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Remote Utilization Management Jobs in Connecticut

Directive

... a CRM * Responsible for personal productivity and utilization * Work directly with Associate ... remote-first company, you'll have the ability to work from anywhere in the US, with the option to ...

Directive

... a CRM * Responsible for personal productivity and utilization * Work directly with Associate ... remote-first company, you'll have the ability to work from anywhere in the US, with the option to ...

Directive

... a CRM * Responsible for personal productivity and utilization * Work directly with Associate ... remote-first company, you'll have the ability to work from anywhere in the US, with the option to ...

Directive

... a CRM * Responsible for personal productivity and utilization * Work directly with Associate ... remote-first company, you'll have the ability to work from anywhere in the US, with the option to ...

Directive

... a CRM * Responsible for personal productivity and utilization * Work directly with Associate ... remote-first company, you'll have the ability to work from anywhere in the US, with the option to ...

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Remote Utilization Management information

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

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

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Connecticut? The most popular types of Utilization Management jobs in Connecticut are:
What are popular job titles related to Remote Utilization Management jobs in Connecticut? For Remote Utilization Management jobs in Connecticut, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Connecticut look for? The top searched job categories for Remote Utilization Management jobs in Connecticut are:
What cities in Connecticut are hiring for Remote Utilization Management jobs? Cities in Connecticut with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Connecticut as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.
YNHHS EP Remote Monitoring nurse; Registered Nurse

YNHHS EP Remote Monitoring nurse; Registered Nurse

Yale New Haven Health

New Haven, CT • On-site, Remote

Full-time

Re-posted 22 days ago

Yale New Haven Health rating

7.3

Company rating: 7.3 out of 10

Based on 228 frontline employees who took The Breakroom Quiz

263rd of 886 rated healthcare providers

Job description

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registered nurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
Hours : This is a hybrid position , 2 days in the office .
EEO/AA/Disability/Veteran
Responsibilities
  • 1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registered nurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
  • 2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.

Qualifications
EDUCATION
Graduation from an accredited school of nursing. BSN preferred. All newly hired registered nurses must have current BCLS certification or must obtain within one month of hire.
EXPERIENCE
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
LICENSURE
Licensed and a currently registered nurse in the State of Connecticut. Clinical specialty certification highly encouraged.
SPECIAL SKILLS
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
PHYSICAL DEMAND
Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.
YNHHS Requisition ID
179143

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