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Work From Home Utilization Review Jobs (NOW HIRING)

Mindful Health

Utilization Review Specialist

$25 - $30/hr

We work to empower clients to live fuller and healthier lives. We maintain these same beliefs in ... Utilization Review Specialist: Responsible for ensuring adherence to Mindful Health's utilization ...

The Meadows

Utilization Review Coordinator

Phoenix, AZ · On-site +1

Our approach is different and success stories from our patients are the proof. Who are you? Are you ... Ability to work in a fast-paced environment We are a Drug Free Company. All positions are ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

Participate in discharge planning for members transitioning from acute, long-term, or residential ... Ability to work independently in fast-paced environments SCHEDULE Monday through Friday - 8:00am ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

Participate in discharge planning for members transitioning from acute, long-term, or residential ... Ability to work independently in fast-paced environments SCHEDULE Monday through Friday - 8:00am ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

This position is responsible for performing initial, concurrent review activities; discharge care ... Provides information regarding utilization management requirements and operational procedures to ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

Participate in discharge planning for members transitioning from acute, long-term, or residential ... Ability to work independently in fast-paced environments SCHEDULE Monday through Friday - 8:00am ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

Participate in discharge planning for members transitioning from acute, long-term, or residential ... Ability to work independently in fast-paced environments SCHEDULE Monday through Friday - 8:00am ...

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Work From Home Utilization Review information

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

As of Jun 28, 2026, the average hourly pay for work from home utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 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 job?

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.

More about Work From Home Utilization Review jobs
What cities are hiring for Work From Home Utilization Review jobs? Cities with the most Work From Home Utilization Review job openings:
What states have the most Work From Home Utilization Review jobs? States with the most job openings for Work From Home Utilization Review jobs include:
What job categories do people searching Work From Home Utilization Review jobs look for? The top searched job categories for Work From Home Utilization Review jobs are:
Work From Home Utilization Review jobs near you
Infographic showing various Work From Home Utilization Review job openings in the United States as of June 2026, with employment types broken down into 4% As Needed, 10% Full Time, and 86% Part Time. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.
Physician Reviewer - Physical Medicine and Rehabilitation (Utilization Review)

Physician Reviewer - Physical Medicine and Rehabilitation (Utilization Review)

Dane Street, LLC

New York, NY • Remote

Other

Posted 11 days ago

Job description

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Physical Medicine and Rehabilitation provider with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews.

This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established.

Key Responsibilities:

  • Review medical records to determine the medical necessity of services
  • Utilize state-specific workers' compensation guidelines and nationally recognized criteria
  • Submit clear, concise, and well-supported determinations
  • Complete reviews within required timeframes (typically 1-5 business days)
  • Participate in peer-to-peer calls as needed (coordinated by Dane Street)
  • Complete addenda when new information is provided

Role Highlights:

  • Independent contractor (1099) status
  • Average case takes 15 minutes or less
  • Flat rate per case - consistent, supplemental income
  • Fully remote - work from anywhere
  • You control volume and availability
  • No direct patient interaction or treatment
  • Chronological, pre-organized medical records provided
  • User-friendly portal and streamlined case management
  • Full onboarding and ongoing support included

Requirements:

  • Board Certification in Physical Medicine and Rehabilitation
  • Active, unrestricted New York medical license
  • Workers' Compensation Board Certification (New York)
  • Active clinical practice

About Dane Street:
Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system.

Apply today to join our Physician Review Panel and start earning on your schedule.

Apply