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Remote Rn Utilization Review Nurse Jobs in Rochester, NY

NCLEX-RN Tutor

Rochester, NY · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

RN Oncology

Rochester, NY · Remote

$2.4K - $2.4K/wk

RN - Oncology Location: Rochester, NY Shift: Monday to Friday Pay: $2,400-$2,430/week RN with a minimum of 2-years acute care experience to join our fast paced and growing team. Position to provide ...

Nurse Practitioner

Rochester, NY · Remote

$40 - $44.44/hr

Nurse Practitioner - Remote Research Study Reviewer Position: Remote - Part Time Work Hours: * Anticipate up to 10 participants per week * Each participant review is anticipated to require ...

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 ...

NCLEX-PN Tutor

Rochester, NY · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

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Remote Rn Utilization Review Nurse information

See Rochester, NY salary details

$21

$41

$68

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

As of Aug 4, 2026, the average hourly pay for remote rn utilization review nurse 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 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 Rochester, NY? The most popular types of Rn Utilization Review Nurse jobs in Rochester, NY are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Rochester, NY? For Remote Rn Utilization Review Nurse jobs in Rochester, NY, the most frequently searched job titles are:
What cities near Rochester, NY are hiring for Remote Rn Utilization Review Nurse jobs? Cities near Rochester, NY with the most Remote Rn Utilization Review Nurse job openings:

Registered Nurse - Communications Center (Central Triage)

Rochester Regional Health

Rochester, NY • On-site, Remote

Full-time

This job post has expired today. Applications are no longer accepted.


Rochester Regional Health rating

7.3

Company rating: 7.3 out of 10

Based on 218 frontline employees who took The Breakroom Quiz

304th of 887 rated healthcare providers


Job description

Job Title: Registered Nurse - Communications Center (Central Triage)
Location: Riedman Center/Remote
*IN PERSON TRAINING (4-5 MONTHS)*
*Working from home / hybrid schedule is an option once trained, will be expected to come into the office when needed*
Hours Per Week: 40
Schedule: Days/Evenings/Nights/Weekends (every other weekend + split holidays) 4, 8 or 12 hr shifts
*Must live within 1 hour of Riedman Center*
SUMMARY:
As a Registered Nurse (RN), you're the engine and the heart of patient care at Rochester Regional Health. You make a positive difference every single day in the lives of our patients, their family members and visitors - going above and beyond to meet their needs with courtesy, kindness, respect and compassion.
RESPONSIBILITIES:
• Performs initial and ongoing assessment of the patient, utilizing appropriate data (i.e. physical, psychological, educational and risk-screen data appropriate for the chronological / developmental age of the patient).
• Demonstrates clinical judgment in responding to priority patient needs.
• Communicates and documents assessment of patient with the interdisciplinary team. Utilizes all available resources in order to meet the needs of the patient and family.
Planning:
• Develops and documents plan of care, treatment and services which is individualized and appropriate for the patient needs, strengths, limitations and goals.
• Includes the interdisciplinary health team as needed.
• Demonstrates effective communication with the patient / family and interdisciplinary team.
Implementation:
• Provides care, treatment and services in collaboration with interdisciplinary health team.
• Maintains an appropriate nurse-patient relationship.
• Complies with organizational policies, procedures and protocols including policies governing safety, medication administration and documentation.
• Initiates and documents education plan for the patient and family based on identified learning.
Evaluations:
• Evaluates, communicates and documents patient responses to care.
• Revises plan of care based on ongoing evaluations and updates documentation appropriately.
Education:
• Ensures the patient and family receives / understands education / training specific to their needs and abilities using the teach back method for evaluation and documents appropriately.
Demonstrates Compassion, Leadership and Professionalism:
• Confidently leads the care delivery team through effective communication, collaboration and leadership.
• Assumes responsibility and accountability on the unit / patient care team.
• Demonstrates the ability to work collaboratively with others.
• Demonstrates knowledge of legal aspects of nursing as evidenced by documentation and professional behaviors.
• Delegates appropriate responsibilities to assigned nurses and ancillary staff.
• Demonstrates ability to manage job related stressors and constructive feedback during intra/interdepartmental relations.
• Demonstrates flexibility in meeting staffing needs throughout the organization.
• Participates in problem-solving activities at the unit level by identifying the problem and collaboratively working toward resolution.
• Provides input regarding protocols, policies and procedures to immediate supervisor.
• Provides training / precepting for new team members on the unit.
Performance Improvement / Evidence Based Practice / Research:
• Demonstrates knowledge of evidence-based practice within practice area and identifies opportunities for performance improvement.
• Participates and utilizes the performance improvement process to improve clinical practice.
• Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.
Compliance
• Completes a minimum of 5 nationally approved contact hours (CNE or CEU) per year.
• Completes mandatory in-services and health screens in timely manner.
• Maintains Basic Life Support (BLS) certification.
REQUIRED QUAILFICATIONS
• Diploma or Associate's Degree in Nursing required; Bachelor's Degree in Nursing preferred.
• Registered Nurse license in New York State.
• Basic Life Support (BLS) certification
• 3 years RN experience minimum
PREFERRED QUALIFICATIONS
• Prior experience pediatrics, adult medicine and triage strongly preferred.
EDUCATION:
AS: Nursing (Required)
LICENSES / CERTIFICATIONS:
BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$35.34 - $47.13
CITY:
Rochester
POSTAL CODE:
14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

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