span multiple case types, including preauthorization, appeals, DRG clinical validation, benefit review, and experimental/investigational determinations.
Key Responsibilities
  • Perform utilization review for:
    • Preauthorization requests
    • Appeals (first and second level)
    • Independent external reviews
    • DRG validation and clinical review
    • Benefit and coverage determinations
    • Experimental/Investigational (E/I) review
  • Apply evidence-based criteria and guidelines, including:
    • InterQual
    • MCG
    • CMS guidelines (including 2-Midnight Rule)
    • LCD/NCD
    • Client-specific policies
  • Produce clear, concise, and defensible clinical rationales
  • Maintain high accuracy and consistency across determinations
  • Meet or exceed turnaround time (TAT) expectations, including urgent cases
  • Participate in peer-to-peer discussions as needed
  • Collaborate with QA and operational teams to ensure quality and compliance
  • Reviews may be conducted within internal systems or client-specific platforms, depending on assignment and client requirements

Performance Metrics
  • High daily review volume with strong accuracy
  • Consistent adherence to client-specific requirements
  • Ability to manage short-TAT and urgent cases efficiently
  • Clear, audit-ready documentation

Required Qualifications
  • MD or DO, board-certified in Internal Medicine, Family Medicine, or similar
  • Active, unrestricted medical license
  • Prior utilization review experience, preferably in a health plan or IRO environment
  • Familiarity with InterQual, MCG, and CMS guidelines
  • Strong clinical judgment and documentation skills
  • Ability to work independently in a high-throughput environment

Technical Skills
  • Proficiency with standard business tools (e.g., Google Workspace, Microsoft Office)
  • Comfortable working across multiple systems, including internal platforms and client-specific portals
  • Strong navigation and documentation skills within web-based applications
  • Ability to manage multiple systems/screens simultaneously in a high-throughput environment
  • Familiarity with Mac operating systems

Work Environment
  • Remote work from home
  • Full-time, Monday-Friday
  • Availability for occasional weekends and holiday coverage for urgent reviews

Benefits
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

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