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Remote Rn Insurance Jobs in East Hanover, NJ (NOW HIRING)

Mercor

Utilisation Management Expert - RN

New York, NY · Remote

$100 - $150/hr

Remote Role Responsibilities * Lead utilisation management and case management operations ... Active clinical licensure ( RN required ; physician advisor/ MD preferred ) with strong medical ...

Baba

Virtual Nurse Practitioner

New York, NY · Remote

Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba ... Baba's insurance-covered advocates have supported thousands of families by writing insurance ...

MedReview

DRG Clinical Validation Nurse

Manhattan, NY · On-site +1

$85K - $95K/yr

We are seeking a registered nurse with experience in clinical validation to work within our coding ... Knowledge of health insurance business, industry terminology, and regulatory guidelines ...

MedReview

DRG Clinical Validation Nurse

New York, NY · Remote

$85K - $95K/yr

We are seeking a registered nurse with experience in clinical validation to work within our coding ... Knowledge of health insurance business, industry terminology, and regulatory guidelines ...

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All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in East Hanover, NJ

Remote Rn Insurance information

See East Hanover, NJ salary details

$7

$44

$76

How much do remote rn insurance jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for remote rn insurance in East Hanover, NJ is $44.87, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $53.12 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote RN Insurance nurse?

To thrive as a Remote RN Insurance Nurse, you need an active RN license, a strong grasp of clinical practice, and experience in case management or utilization review. Familiarity with claims processing systems, telehealth platforms, and knowledge of medical coding (ICD-10, CPT) are typically required, along with certifications like CCM or URAC being advantageous. Exceptional communication, critical thinking, and time management skills help you collaborate with patients, providers, and insurance teams effectively. These competencies ensure accurate assessments, efficient case handling, and high-quality service in a remote, compliance-driven environment.

What is the difference between Remote Rn Insurance vs Remote Rn Case Manager?

AspectRemote Rn InsuranceRemote Rn Case Manager
CertificationsRN license, insurance knowledgeRN license, case management certification
Work EnvironmentInsurance companies, telehealthHealthcare facilities, telehealth
Employer & IndustryInsurance providers, telehealth companiesHospitals, insurance companies, healthcare agencies

Remote Rn Insurance focuses on assessing insurance claims and policy coverage, while Remote Rn Case Managers coordinate patient care plans. Both roles require RN licensure and involve telehealth work, but their primary responsibilities and employer settings differ.

What is a Remote RN Insurance nurse?

A Remote RN Insurance nurse is a registered nurse who works with insurance companies to review medical claims, assess patient care needs, and help determine the medical necessity of treatments—often from a home office. Their responsibilities may include case management, utilization review, and providing telephonic support to patients or healthcare providers. This role requires strong clinical experience, excellent communication skills, and the ability to analyze medical records and insurance policies. Working remotely, these nurses help ensure patients receive appropriate care while also managing healthcare costs for insurance providers.

What are some common challenges faced by Remote RN Insurance professionals, and how can they be managed effectively?

Remote RN Insurance professionals often encounter challenges such as managing a high volume of case reviews, maintaining clear communication with both patients and insurance teams, and staying updated with changing insurance policies and regulations. To manage these challenges, it’s important to develop strong organizational skills, utilize effective digital communication tools, and participate in ongoing training. Engaging with a supportive team and seeking mentorship within the organization can also help in adapting to the remote environment and ensuring quality outcomes.
What are popular job titles related to Remote Rn Insurance jobs in East Hanover, NJ? For Remote Rn Insurance jobs in East Hanover, NJ, the most frequently searched job titles are:
What job categories do people searching Remote Rn Insurance jobs in East Hanover, NJ look for? The top searched job categories for Remote Rn Insurance jobs in East Hanover, NJ are:
What cities near East Hanover, NJ are hiring for Remote Rn Insurance jobs? Cities near East Hanover, NJ with the most Remote Rn Insurance job openings:
Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in East Hanover, NJ as of August 2026, with employment types broken down into 54% Full Time, 27% Part Time, and 19% Contract. Highlights an 4% In-person, and 96% Remote job distribution, with an average salary of $93,331 per year, or $44.9 per hour.

Utilisation Management Expert - RN

Mercor

New York, NY • Remote

$100 - $150/hr

Full-time

Re-posted 8 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Utilisation Management / Case Management leader (RN/Physician-advisor)
Type: Contract
Compensation: $100–$150/hour
Location: Remote

Role Responsibilities

  • Lead utilisation management and case management operations, including concurrent review, retrospective review, discharge planning, and care coordination.
  • Evaluate AI-generated medical necessity determinations and clinical review outputs for accuracy and clinical appropriateness.
  • Conduct and oversee clinical reviews against InterQual, MCG, or Milliman care guidelines to support admission and level-of-care determinations.
  • Manage the physician advisor program to support complex UM cases, peer-to-peer review requests, and denial appeals.
  • Coordinate with clinical teams, payers, and post-acute providers to facilitate appropriate care transitions and discharge planning.
  • Annotate AI outputs and provide structured clinical feedback to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in utilisation management, case management, or clinical review, with at least 2 years in a leadership role.
  • Active clinical licensure (RN required; physician advisor/MD preferred) with strong medical necessity review expertise.
  • Deep knowledge of InterQual, MCG, or Milliman clinical review criteria.
  • Expertise in CMS Two-Midnight Rule, observation status regulations, and inpatient criteria.
  • Experience managing physician advisor programs and peer-to-peer review processes with payers.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to critically evaluate clinical documentation and AI-generated UM outputs.

Preferred

  • CPUR, ACM, or CCM credential.
  • MD or DO with UM/physician advisor experience preferred for physician advisor roles.
  • Experience with UM software platforms (Allscripts, Utilisation Management software, or equivalent).
  • Familiarity with AI tools and comfort evaluating AI-generated clinical review content.
  • Background in health system, ACO, or value-based care organisation UM programs.

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.