Remote Utilization Management Coordinator Jobs
Remote utilization management coordinator jobs are open across the U.S. at health plans, managed care organizations, and insurance carriers that run fully distributed clinical operations teams. Employers hiring remotely right now include CVS Health, Toney HealthCare Consulting, and Humana. Scan the live roles below and apply to whichever ones fit.
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Become a part of our caring community
The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
- Degree in Nursing
- Must be licensed Registered Nurse in the State of Indiana or Compaq Nursing License with no disciplinary action
- 3+ years of post-degree clinical experience in direct patient care
- 3+ years of Behavioral Health experience
- Proficient with MS Office, navigating multiple systems and platforms and general technical skills to troubleshoot and resolve within a remote environment.
- Ability to work independently.
Preferred Qualifications
- Behavioral Health UM experience, performing medical necessity reviews against criteria such as MCG, ASAM, InterQual
- Managed Care, Medicaid or health plan experience
Workstyle: Remote Work at Home
Location: Indiana
Schedule: Monday through Friday 8:00-5:00 PM Eastern Time
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Become a part of our caring community
The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
- Degree in Nursing
- Must be licensed Registered Nurse in the State of Indiana or Compaq Nursing License with no disciplinary action
- 3+ years of post-degree clinical experience in direct patient care
- 3+ years of Behavioral Health experience
- Proficient with MS Office, navigating multiple systems and platforms and general technical skills to troubleshoot and resolve within a remote environment.
- Ability to work independently.
Preferred Qualifications
- Behavioral Health UM experience, performing medical necessity reviews against criteria such as MCG, ASAM, InterQual
- Managed Care, Medicaid or health plan experience
Workstyle: Remote Work at Home
Location: Indiana
Schedule: Monday through Friday 8:00-5:00 PM Eastern Time
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Find JobsRemote Utilization Management Coordinator Job Market
Who's Hiring
Top Industries Hiring
- Insurance
- Technology & Software
- Healthcare & Medical Services
What Employers Look For
The qualifications that appear most often in remote utilization management coordinator jobs.
- Experience applying InterQual or Milliman criteria for medical necessity review
- Active RN, LPN, or other clinical licensure preferred or required
- Proficiency with utilization management or care management software platforms
- Knowledge of insurance benefits, claims processes, and coverage determination
- Strong written communication skills for denial letters and clinical documentation
- Certified Professional in Utilization Review (CPUR) or case management certification preferred
Tips for Your Remote Utilization Management Coordinator Job Search
Apply early to remote roles that fit
Migrate Mate lists remote utilization management coordinator openings from across the U.S. in one place, so you can find roles that match your clinical background and apply directly without sorting through unrelated postings.
Highlight async documentation skills upfront
Remote utilization management coordinators communicate almost entirely through written case notes, denial letters, and platform entries. Lead your resume and cover letter with specific documentation systems you've used, such as Jiva, NiaTx, or InterQual, and volume or accuracy metrics where you have them.
Show your independent caseload management
Remote employers can't observe your day-to-day workflow, so they hire on evidence of self-direction. Describe how you managed concurrent prior authorization queues, met turnaround time requirements without supervision, and flagged escalations independently in previous roles.
Prepare for virtual clinical scenario interviews
Remote utilization management interviews frequently include live case reviews or written scenario assessments delivered over video. Practice walking through a medical necessity determination out loud, citing criteria clearly, and asking clarifying questions the way you would on an async case note.
Remote Utilization Management Coordinator Jobs: Frequently Asked Questions
How do I get a remote utilization management coordinator job?
Target health plans, third-party administrators, and managed care organizations that have built distributed utilization management teams, since those employers already have the infrastructure for remote clinical workflows. Remote hiring managers screen heavily for self-directed case management, strong written documentation in systems like Jiva or InterQual, and the ability to collaborate asynchronously with medical directors and care teams. A demonstrated history of independent caseload management and clean, complete clinical notes gives candidates a clear edge.
Which companies hire remote utilization management coordinators?
Remote utilization management coordinator roles are posted by CVS Health, Toney HealthCare Consulting, and Humana and others right now, based on current remote listings on Migrate Mate as of November 2026. These include national health insurers, specialty managed care firms, and behavioral health organizations that staff their utilization review functions entirely through distributed teams.
Can you get a remote utilization management coordinator job with no experience?
Yes, but remote entry-level utilization management coordinator roles are harder to land because you must demonstrate you can work independently before an employer can observe you in person. Smaller health plans and specialty utilization management vendors are more likely to hire newer candidates remotely. Showing completed InterQual or MCG training, familiarity with payer clinical criteria, and any hands-on case management or care coordination work, even from a clinical or administrative setting, opens the door.
Do you need a degree for remote utilization management coordinator jobs?
Not always, though most remote employers prefer a clinical or health-related background over a specific degree. Remote hiring teams weigh your working knowledge of medical necessity criteria, experience using utilization review platforms, and your ability to document and communicate decisions clearly in writing. Candidates who can show real case management output, completed clinical certification coursework, or prior authorization experience routinely compete with degree holders for remote openings.
Which industries hire the most remote utilization management coordinators?
The sectors hiring the most remote utilization management coordinators are Insurance, Technology & Software, and Healthcare & Medical Services, based on current remote listings on Migrate Mate as of November 2026. These industries rely on distributed utilization management teams to review medical necessity, manage prior authorizations, and coordinate care across geographically spread member populations.
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