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Remote Aetna Utilization Review Jobs in Rochester, NY

While this is a remote position, candidates must reside in or be willing to relocate to one of the ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

Remote Aetna Utilization Review information

See Rochester, NY salary details

$21

$41

$68

How much do remote aetna utilization review jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for remote aetna utilization review in Rochester, NY is $41.72, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote Aetna Utilization Review nurse?

To thrive as a Remote Aetna Utilization Review nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with Aetna's systems, utilization management software, and knowledge of medical necessity criteria such as MCG or InterQual are typically required. Excellent communication, attention to detail, and time management are vital soft skills for coordinating care and efficiently handling remote assessments. These skills ensure accurate evaluations, regulatory compliance, and optimal resource utilization in a healthcare payer setting.

What are some common challenges faced in a remote Aetna Utilization Review role and how can they be managed?

One common challenge in a remote Aetna Utilization Review position is maintaining effective communication with healthcare providers and internal teams, as much of the coordination happens virtually. To manage this, professionals often rely on secure digital communication tools and establish clear protocols for timely responses. Another challenge is staying updated with changing healthcare regulations and Aetna policies, which requires proactive learning and frequent collaboration with colleagues. Developing strong organizational skills and participating in regular virtual team meetings can help ensure efficient workflow and compliance.

What is the difference between Remote Aetna Utilization Review vs Remote UnitedHealthcare Utilization Review?

AspectRemote Aetna Utilization ReviewRemote UnitedHealthcare Utilization Review
CertificationsTypically requires nursing or healthcare-related licenses, certifications in utilization reviewSimilar licensing and certifications, often requiring nursing or healthcare credentials
Work EnvironmentRemote, healthcare insurance setting, reviewing medical necessity and coverageRemote, healthcare insurance setting, assessing medical claims and coverage appropriateness
Employer & Industry UsageUsed by Aetna insurance providers for member care managementUsed by UnitedHealthcare for claims review and member care decisions

Both Remote Aetna Utilization Review and Remote UnitedHealthcare Utilization Review involve remote assessments of medical necessity and coverage. They require similar healthcare credentials and operate within the health insurance industry, focusing on claims and member care management for their respective providers.

What is a remote Aetna Utilization Review?

Remote Aetna Utilization Review jobs involve evaluating medical necessity, appropriateness, and efficiency of healthcare services provided to Aetna members. Professionals in these roles, often nurses or clinicians, review patient records and claims remotely to ensure treatments meet established guidelines and policies. The goal is to support quality care while managing healthcare costs and preventing unnecessary procedures. These positions require clinical experience, attention to detail, and familiarity with insurance processes.
What are the most commonly searched types of Aetna Utilization Review jobs in Rochester, NY? The most popular types of Aetna Utilization Review jobs in Rochester, NY are:
What are popular job titles related to Remote Aetna Utilization Review jobs in Rochester, NY? For Remote Aetna Utilization Review jobs in Rochester, NY, the most frequently searched job titles are:
What cities near Rochester, NY are hiring for Remote Aetna Utilization Review jobs? Cities near Rochester, NY with the most Remote Aetna Utilization Review job openings:

Aetna/CVS Health Virtual Underwriting Externship Program

CVS Health

Geneseo, NY • On-site, Remote

Full-time

Posted 10 days ago


CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,329 frontline employees who took The Breakroom Quiz

88th of 110 rated pharmacies


Job description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Values in Action support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable.

Position Summary:

Are you a current college student eager to explore the dynamic world of insurance and underwriting? Join us for a transformative 3-week virtual externship program designed to introduce you to the fundamentals of underwriting and risk analysis and offer professional development sessions to build your professional skill set. This program is ideal for individuals looking to learn more about the underwriting field and jump start their career with an industry leader.

The Underwriting Externship Program looks to provide externs with immersive, hands-on underwriting experience that helps them understand the role of a full-time underwriter and Aetna’s underwriting organization. This program serves as one of the primary pipelines for the Underwriting Internship Program and the full-time Underwriting Leadership Development Program.

You will also have the opportunity to apply and interview for a position in our 2028 Summer Corporate Underwriting Internship Program (UIP). This program is intended to take place at our Hartford, CT office location following a hybrid work model.

Position: Underwriting Extern

Duration: Three Week Program; Tuesday, Wednesday, Thursday from 3:00pm-4:30pm ET

Program Dates:

  • Week 1: September 29th, 30th and October 1st
  • Week 2: October 6th, 7th, 8th
  • Week 3: October 13th, 14th, 15th

Location: Remote/Virtual (Using your own personal laptop/computer)

Program Overview:

  • Unpaid Educational Experience: Participants who complete the program will receive priority during the following internship recruiting season.
  • Introduction to Underwriting: Learn the basics of underwriting, risk analysis, and pricing strategies.
  • Virtual Training Sessions: Engage in interactive virtual sessions led by industry experts to deepen your understanding of underwriting concepts and practices.
  • Case Studies: Apply your knowledge to real-world scenarios and collaborate with peers to analyze risks, make underwriting decisions, and present recommendations.
  • Professional Development: Gain insights into career paths within the insurance industry, receive mentorship from seasoned professionals, and build foundational skills in communication, problem solving, and decision-making.
  • Networking Opportunities: Connect with company leaders, underwriters, and other industry professionals to expand your network and gain valuable insights into the industry.

Required Qualifications:

  • Currently enrolled in an undergraduate program; Sophomore students preferred (12/2028 – 5/2029 Graduation date).
  • Access to a computer with reliable internet connection for virtual sessions.
  • Available for ALL Externship Dates (listed above)

Preferred Qualifications:

  • Majors in: Risk Management/Insurance, Math, Statistics, Business Analytics, Economics (and related majors)
  • Strong analytical skills and attention to detail.
  • Excellent communication and interpersonal skills.
  • Curiosity about the insurance industry and eagerness to learn about underwriting and risk analysis.

Program Highlights:

  • Gain a comprehensive understanding of underwriting and risk analysis from industry leaders.
  • Develop foundational skills essential for a successful career in the insurance industry.
  • Build a professional network and establish connections with insurance professionals.
  • Receive a certificate of completion at the end of the externship.
  • Receive priority in the following underwriting internship recruiting process.

Recruiting Process:

To be considered, please submit a resume with your application. We will be reviewing applications on a rolling basis with the opportunity tentatively closing on Sunday, September 6th, at 11:59 p.m. (ET) or if externship spots are filled sooner. The recruiting process consists of an On-Demand Virtual Interview. We will inform you of an interview decision two weeks after your interview submission.

Embark on a journey of exploration and discovery in the world of underwriting with one of the top insurance companies. Apply now and take the first step towards a rewarding career in insurance!

This role is part of an unpaid program and is not eligible for pay or benefits.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.


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