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Part Time Remote Utilization Review Nurse Jobs in Edison, NJ

Centerbrite

BCBA (Part-time) (Remote)

Newark, NJ · Remote

$90 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $100110/hr Flexible Schedule Hybrid (Remote ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Centerbrite

BCBA (Part-time)

Newark, NJ · On-site +1

$90 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $100-110/hr Flexible Schedule Hybrid (Remote ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

YO AI Labs

AI Consulting Expert - Remote

New York, NY · Remote

$100 - $200/hr

Contractor (Part-Time) Location: Remote Job Overview We are seeking experienced AI Consulting ... In this role, you will evaluate, review, and refine AI-generated business content, helping enhance ...

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All JobsUtilization Review Nurse JobsPart Time Remote Utilization Review Nurse JobsPart Time Remote Utilization Review Nurse Jobs in Edison, NJ

Part Time Remote Utilization Review Nurse information

See Edison, NJ salary details

$22

$43

$71

How much do part time remote utilization review nurse jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for part time remote utilization review nurse in Edison, NJ is $43.77, according to ZipRecruiter salary data. Most workers in this role earn between $34.62 and $50.29 per hour, depending on experience, location, and employer.

What does a part time remote utilization review nurse do?

A Part Time Remote Utilization Review Nurse evaluates medical records and treatment plans to ensure that healthcare services are medically necessary and comply with insurance guidelines. Working remotely, they review patient cases, communicate with healthcare providers, and make recommendations on the appropriateness of care. Their role helps manage healthcare costs and ensures patients receive appropriate care while adhering to regulatory and insurance standards.

What are the key skills and qualifications needed to thrive as a part time remote utilization review nurse?

To thrive as a Part Time Remote Utilization Review Nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (like ICD-10 and CPT), healthcare management software, and payer guidelines is often required. Excellent written communication, attention to detail, and the ability to work independently are essential soft skills for remote success. These competencies ensure accurate review of medical records, compliance with regulations, and effective coordination with healthcare teams while working remotely.

How does a part time remote utilization review nurse typically collaborate with physicians and other healthcare professionals?

Part-time remote Utilization Review Nurses often communicate with physicians, case managers, and insurance representatives through secure digital platforms, emails, and scheduled virtual meetings. They review patient records and coordinate care authorizations, frequently clarifying clinical information or policy requirements with providers. Balancing asynchronous communication and timely responses is essential, as collaboration impacts both patient outcomes and reimbursement processes. Building strong professional relationships and maintaining clear documentation are key to effective teamwork in this remote setting.

What is the difference between Part Time Remote Utilization Review Nurse vs Part Time Remote Case Manager?

AspectPart Time Remote Utilization Review NursePart Time Remote Case Manager
CredentialsRN license, certifications in utilization review (e.g., CUC, URAC)RN or social work license, case management certification (e.g., CCM)
Work EnvironmentRemote, reviewing medical records and authorizationsRemote, coordinating care and discharge planning
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsInsurance companies, healthcare organizations, managed care firms

The Part Time Remote Utilization Review Nurse primarily evaluates medical necessity for insurance approvals, focusing on documentation review. In contrast, the Part Time Remote Case Manager manages patient care plans, coordinating services and discharge planning. Both roles are remote, require healthcare credentials, and are common in the insurance and healthcare industries, but they differ in daily responsibilities and focus areas.

What are popular job titles related to Part Time Remote Utilization Review Nurse jobs in Edison, NJ?

For Part Time Remote Utilization Review Nurse jobs in Edison, NJ, the most frequently searched job titles are:

What job categories do people searching Part Time Remote Utilization Review Nurse jobs in Edison, NJ look for?

The top searched job categories for Part Time Remote Utilization Review Nurse jobs in Edison, NJ are:

What cities near Edison, NJ are hiring for Part Time Remote Utilization Review Nurse jobs?

Cities near Edison, NJ with the most Part Time Remote Utilization Review Nurse job openings:

Part Time Remote Utilization Review Nurse jobs near you
Infographic showing various Part Time Remote Utilization Review Nurse job openings in Edison, NJ as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $91,047 per year, or $43.8 per hour.

Physician Reviewer (Part -Time) - Utilization Management

Oscar Health

New York, NY • Remote

$140 - $145/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement

Posted yesterday

New

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

263rd of 315 rated insurance

Job description

Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management Team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.

Hours: 8am - 5pm in your local time zone.  A minimum commitment of 20-25 hours per week is required. 

Call rotation - 16 weekend hours per month

You will report into the Associate Medical Director, Utilization Management.

Work Location: This is a remote position, open to candidates who reside in the United States. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $140-$145 per hour.  

Responsibilities:

  • Provide timely medical reviews that meet Oscar's stringent quality parameters.
  • Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.
  • Clearly and accurately document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision (Flesch-Kincaid grade level).
  • Use correct templates for documenting decisions during case review.
  • Meet the appropriate turn-around times for clinical reviews.
  • Receive and review escalated reviews.
  • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Board certification as an MD or DO
  • Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC).
  • 6+ years of clinical practice

Bonus points:

  • Licensure in multiple Oscar states
  • 1+ years of utilization review experience in a managed care plan (health care industry)
  • BC in Cardiology, Radiation/Oncology, or Neurology
  • Experience with care management within the health insurance industry.
  • Willing and able to obtain additional state licensure as needed, with Oscar's support

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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