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Remote Supervisor Utilization Management Jobs (NOW HIRING)

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Corrohealth

Coordinator, Utilization Management

OR · Remote

$19 - $20/hr

Remote (Within US Only) Required Schedule : Full-time shifts from 8:00 AM to 5:00 PM EST either ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

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$167.5K

How much do remote supervisor utilization management jobs pay per year?

As of Jun 1, 2026, the average yearly pay for remote supervisor utilization management in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What is the difference between Remote Supervisor Utilization Management vs Remote Utilization Review Nurse?

AspectRemote Supervisor Utilization ManagementRemote Utilization Review Nurse
CredentialsRN, often with management or supervisor certificationsRN, with clinical review certifications
Work EnvironmentSupervises teams, manages utilization processes remotelyPerforms clinical reviews, assesses patient necessity remotely
Employer & Industry UsageHealth insurance companies, managed care organizationsInsurance companies, third-party administrators
Primary FocusOverseeing utilization management operationsConducting clinical utilization reviews

Remote Supervisor Utilization Management roles focus on overseeing utilization management teams and processes, ensuring compliance and efficiency. In contrast, Remote Utilization Review Nurses primarily perform clinical assessments to determine the necessity of services. Both roles require RN credentials but differ in responsibilities and scope within the utilization management field.

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What cities are hiring for Remote Supervisor Utilization Management jobs? Cities with the most Remote Supervisor Utilization Management job openings:
What are the most commonly searched types of Supervisor Utilization Management jobs? The most popular types of Supervisor Utilization Management jobs are:
What states have the most Remote Supervisor Utilization Management jobs? States with the most job openings for Remote Supervisor Utilization Management jobs include:
What job categories do people searching Remote Supervisor Utilization Management jobs look for? The top searched job categories for Remote Supervisor Utilization Management jobs are:
Remote Supervisor Utilization Management jobs near you
Infographic showing various Remote Supervisor Utilization Management job openings in the United States as of May 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 43% Physical, 4% Hybrid, and 53% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.
Utilization Management RN - Pediatrics (Remote) | New York RN License Required |

Utilization Management RN - Pediatrics (Remote) | New York RN License Required |

Morgan Stephens

Manhattan, NY • Remote

Other

Posted 20 days ago

Job description

Utilization Management RN - Pediatrics (Remote) | New York RN License Required | 110K+

Fully remote opportunity
Pediatric Utilization Management focus
Fast interview process

Location: Remote - Must hold active New York RN license
Job Type: Full-Time
Department: Utilization Management

About Us
Morgan Stephens represents the nation's top healthcare systems, offering highly competitive compensation and benefits to top candidates. We are led by experienced healthcare industry professionals and specialize in contract, contract-to-hire, and direct placement services nationwide.

We have successfully placed thousands of healthcare professionals into organizations seeking high-quality talent and continue to partner with leading health systems and managed care organizations.

Position Summary
The Utilization Management RN - Pediatrics plays a critical role in ensuring pediatric healthcare services are delivered with quality, cost efficiency, and full regulatory compliance. Through clinical review and coordination, this role supports appropriate levels of care, medical necessity determinations, and positive outcomes for pediatric patients and families.

This position is ideal for an RN with pediatric clinical experience and a strong background in utilization review, prior authorization, case management, or managed care.

Job Duties and Responsibilities

Perform concurrent review of pediatric clinical cases for medical necessity and appropriateness of care

Conduct review of prior authorization and precertification requests for pediatric services and treatments

Ensure services align with established clinical guidelines including MCG or InterQual criteria

Collaborate with providers, care teams, and health plan representatives to support coordinated care planning

Monitor utilization trends and identify opportunities to improve quality and cost efficiency

Assist with discharge planning and transition of care coordination for pediatric populations

Advocate for quality patient outcomes and timely access to medically necessary services

Maintain accurate and timely clinical documentation within EMR and utilization management systems

Prepare reports related to utilization activity, case outcomes, and authorization trends

Work independently in a fast-paced remote environment while maintaining productivity and quality standards

Skills and Qualifications

Active, unrestricted Registered Nurse (RN) license in New York required

Minimum of 2+ years of pediatric nursing experience required

Minimum of 2+ years of Utilization Management, Case Management, or Prior Authorization experience preferred

Strong knowledge of MCG or InterQual guidelines

Experience with medical necessity review, concurrent review, and utilization management workflows

Proficiency with EMR systems and Microsoft Office (Excel, Word, Outlook)

Strong communication, critical thinking, and organizational skills

Ability to work independently in a fully remote environment

Preferred Experience

Pediatric managed care or pediatric hospital experience

Medicaid or commercial pediatric population experience

Experience working with children with complex medical needs or chronic conditions

UM or Case Management certification (CCM, ACM) preferred

Why This Role Matters
This role directly supports improved healthcare outcomes for pediatric patients by ensuring medically appropriate, timely, and cost-effective care. You will help families navigate healthcare services while supporting quality-driven clinical decision-making.

Apply