ZipRecruiter

Log In

2

Remote Utilization Management Jobs in New Jersey

Virtua Health

Outcomes Manager - UR (Per Diem)

Pennsauken, NJ · On-site +1

$38.33 - $59.58/hr

Remote Type: 100% Remote Employment Type: Employee Employment Classification: Per Diem Time Type ... Utilization Management • Utilizes Payer specific screening tools as a resource to assist in the ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

ACHIEVE TEST PREP

Lead PMO - Remote

Newark, NJ · On-site +1

Lead a team of project managers to support them in standardizing projects, integrating best ... Work closely with the IT department to ensure effective utilization and prioritization of ...

Sbdinc

$98K - $126K/yr

... management. You'll get to: * Manage the largest and most complex End User Accounts which are ... Utilization of External Reporting as a Compass/Guide - Working with Grainger to pull Item Purchase ...

Centerbrite

BCBA

Newark, NJ · On-site +1

$90K - $110K/yr

BCBA (Board Certified Behavior Analyst) $90,000-$110,000 Full-time Hybrid (Remote + In-home) A rare ... Carry and manage a client caseload , serving as the clinical standard-bearer for the organization

Akkadian Labs

Account Manager

Hoboken, NJ · On-site +1

Our culture is people-first, fully remote, and rooted in grit, clarity, trust, and respect, because ... Recognize signs of under-utilization or account risk early and step in with recommendations ...

Akkadian Labs

Account Manager

Hoboken, NJ · Remote

Our culture is people-first, fully remote, and rooted in grit, clarity, trust, and respect, because ... Recognize signs of under-utilization or account risk early and step in with recommendations ...

next page

Showing results 1-20

All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in New Jersey

Remote Utilization Management information

See New Jersey salary details

$21

$42

$70

How much do remote utilization management jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for remote utilization management in New Jersey is $42.93, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $49.28 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive in remote utilization management?

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.

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 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 New Jersey?

The most popular types of Utilization Management jobs in New Jersey are:

What are popular job titles related to Remote Utilization Management jobs in New Jersey?

For Remote Utilization Management jobs in New Jersey, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in New Jersey look for?

The top searched job categories for Remote Utilization Management jobs in New Jersey are:

What cities in New Jersey are hiring for Remote Utilization Management jobs?

Cities in New Jersey with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in New Jersey as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $89,286 per year, or $42.9 per hour.

Remote Registered Nurse - Utilization Review - RRNUR 26-10215

Compu-Vision - Healthcare

Princeton, NJ • Remote

$1.9K/wk

Full-time

Posted 6 days ago

Job description

Remote Registered Nurse – Utilization Review

Location: Fort Myers, FL 33916
Work Arrangement: Remote
Duration: Contract - 13 Weeks
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Radius Requirement: 50-mile radius rule applies — travelers only

Position Overview

We are seeking an experienced Registered Nurse – Utilization Review for a remote Utilization Management position. The ideal candidate will have strong provider-side Utilization Management experience, along with hands-on experience using Dragonfly and Epic.

This role requires an experienced RN who can independently perform utilization review activities in a remote environment and effectively collaborate with providers and healthcare teams.

Key Responsibilities
  • Perform Utilization Review and Utilization Management activities in a provider-side healthcare environment.
  • Review clinical documentation to determine medical necessity and appropriate levels of care.
  • Apply established clinical criteria, policies, and guidelines to utilization decisions.
  • Collaborate with providers, physicians, case management teams, and other healthcare professionals.
  • Review patient records and clinical information using Epic EMR.
  • Utilize Dragonfly for utilization management activities.
  • Identify potential gaps in care and escalate issues appropriately.
  • Maintain accurate and timely documentation of utilization review activities.
  • Communicate effectively with clinical and administrative teams.
  • Support organizational quality, compliance, and utilization management objectives.
  • Float to sister campuses when required.
Required Qualifications
  • Active Registered Nurse (RN) license.
  • Minimum 2 years of relevant experience.
  • Provider-side Utilization Management experience required.
    • Payer-only Utilization Management experience does not qualify.
  • Dragonfly experience required.
  • Epic EMR experience required.
  • CCM or CMCN certification required.
  • Strong clinical assessment, analytical, and documentation skills.
  • Comfortable working independently in a remote environment.
  • Strong computer skills and ability to work effectively with remote technology.
  • Must have access to a personal computer/laptop; equipment is not provided.
  • Prior travel nursing experience highly preferred.
  • Degree accreditation verification required, or 5 years of qualifying experience.
Additional Requirements
  • Must be willing to participate in an every 5th weekend rotation.
  • Must meet the 50-mile radius rule and qualify as a traveler.
  • Floating to sister campuses may be required.
  • Must be comfortable working remotely with minimal supervision.
  • Excellent communication and organizational skills required.