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Remote Utilization Management Jobs in New York (NOW HIRING)

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...

Medical Director

New York, NY · Remote

$225K - $300K/yr

Remote (must have an active medical license in NY, PA or WV) PAY RATE : $135- $178/hr. W2 ... utilization management responsibilities are performed in accordance with the highest and most ...

This position will be remote within the designated market with occasional in-home patient treatment ... medical utilization management, and risk adjustment. * Current state medical license without ...

Showing results 41-60

Remote Utilization Management information

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 York?

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

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

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

Infographic showing various Remote Utilization Management job openings in New York as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 85% Physical, 3% Hybrid, and 12% Remote job distribution.

Licensed Clinical Social Worker - Remote - Hospice Center

Phoebe Putney Health Solutions

Yonkers, NY • Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Posted yesterday

New


Job description

Position Overview

Phoebe Putney Health Solutions is seeking a compassionate and skilled Licensed Clinical Social Worker (LCSW) to join our dedicated remote team. In this full-time role, you will play a vital part in providing exceptional mental health support to our patients, specifically focusing on individuals in a hospice setting. Your expertise will help foster emotional well-being, aid in communication with families, and facilitate discharge planning, all essential for enhancing the quality of life for our patients.

About the Organization

Phoebe Putney Health Solutions is a leader in delivering comprehensive healthcare services, with a strong emphasis on mental health. We pride ourselves on creating a supportive and empathetic environment that acknowledges the diverse backgrounds, identities, and needs of our clients. Our mission is to provide holistic care that promotes healing and personal growth within a nurturing space.

Work Environment

This position is fully remote, allowing you to work from the comfort of your own home while still being an integral part of our team. The flexibility of working in a remote setting does not diminish the collaborative spirit we foster among our staff. You will have access to virtual meetings, team-building activities, and ongoing training that reinforce our commitment to providing top-notch care.

Key Responsibilities
  • Serve as a liaison between patients, families, and outpatient service providers to ensure seamless communication and care coordination.
  • Engage in interactions with insurance companies for pre-certification processes and utilization management to secure necessary services for clients.
  • Participate in discharge and aftercare planning to facilitate safe transitions for patients back to their home environments.
  • Provide therapeutic meal support, educating clients on developing a healthy relationship with food while promoting mental well-being.
  • Deliver care that is safe, empathetic, and affirmatively acknowledges the unique contexts and intersecting identities of each client.
Patient Population / Client Focus

Our focus is primarily on older adults who may be dealing with complex psychological and emotional challenges associated with end-of-life issues. You will work closely with patients facing serious ailments, providing not just assistance in coping with their health conditions but also offering emotional support and facilitating dignity in their final stages of life. Your work will significantly impact their families, helping them navigate this sensitive period with understanding and compassion.

Qualifications
  • Master's degree in Social Work from an accredited institution is required.
  • Possession of a valid Licensed Clinical Social Worker (LCSW) license in New York is mandatory.
  • Demonstrated experience working with the geriatric population is essential.
  • Strong clinical and diagnostic skills to assess and address various mental health issues effectively.
  • Superior communication and interpersonal skills are crucial for working collaboratively with families and team members.
  • The ability to work independently while also being a team player in a remote environment is necessary.
Preferred Experience
  • Experience with hospice care and understanding of palliative care principles will be highly regarded.
  • Prior involvement in multi-disciplinary care teams that focus on holistic patient approaches is advantageous.
  • Familiarity with electronic health record (EHR) systems is preferred, ensuring accurate documentation and data management.
Compensation and Benefits

Phoebe Putney Health Solutions offers a competitive salary ranging from USD 90,000 to 105,000 per year, commensurate with experience and qualifications. In addition to a robust salary, we provide comprehensive benefits including:

  • Medical, dental, and vision coverage for you and your family.
  • A 401(k) plan with matching contributions and flexible spending accounts.
  • Life insurance and options for accidental and short-term disability coverage.
Career Growth Opportunities

At Phoebe Putney Health Solutions, we are committed to the professional development of our staff. We offer ongoing training, access to continuing education programs, and opportunities for advancement within our organization. Your contributions are not just valued; they are recognized, and we strive to support your career journey.

Why Join Our Team

Joining Phoebe Putney Health Solutions means being part of a team that deeply cares about making a difference in the lives of patients and their families. We are dedicated to inclusivity, collaboration, and supporting each other in a work culture that promotes empathy and kindness. Your skills and empathy can truly transform the experiences of those we serve as we work together towards common goals.

Application Information

If you are a driven and compassionate Licensed Clinical Social Worker looking to make a meaningful impact in hospice care, we invite you to apply today. Become part of a purpose-driven organization that is committed to making a difference in the lives of our patients and their families.