Remote Utilization Review Coordinator Jobs
Remote Utilization Review Coordinator jobs are open across the U.S. in health insurance, managed care, and hospital systems, from entry-level coordinator roles at growing payer organizations to senior positions on fully distributed clinical operations teams. Employers hiring remotely right now include Brundage Medical, Centene, and Personify Health. See the openings below and apply to the ones that match your experience.
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Showing 5 of 23+ Remote Utilization Review Coordinator jobs
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
This role is work from home with the following hours: 4 ten hour shifts in EST, with rotating days off, rotating on-call weekends and holidays
Applicants must be a RN with a compact licensure required with ability to obtain additional licenses as needed.
- Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of services.
- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
- Gathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care
- Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)
- Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment
- Identifies members who may benefit from care management programs and facilitates referral
- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization
Required Qualifications
- 3+ years of clinical practice experience in an inpatient setting required
- RN with unrestricted state licensure required
- Willingness to obtain additional state licenses
- Ability to work rotating weekends
Preferred Qualifications
- Managed care/utilization review experience
- Acute care/critical care experience Discharge planning experience
Education
AA Nursing Required
BSN Preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$26.01 - $74.78This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 11/19/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
This role is work from home with the following hours: 4 ten hour shifts in EST, with rotating days off, rotating on-call weekends and holidays
Applicants must be a RN with a compact licensure required with ability to obtain additional licenses as needed.
- Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of services.
- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
- Gathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care
- Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)
- Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment
- Identifies members who may benefit from care management programs and facilitates referral
- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization
Required Qualifications
- 3+ years of clinical practice experience in an inpatient setting required
- RN with unrestricted state licensure required
- Willingness to obtain additional state licenses
- Ability to work rotating weekends
Preferred Qualifications
- Managed care/utilization review experience
- Acute care/critical care experience Discharge planning experience
Education
AA Nursing Required
BSN Preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$26.01 - $74.78This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 11/19/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
See All 23 Remote Utilization Review Coordinator Jobs
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Find JobsRemote Utilization Review Coordinator Job Market
Who's Hiring
Top Industries Hiring
- Insurance
- Human Resources
- Technology & Software
What Employers Look For
The qualifications that appear most often in remote utilization review coordinator jobs.
- Active RN, LPN, or related clinical license required by most employers
- Working knowledge of InterQual or MCG clinical criteria for review decisions
- Experience with prior authorization, concurrent review, or discharge planning workflows
- Familiarity with ICD-10 coding and medical terminology across care settings
- Proficiency with electronic health record systems and payer portals
- CPUR, CMCN, or similar utilization management certification preferred for senior roles
Tips for Your Remote Utilization Review Coordinator Job Search
Apply early to remote roles that fit
Migrate Mate lists remote utilization review coordinator openings from across the U.S. in one place, so you can find roles that match your credentials and apply directly without sifting through unrelated postings.
Show your remote clinical workflow experience
Name the utilization management platforms you've used, such as InterQual, MCG, or Milliman, in your resume and cover letter. Remote employers want confirmation you can apply clinical criteria independently inside a distributed system, not just in a supervised office setting.
Demonstrate strong async written communication
Remote utilization review work runs on written documentation, case notes, and denial rationale. Highlight examples of clear, accurate clinical writing in your application materials, since remote teams rely on written handoffs instead of in-person check-ins.
Prepare for a skills-based remote interview
Remote hiring panels for utilization review coordinators often include a scenario question about applying a coverage guideline or handling a concurrent review under time pressure. Practice walking through your decision-making process out loud, since remote interviewers can't observe your clinical instincts any other way.
Remote Utilization Review Coordinator Jobs: Frequently Asked Questions
How do I get a remote utilization review coordinator job?
Target payers, managed care organizations, and third-party review companies that run distributed clinical teams, since those employers are most likely to hire utilization review coordinators remotely from the start. Remote hiring managers screen heavily for self-direction, clear written communication, and comfort with electronic health records and utilization management platforms like InterQual or MCG. Demonstrating prior remote work, even in a related clinical or administrative role, gives you a real edge.
Which companies hire remote utilization review coordinators?
Employers currently hiring remote utilization review coordinators include Brundage Medical, Centene, and Personify Health, per current remote listings on Migrate Mate as of November 2026. The majority of these openings come from health insurers, managed care companies, and benefits administration firms that operate fully distributed clinical review teams.
Can you get a remote utilization review coordinator job with no experience?
Yes, but remote entry-level roles are harder to land because employers expect you to manage case queues and clinical criteria independently from day one. Your best path is targeting smaller managed care companies or third-party review vendors that hire entry-level remote, and showing medical coding knowledge, familiarity with InterQual or MCG guidelines, or prior clinical support experience to offset the lack of direct utilization review history.
Do you need a degree for remote utilization review coordinator jobs?
Not always. Many remote employers care more about clinical or administrative credentials, such as an RN license, LPN, or medical coding certification, than a four-year degree. Demonstrated experience reading and applying utilization management criteria, working within electronic health record systems, and handling prior authorizations often carries more weight than formal education alone.
Which industries hire the most remote utilization review coordinators?
Remote utilization review coordinator roles concentrate in Insurance, Human Resources, and Technology & Software, based on current remote listings on Migrate Mate as of November 2026. These sectors rely on distributed clinical and administrative teams to manage authorization workflows and case reviews across large geographic footprints without requiring on-site presence.
See All 23 Remote Utilization Review Coordinator Jobs
Find roles that match your experience and apply in just a few clicks.
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