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Remote Rn Utilization Review Nurse Jobs in New York

HURC

UR Clinical Operations Lead

Short Hills, NJ · Remote

Position Summary The Utilization Review (UR) Clinical lead serves as a subject matter expert in ... Registered Nurse (RN) required; BSN preferred. * Advanced degree (MSN, MHA, MBA) preferred.

Phaxis

AIMS- REMOTE RN CARE MANAGER

NY · On-site +1

$61 - $63/hr

... appropriate utilization of services. This role supports patients across the continuum of care ... Current NYS RN license * Experience in case management, care coordination, or similar clinical ...

CVS Health

Case Manager, Registered Nurse

New York, NY · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...

TheraCare

RN Supervisor (Hybrid Remote)

Bronx, NY · On-site +1

$80K - $85K/yr

... and remote training * Proficiency with Word, Excel, Outlook Calendar, and other software programs needed in the role Supervisory Responsibilities: * Supervise Registered Nurses in school/clinic ...

Mercor

Utilisation Management Expert - RN

New York, NY · Remote

$100 - $150/hr

Remote Role Responsibilities * Lead utilisation management and case management operations ... Conduct and oversee clinical reviews against InterQual , MCG , or Milliman care guidelines to ...

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All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in New York

Remote Rn Utilization Review Nurse information

See New York salary details

$23

$46

$75

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

As of Aug 6, 2026, the average hourly pay for remote rn utilization review nurse in New York is $46.26, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.12 per hour, depending on experience, location, and employer.

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

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

What is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in New York? The most popular types of Rn Utilization Review Nurse jobs in New York are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in New York? For Remote Rn Utilization Review Nurse jobs in New York, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in New York look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in New York are:
What cities in New York are hiring for Remote Rn Utilization Review Nurse jobs? Cities in New York with the most Remote Rn Utilization Review Nurse job openings:
Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in New York as of August 2026, with employment types broken down into 67% Full Time, 22% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $96,216 per year, or $46.3 per hour.

Registered Nurse (RN) - Principal Care Management (PCM)

Elaya Health

Passaic, NJ • Remote

$35 - $45/hr

Other

Re-posted 27 days ago

Job description

Remote Registered Nurse (RN) – Principal Care Management (PCM)Join Elaya Health – Improving Specialty Care in Nursing Homes

📍 Remote Position
🕒 Full Time / Part Time Available
💻 Work From Home
💰 Competitive Compensation

Elaya Health is a leading provider of endocrinology and specialty care services for nursing home residents. We partner closely with long term care facilities to improve outcomes for patients with chronic conditions, primarily diabetes and thyroid disease.

We are looking for a compassionate, organized, and detail oriented Registered Nurse (RN) to join our growing team and assist with Principal Care Management (PCM) services remotely.

Responsibilities

• Review patient charts, medications, labs, and care plans
• Coordinate care with providers, nursing staff, pharmacies, and families when needed
• Document patient interactions accurately and thoroughly
• Identify changes in condition and escalate concerns appropriately
• Assist with chronic disease management and patient education
• Ensure PCM services are completed in compliance with CMS guidelines

Qualifications

• Active RN license required
• Nursing home or long term care experience preferred
• Experience with chronic care management or PCM is a plus
• Strong communication and organizational skills
• Comfortable working independently in a remote environment
• EMR experience preferred

Why Join Us?

✅ Fully remote position
✅ Flexible scheduling options
✅ Supportive and collaborative team
✅ Opportunity for growth within a rapidly expanding healthcare company
✅ Meaningful work improving care for nursing home residents

To apply, please send your resume to [insert email].

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