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Remote Hca Utilization Review Jobs in Connecticut

Gateway Recruiting

Territory Manager

New Haven, CT · Remote

Conduct quarterly business reviews with key accounts to assess performance and identify growth ... Remote monitoring workflow development, Utilization ramp and adoption metrics * Strong executive ...

Worldwide Clinical Trials

$223K/yr

Review and assess ongoing budget utilization and revenue recognition with Operations Managers to ensure projects are meeting financial targets * Manage internal CAT operations meetings and other ...

JLL

PDS Strategic Sourcing Specialist

Hartford, CT · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Location: Remote -Boston, MA, Hartford, CT, New York, NY, Pittsburgh, PA, Providence, RI ...

Amgen

Field Reimbursement Manager - Hartford, CT

Hartford, CT · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Review patient-specific information in cases where the site has specifically requested assistance ... General office demands - Remote, Work from Home. * One to two home office days per week. * Must be ...

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Remote Hca Utilization Review information

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Connecticut?

For Remote Hca Utilization Review jobs in Connecticut, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Connecticut look for?

The top searched job categories for Remote Hca Utilization Review jobs in Connecticut are:

What cities in Connecticut are hiring for Remote Hca Utilization Review jobs?

Cities in Connecticut with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Connecticut as of June 2026, with employment types broken down into 38% As Needed, 29% Full Time, 21% Part Time, 4% Temporary, 4% Contract, and 4% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution.

Director, Quality Systems & Regulatory Affairs (Remote - East Coast)

CEFALY Technology

Darien, CT • On-site, Remote

$160K - $180K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

Job description

Director, Quality Systems & Regulatory Affairs
Department: Quality & Regulatory Affairs
Reports To: SVP, Operations
Location: Remote or Hybrid - East Coast ONLY
FLSA Status: Exempt, Full-Time
Position Summary
CEFALY Technology is seeking an experienced Quality Systems & Regulatory Affairs leader to strengthen and scale the organization's quality and regulatory infrastructure. This individual will serve as the functional lead for Quality Systems and Regulatory Affairs and will be responsible for improving organizational compliance, strengthening audit readiness, and reducing quality system risk through robust process ownership and execution.
A critical priority for this role will be optimizing and expanding the company's electronic Quality Management System (eQMS), conducting comprehensive assessments of quality documentation and system effectiveness, and driving sustainable process improvements across the organization. This position will provide experienced leadership during notified body audits and regulatory inspections and will help build long-term organizational capability through mentorship and process maturity.
The role serves as a strategic and hands-on partner across Operations, Supply Chain, Customer Service, Product Development, and leadership teams to ensure compliance excellence and scalable growth.
Essential Responsibilities
Quality Management System (QMS) & eQMS Leadership
  • Serve as system owner and business lead for the organization's eQMS platform including optimization, implementation expansion, workflow design, governance, and user adoption.
  • Assess current eQMS utilization and develop a roadmap for full implementation and process maturity.
  • Own and administer day-to-day QMS and eQMS activities and processes.
  • Lead continual improvement initiatives across quality system processes and documentation.
  • Lead comprehensive audits of controlled documentation and quality records to identify inconsistencies, gaps, obsolete content, and systemic documentation deficiencies.
  • Establish processes and controls ensuring consistency across SOPs, work instructions, forms, labels, templates, and quality records.
  • Drive document control processes including creation, revision workflows, review cycles, training assignments, archival activities, and change management.
  • Develop sustainable document governance practices to reduce repeat nonconformances and improve inspection readiness.
  • Monitor quality metrics and identify opportunities for process improvements.
  • Support and improve CAPA, nonconformance, complaint handling, change control, risk management, and supplier quality processes.
  • Ensure QMS alignment with ISO 13485, FDA Quality System Regulation (21 CFR Part 820/QMSR), EU MDR, and applicable global requirements.
  • Lead initiatives to improve quality system effectiveness, data integrity, and organizational compliance maturity.
  • Maintain ongoing inspection and audit readiness.

Audit & Compliance Leadership
  • Act as primary Quality and Regulatory lead during notified body audits, FDA inspections, supplier audits, and external quality assessments.
  • Lead audit preparation strategy, evidence collection, coordination activities, and response management.
  • Drive audit finding remediation through root cause analysis and sustainable CAPA implementation.
  • Support management review processes and quality reporting.
  • Maintain a continuous state of organizational inspection readiness.

Regulatory Affairs Leadership
  • Independently lead FDA and international regulatory submissions and agency interactions.
  • Prepare, coordinate, and execute regulatory filings and lifecycle submissions.
  • Conduct regulatory impact assessments related to product, process, manufacturing, supplier, labeling, and operational changes.
  • Provide regulatory strategy recommendations and communicate business impact to leadership.
  • Support registrations, renewals, amendments, and post-market regulatory activities.
  • Interpret changing regulatory requirements and proactively communicate implications.
  • Maintain regulatory records and submission archives.

Leadership & Cross-Functional Partnership
  • Mentor and help develop junior QA/RA personnel.
  • Provide quality and regulatory leadership across Operations, Supply Chain, Customer Service, Product Development, and leadership teams.
  • Act as an internal subject matter expert for QMS and regulatory requirements.
  • Support employee training initiatives related to quality systems and compliance.
  • Provide guidance during business, operational, and product decisions.

Qualifications
Education
  • Bachelor's degree in Engineering, Life Sciences, Regulatory Affairs, Quality, or related field required.
  • Advanced degree preferred.

Experience
  • 8-12+ years of progressive Quality and Regulatory Affairs experience within medical devices.
  • Demonstrated experience serving as lead quality or regulatory representative during notified body audits and regulatory inspections.
  • Proven experience owning, implementing, or significantly improving an electronic QMS platform; Greenlight Guru experience strongly preferred.
  • Demonstrated experience identifying and remediating systemic documentation and quality system deficiencies.
  • Experience independently leading FDA submissions and EU MDR activities.
  • Experience with CAPA, complaint handling, risk management, supplier quality, document control, and change management systems.
  • Demonstrated success improving audit outcomes and quality system maturity.
  • Prior people leadership or mentoring experience strongly preferred.
  • Experience supporting Class II and/or Class III medical devices preferred.

Knowledge & Skills
  • Deep understanding of ISO 13485, FDA Quality System Regulation (21 CFR Part 820/QMSR), EU MDR, and related global regulations.
  • Strong understanding of quality systems architecture and eQMS administration.
  • Excellent technical writing and documentation skills.
  • Strong project management and organizational capabilities.
  • Strong leadership presence during audits and external interactions.
  • Ability to manage multiple priorities within fast-paced environments.
  • Excellent communication and cross-functional influencing skills.
  • Strong analytical, problem-solving, and systems-thinking abilities.

Preferred Certifications
  • RAC, CQE, CQA, ASQ certifications, or equivalent preferred.

Success in this role includes:
  • Complete a comprehensive assessment of current QMS and eQMS state.
  • Develop and execute a Greenlight Guru optimization roadmap.
  • Conduct a full controlled-document audit and remediation initiative.
  • Reduce repeat audit observations and documentation inconsistencies.
  • Improve notified body audit readiness and inspection confidence.
  • Strengthen quality system governance and documentation control processes.
  • Improve organizational QA/RA capability and mentorship support.
  • Build scalable infrastructure supporting future growth.

Why This Role Matters
This role is being added to strengthen organizational quality and regulatory capabilities, reduce single-point dependency risk, improve QMS sustainability, and establish scalable systems supporting long-term growth and compliance excellence.
Benefits
  • Health insurance (80% employer-paid)
  • Employer-paid Dental and Vision
  • Short-Term and Long-Term Disability
  • Group Life Insurance
  • IRA with company match (no vesting period)
  • Paid PTO
  • Paid company holidays

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