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Remote Utilization Management Nurse Jobs in Chaplin, CT

CRH

Technical Sales Rep - Remote

Oxford, MA · On-site +1

$130K - $160K/yr

S. It is the nation's largest marketer and manager of fly ash, with the industry's only true ... utilization * Maintain and grow the current account base through regular customer interaction ...

Aflac Incorporated

Behav Health Clinician Rev

Windsor, CT · Remote

$75K - $90K/yr

If the role is remote, there may be occasions that you are requested to come to the office based on ... managing claims. * CDMS or CCM designations. * Utilization review experience and/or experience ...

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How much do remote utilization management nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote utilization management nurse in Chaplin, CT is $42.91, according to ZipRecruiter salary data. Most workers in this role earn between $33.89 and $49.28 per hour, depending on experience, location, and employer.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.

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

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

More about Remote Utilization Management Nurse jobs

What cities near Chaplin, CT are hiring for Remote Utilization Management Nurse jobs?

Cities near Chaplin, CT with the most Remote Utilization Management Nurse job openings:

Remote Utilization Management Nurse jobs near you

Full-Time Licensed Independent Clinical Social Worker (LICSW) - Remote in Springfield, MA

Wellmore Health Center

Springfield, MA • Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 4 days ago

Job description

Position Overview

Wellmore Health Center is seeking a dedicated and compassionate Licensed Independent Clinical Social Worker (LICSW) to join our dynamic team in Springfield, Massachusetts. This full-time role offers a unique opportunity to provide remote support within a school setting, focusing on enhancing the mental health and wellbeing of students. The ideal candidate will play an integral role in fostering a safe and nurturing environment that promotes healing, personal growth, and empowerment among our clients.

About the Organization

At Wellmore Health Center, we are committed to delivering exceptional mental health support tailored to meet a diverse range of needs. We believe in the importance of a holistic approach that addresses the complex intersection of mental health and individual identity. Our team consists of skilled professionals who prioritize a collaborative and compassionate care model, ensuring that every client feels valued, understood, and supported throughout their journey.

Work Environment

This position involves a remote work setting, allowing for flexibility while maintaining a close-knit connection with the school community. Our team values open communication and collaboration, ensuring that every team member’s contributions are recognized and integrated into our service model. Working Monday through Friday from 9:00 AM to 5:00 PM, you will engage directly with students and their families, providing essential support during and after school hours.

Key Responsibilities
  • Serve as a liaison between students, families, and outpatient providers, ensuring seamless communication and support during transitions.
  • Interact with insurance companies for pre-certification and utilization management, advocating for the necessary services and support for our clients.
  • Participate in discharge and aftercare planning, ensuring that clients receive continuity of care and resources upon exiting our services.
  • Offer therapeutic meal support, helping clients model healthy relationships with food and fostering positive self-image in a supportive environment.
  • Deliver safe, empathetic, and affirming care tailored to each client's unique circumstances, taking into account their intersecting identities.
Patient Population / Client Focus

Your primary focus will be on students in a school setting, working closely with older adolescents who may face mental health challenges related to academic pressures, family dynamics, and social issues. You will assist in developing individualized care plans that support academic success while promoting emotional wellbeing.

Qualifications
  • Master's degree in Social Work from an accredited institution.
  • Active LICSW license in the state of Massachusetts.
  • Experience working with older adults and youth populations is essential.
  • Strong clinical and diagnostic skills, with a proven ability to assess mental health needs accurately.
  • Excellent interpersonal and communication skills, enabling effective collaboration with clients and multidisciplinary teams.
  • A demonstrated ability to work independently within remote settings while contributing positively to team dynamics.
Preferred Experience
  • Experience with therapeutic modalities that are particularly suited for youth and family engagement.
  • Familiarity with school mental health practices and educational systems.
  • Proficiency in using electronic health record (EHR) systems and telehealth platforms.
Compensation and Benefits

This position offers a competitive annual salary ranging from $90,000 to $105,000, commensurate with experience and qualifications. Additional benefits include:

  • Medical, dental, and vision coverage to support your health and wellbeing.
  • A robust 401(k) plan with flexible spending options to help secure your financial future.
  • Life insurance and accidental coverage, ensuring peace of mind for you and your family.
  • Short-term disability coverage to support you in the event of unforeseen circumstances.
Career Growth Opportunities

Joining Wellmore Health Center opens the door to continuous professional development and career growth within a supportive environment. We encourage our social workers to pursue additional certifications and specialize in areas of interest, offering ongoing training and development opportunities. Our commitment to personal and professional growth sets the stage for your success.

Why Join Our Team

By becoming part of Wellmore Health Center, you will be part of a vibrant network of professionals dedicated to making a difference in the lives of students and their families. Our collaborative approach to mental health care ensures that your expertise contributes directly to improved patient outcomes and fosters a supportive community. We believe in the value of your input and recognize the importance of work-life balance, which our remote setting allows.

Application Information

If you are passionate about making a positive impact in the mental health field and meet the qualifications listed above, we invite you to apply today. Join us at Wellmore Health Center, where your skills and compassion can transform lives!

Apply