Utilization Review Specialist (RN) - Remote
$65k - $85kConcierge Home Care
Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential
At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team.
This role is ideal for an RN with strong experience in OASIS, coding, QA, and home health documentation review who thrives in a fast-paced,remote environment.
Quick Highlights
- Fully Remote Position
- Salary: $65,000–$85,000 (based on years of experience)
- Florida RN License Required
- OASIS Certification Required
- Home Health Coding Certification Required
- Monday–Friday or Weekend Schedule Options
- Quarterly Bonuses & Incentives
- Full Benefits Package
What You’ll Do
- Review home health clinical documentation for accuracy and compliance
- Audit OASIS documentation and care plans
- Ensure coding accuracy and reimbursement integrity
- Collaborate with Branch Directors, Clinical Managers, and field clinicians
- Support quality assurance and regulatory compliance initiatives
- Maintain productivity while reviewing high-volume documentation
Qualifications
Required
- OASIS Certification
- Home Health Coding Certification
- Minimum 2 years of Home Health experience
- Strong knowledge of Medicare guidelines and home health regulations
- Ability to work independently in a remote setting
- Excellent attention to detail and organizational skills
Preferred
- SHP platform experience
- Prior QA, Utilization Review, or Clinical Auditing experience
Schedule Options
Weekday Position
- Monday–Friday
- Life Insurance
- 401(k)
- Quarterly Bonus Opportunities
- Employee Referral Program
- Free CEUs
Why Concierge Home Care?
At Concierge Home Care, our mission is simple: Caring for people who care for people.
We are committed to supporting our clinicians with strong leadership, flexibility, and opportunities for professional growth.
Join a team that empowers you to practice at the top of your license while maintaining the flexibility and income potential you deserve.
Employment is contingent upon successful completion of an AHCA Level 2 background screening. For more information, please visit the Florida Care Provider Background Screening Clearinghouse.
#J-18808-Ljbffr$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management... ...a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of...Remote workFull time- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
- ...Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and discharge planning in collaboration...Remote workPart timeRelief
- ...Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and continued stays, collaborate with...Remote workRelief
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care. The role collaborates with Admitting, Financial...Remote work
- Banner Health is seeking a fully remote RN in the Utilization Review Department to impact patient care across our health system. You will review clinical information, conduct audits of billings, and collaborate with providers on medical decisions from home. Requires 5+...Remote job
- ...Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote workWork from homeHome office
- ...UnitedHealth Group in the DC area is seeking an HCBS Utilization Management Nurse to perform pre-service coverage reviews for PDN and PCS, reporting to the DC Manager of... ...care. Requires a District of Columbia RN license and 2+ years in clinical settings, managed...Remote work
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation and determining appropriate... ...proficiency, with a four-day work week and remote options for Montana residents. #J-18808-Ljbffr...Remote work
- ...Health Medical Center is seeking a Utilization Management Specialist to review admissions across the system and determine... ...status. This role suits an RN or Social Worker with acute care experience... ...insurers. The position is fully remote for Montana residents and offers a...Remote work
- ...Logan Health is seeking a Utilization Management Specialist to join our dedicated team. You’ll review admissions across the Logan Health system, collaborate with physicians... ...offers a four 10-hour shift schedule, remote work with Montana residency, and a competitive...Remote workShift work
$90.9k - $129.9k
...patient interactions for this role, rather you will provide utilization review and quality assurance.Your role in our missionReview and evaluate... ...and proceduresWhat you should expect in this role100% Remote home office.Full-time position.Applications will be accepted...Remote workFull timeHome officeFlexible hours- ...Athens Administrators has an immediate need for a full-time Utilization Review Specialist to support our Athens Managed Care department and can be located remotely if technical requirements are met and the employee resides in a state Athens operates in. The schedule for...Remote workFull timeImmediate startMonday to Friday
- ...Cincinnati Children's is seeking a Utilization Review professional to perform admission and continued stay reviews... ...certification for inpatient stays. The role requires RN licensure with relevant experience and works remotely in the United States. The position includes...Remote work
- ...Optum is seeking a Behavioral Health Utilization Review Specialist to support case management and care coordination remotely. You will review cases, determine levels of care, and coordinate transitions between inpatient and outpatient settings.You will collaborate with...Remote workMonday to Friday
- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
- ...Optum is seeking a remote Behavioral Health Utilization Review Specialist to support case management and care coordination. This full-time, Monday–Friday role offers standard business hours with occasional on-call needs based on business requirement. The position requires...Remote workFull timeMonday to Friday
- ...advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement... ...status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review...Remote workTemporary workWork experience placementLive outFlexible hours
- ...Kent County Cmh Authority is seeking a Utilization Review Specialist to perform reviews for I/DD, mental health, and SUD services. You will assess... ...appropriate intensity settings. The role is full-time and remote with occasional local travel within the Kent County area....Remote workFull timeLocal area
$30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ...along with experience in Epic EHR and Utilization Review. The selected candidate will perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote workHourly payContract work- ...excellence. Who We're Looking For We are seeking an experienced specialist who is passionate about making a difference in the lives of... ...Health or related field required preferred. 2-3 years of utilization review experience in behavioral health, addiction treatment, or managed...Remote workDaily paidFull time
- ...Camber Connect in Olathe, KS seeks a detail-oriented Utilization Review Specialist to bridge clinical teams and health plans, managing initial, concurrent... ...a 90-day review, with 2 days in the office and 3 days remote. The role demands accuracy, urgency, and advocacy, with...Remote workWork at office
$40k - $50k
...Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply. Job Details...Remote workFull timePart timeWork at officeWeekend work$18 - $20 per hour
...compassionate professional to join our Utilization Review department. At Camber, we do not... ...The Role As a Utilization Review Specialist, you serve as the vital link between our... ...at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary...Remote workHourly payFull timeWork at office$60k - $70k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range: $... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization... ...or relevant certification, such as RN, LPN/LVN, LMSW, LPC, CADC, LADAC, CCM,...Remote workFull timePart timeWork at office$63.1k - $83.65k
...by helping others. We are seeking a Utilization Review Specialist to perform utilization review of... ...this position. While the position is remote, the individual in this position will... ...licensure preferred); or Registered Nurse (RN) in Michigan with at least two (2)...Remote workFull timeTemporary workMonday to Friday- ...UofL Health is seeking a Utilization Review RN to perform admission and concurrent reviews, ensuring medical necessity and appropriate level of care across designated services. You will collaborate with physicians, case managers, and payors to secure authorizations while...
$60k - $66.56k
...SUMMARY: The Utilization Review Specialist will perform utilization review of pre-certification and concurrent clinical utilization reviews with insurance companies in accordance with certification requirements of each patient’s insurance plan. This position requires...Remote workFull timeFlexible hours- ...Brundage Group is seeking an experienced Utilization Review Nurse to perform admission and continued stay reviews, ensuring medical necessity, payer requirements, regulatory standards, and quality patient care in a hospital setting. The role collaborates with physicians...
- ...A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...Monday to Friday
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