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Remote Utilization Management Nurse Jobs in Rochester, NY

Keenfinity

Associate Automation Engineer

Fairport, NY · On-site +1

$70K - $85K/yr

... Remote Security Manger app. Fairport, NY is the headquarters for the Radionix sales & marketing ... resource utilization) Preferred Skills/Experience: * Exposure to mobile automation (Appium ...

Keenfinity

Associate Automation Engineer

Fairport, NY · On-site +1

... Remote Security Manger app. ​Fairport, NY is the headquarters for the Radionix sales & marketing ... resource utilization) Preferred Skills/Experience: * Exposure to mobile automation (Appium ...

micro1 AI

Clinical Pharmacy Technicians

Rochester, NY · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Working fluency with ICH E2F, ICH E2C(R2), and GVP guidelines, including signal management and ...

micro1 AI

Pharmacovigilance Expert

Rochester, NY · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Working fluency with ICH E2F, ICH E2C(R2), and GVP guidelines, including signal management and ...

ShiftHop LLC

Director of Operations

Rochester, NY · Remote

$85K - $135K/yr

This is a remote position with a residency requirement of Rochester, New York. The ideal candidate ... Manage and communicate with healthcare facilities, offering complaint resolution and high-level ...

University of Kentucky

Oncologist

Pavilion, NY · On-site +1

$188.75/hr

Clinic Manager Work Location: Medical Pavilion Grade Level: 0 Type of Position: Contractor Position ... Work effectively within a multi-disciplinary care team, including nursing, allied health, and ...

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Remote Utilization Management Nurse information

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

As of Aug 11, 2026, the average hourly pay for remote utilization management nurse in Rochester, NY is $41.75, 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 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 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.
More about Remote Utilization Management Nurse jobs
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 are popular job titles related to Remote Utilization Management Nurse jobs in Rochester, NY? For Remote Utilization Management Nurse jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management Nurse jobs in Rochester, NY look for? The top searched job categories for Remote 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:
Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Rochester, NY as of August 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 100% Remote job distribution, with an average salary of $86,813 per year, or $41.7 per hour.

Integrated Care Coordinator (ICC)

Essen Medical Associates

Rochester, NY • On-site, Remote

$20 - $25/hr

Full-time

Re-posted 29 days ago

Essen Health Care rating

4.6

Company rating: 4.6 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Overview
Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state's most vulnerable and underserved residents.
Founded in 1999, we've grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women's health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.
We're looking for talented, motivated individuals to join our growing team. Whether you're a medical provider, administrator, or operations professional, there's a career here for you. Join us in making a real difference in the health of our community.
Job Summary
Position Title: Integrated Care Coordinator
Position Summary: The Integrated Care Coordinator serves as a vital link between patients and healthcare services, ensuring seamless coordination across our multispecialty network. This role focuses on breaking down barriers to care for underserved populations in the Bronx, coordinating between primary care, specialty services, behavioral health, and community resources to deliver comprehensive, patient-centered care.
This position is ideal for individuals looking to make a meaningful impact in the healthcare field while working in a supportive team environment. You'll be part of an organization that has demonstrated over 25 years of commitment to innovating healthcare delivery for underserved communities, with opportunities to grow alongside our rapidly expanding multispecialty medical group.
Responsibilities
Key Responsibilities
  • Develop and maintain comprehensive care plans addressing medical, behavioral, and social determinants of health
  • Coordinate services across Essen's integrated clinical divisions including urgent care, primary care, and specialty services
  • Facilitate smooth transitions between care settings including telehealth, in-person visits, and home care through Essen House Calls
  • Utilize Remote Patient Monitoring tools to track patient progress and proactively address health concerns
  • Monitor patient adherence to care plans and adjust interventions based on outcomes

Patient Engagement & Outreach
  • Conduct initial assessments to identify patient needs, preferences, and barriers to care
  • Perform community outreach to engage underserved populations in the Bronx
  • Educate patients and families about health conditions, treatment options, and self-management strategies in both English and Spanish
  • Support patients in navigating community resources and social services throughout New York City
  • Advocate for patients within the healthcare system to ensure access to appropriate service

Qualifications
Experience / Education
  • High School Diploma
  • 1-2 years of direct patient care experience
  • Experience in Care Coordination or Case Management
  • Experience with Remote Patient Monitoring
  • Familiarity with Electronic Health Records (EHR)
  • Previous experience in outreach, community engagement, social services, or related field

Skills & Competencies
  • Bilingual: Fluent in Spanish and English (Highly preferred)
  • Excellent communication and public speaking skills
  • Ability to work independently and travel within the Bronx
  • Knowledge of community resources and services in New York City
  • Strong organizational and time management skills
  • Cultural sensitivity and ability to work with diverse, underserved populations
  • Proficiency in motivational interviewing and health coaching techniques

Compensation & Benefits
  • Pay: $20.00 - $25.00 per hour
  • Job Type: Full-time
  • Remote & Hybrid opportunities available

Equal Opportunity Employer
  • Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

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