2

Remote Utilization Management Nurse Jobs in Rochester, NY

next page

Showing results 1-20

Remote Utilization Management Nurse information

See Rochester, NY salary details

$21

$41

$68

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

As of Sep 5, 2026, the average hourly pay for remote utilization management 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 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.

What are the most commonly searched types of Utilization Management Nurse jobs in Rochester, NY?

The most popular types of Utilization Management Nurse jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Remote Utilization Management Nurse jobs?

Cities near Rochester, NY with the most Remote Utilization Management Nurse job openings:

Infographic showing various Remote Utilization Management Nurse job openings in Rochester, NY as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $86,774 per year, or $41.7 per hour.

Remote Licensed Clinical Social Worker at Atlantic Academy, RTC

Atlantic Academy, RTC

Rochester, NY โ€ข Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 2 days ago

New


Job description

Position Overview

Atlantic Academy, RTC is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) for a full-time remote position, primarily focused on providing essential mental health support. In this critical role, you will be responsible for developing strong therapeutic relationships with clients, facilitating their healing journey, and providing tailored interventions that empower individuals to achieve their mental health goals.

About the Organization

At Atlantic Academy, RTC, we specialize in delivering exceptional mental health support catered to a diverse spectrum of needs. Our professionals cultivate a safe and nurturing environment where personal growth, healing, and empowerment are prioritized. We believe in an integrated approach to mental health care, ensuring our practices reflect the values of inclusivity, respect, and dignity for all clients.

Work Environment

This role provides a unique opportunity to work remotely, allowing you to balance professional responsibilities and personal life effectively. As a member of our community health clinic team, you will enjoy a supportive work culture that recognizes and values your contributions. Regular team meetings and training sessions are conducted virtually to promote collaboration and professional development.

Key Responsibilities
  • Act as a liaison between clients, their families, and outpatient providers to facilitate comprehensive care and support.
  • Engage with various insurance companies for pre-certification and utilization management, ensuring that clients receive necessary coverage for their treatment.
  • Participate actively in discharge and aftercare planning, preparing clients for successful transitions and support post-treatment.
  • Provide therapeutic meal support, modeling healthy relationships with food, encouraging mindful eating practices, and fostering positive body image.
  • Deliver safe, empathetic, and affirming care tailored to each client's unique circumstances, particularly taking into account their intersecting identities and experiences.
Patient Population / Client Focus

As a Licensed Clinical Social Worker at Atlantic Academy, you will work with a diverse client population that includes children, adolescents, and adults facing various mental health challenges. Through our remote community health clinic, you will engage individuals from different backgrounds, helping them cope with mental health issues including depression, anxiety, trauma, and more. Your role is essential in enhancing their quality of life and promoting recovery.

Qualifications
  • A Master's degree in Social Work from an accredited institution is required.
  • Must hold a valid Licensed Clinical Social Worker (LCSW) license in the state of New York.
  • Experience working with older adults and understanding the unique challenges they face in mental health.
  • Exceptional clinical and diagnostic skills to assess and formulate treatment plans effectively.
  • Outstanding communication and interpersonal skills to foster strong relationships with clients and team members.
  • A willingness to work independently and as part of a collaborative team environment.
Preferred Experience
  • A background in working with patients facing complex trauma or multi-faceted mental health concerns is highly preferred.
  • Familiarity with telehealth technologies and electronic health records systems to document sessions and coordinate care efficiently.
  • Knowledge of community resources and local mental health services that can assist clients in their recovery journey.
Compensation and Benefits

We offer a competitive salary range of $90,000 to $105,000 per year, commensurate with experience and qualifications. In addition to a competitive salary, you will receive a robust benefits package that includes:

  • Comprehensive medical, dental, and vision insurance.
  • 401(k) retirement plan with employer matching contributions.
  • Flexible spending accounts for healthcare and dependent care expenses.
  • Life insurance and short-term disability coverage for added peace of mind.
  • A supportive work environment that encourages professional development and growth.
Career Growth Opportunities

At Atlantic Academy, we are committed to the professional advancement of our staff. As a Licensed Clinical Social Worker, you will have opportunities for continued education, training in specialized therapeutic techniques, and leadership roles within the organization. We encourage you to pursue further certifications and qualifications to enhance your skills and impact on our clients.

Why Join Our Team

Joining Atlantic Academy means becoming part of a forward-thinking team that is passionate about mental health advocacy and patient care. Here, your insights and contributions matter. You will work alongside a team of skilled professionals who share your commitment to empowering individuals and enhancing mental health outcomes across the community.

Application Information

If you are a dedicated Licensed Clinical Social Worker looking to make a significant impact in the lives of others while enjoying the flexibility of remote work, we encourage you to apply today! Please submit your resume and a cover letter detailing your qualifications and motivation for joining our team.