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Work From Home Utilization Review Jobs in Arizona

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...

University of Kentucky

Supervisor, Utilization Review Work Location: UK Chandler Hospital, Pavilion A Grade Level: 11 Type of Position: Regular Position Time Status: Full time Equivalency Link Shift: Day (United States of ...

The Jernigan Agency

WORK FROM HOME

Peoria, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... Help each client to review their options and apply for that coverage. * See the application through ...

The Jernigan Agency

WORK FROM HOME

Phoenix, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... Help each client to review their options and apply for that coverage. * See the application through ...

The Jernigan Agency

WORK FROM HOME

Phoenix, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... Help each client to review their options and apply for that coverage. * See the application through ...

IQVIA

Work from Home

Tucson, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

New

IQVIA

Work from Home

Gilbert, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

New

IQVIA

Work from Home

Chandler, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will ...

New

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All JobsUtilization Review JobsWork From Home Utilization Review JobsWork From Home Utilization Review Jobs in Arizona

Work From Home Utilization Review information

See Arizona salary details

$14

$29

$49

How much do work from home utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for work from home utilization review in Arizona is $29.76, according to ZipRecruiter salary data. Most workers in this role earn between $20.82 and $37.84 per hour, depending on experience, location, and employer.

What are some common challenges faced by work from home utilization review professionals, and how can they be managed?

Work From Home Utilization Review professionals often face challenges such as maintaining effective communication with healthcare providers and team members, managing time efficiently without in-person supervision, and navigating multiple electronic health record systems remotely. To manage these challenges, it’s important to establish clear communication channels, set structured daily routines, and stay updated with technology training. Many organizations offer virtual team meetings and resources to support remote collaboration and continuous professional development.

What are the key skills and qualifications needed to thrive as a work from home utilization review nurse, and why are they important?

To thrive as a Work From Home Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ) are often required. Exceptional communication, critical thinking, and time management skills help in effectively coordinating care and interacting with patients and providers remotely. These skills ensure accurate and efficient reviews, compliance with guidelines, and optimal patient outcomes while working independently.

What is a work from home utilization review?

A Work From Home Utilization Review job involves evaluating the necessity, appropriateness, and efficiency of medical services provided to patients, typically for insurance companies or healthcare organizations. Employees in this role review patient records, treatment plans, and medical claims to ensure compliance with established guidelines and standards. Working remotely, these professionals often communicate with healthcare providers, patients, and insurance representatives to gather information and make recommendations regarding coverage or continued care.

What is the difference between Work From Home Utilization Review vs Work From Home Medical Coder?

AspectWork From Home Utilization ReviewWork From Home Medical Coder
CredentialsTypically requires healthcare-related certifications, such as RN, LPN, or medical reviewer credentialsRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentRemote, often involves reviewing medical records and insurance claimsRemote, involves reviewing and assigning medical codes to patient records
Industry UsageCommon in insurance, healthcare administration, and utilization managementCommon in medical billing, coding, and healthcare documentation

Work From Home Utilization Review and Work From Home Medical Coder roles both operate remotely within the healthcare industry. While utilization reviewers focus on assessing the necessity of medical services, medical coders assign standardized codes to patient records. Both require healthcare-related certifications and are essential for healthcare administration, but they differ in daily tasks and specific credentials.

What are popular job titles related to Work From Home Utilization Review jobs in Arizona?

For Work From Home Utilization Review jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Work From Home Utilization Review jobs in Arizona look for?

The top searched job categories for Work From Home Utilization Review jobs in Arizona are:

What cities in Arizona are hiring for Work From Home Utilization Review jobs?

Cities in Arizona with the most Work From Home Utilization Review job openings:

Work From Home Utilization Review jobs near you
Infographic showing various Work From Home Utilization Review job openings in Arizona as of August 2026, with employment types broken down into 78% Full Time, 11% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $61,911 per year, or $29.8 per hour.

Utilization Review Nurse

Oscar Health

Tempe, AZ • Remote

$35 - $45.94/hr

Full-time

Re-posted 5 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

257th of 308 rated insurance

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

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; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines)
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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