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Remote Utilization Management Jobs in Hopewell, NJ

Northpointe Staffing Professionals

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Healthcare - Managed Care Coordinator

Hopewell, NJ · Remote

$20/hr

*Remote role but requires travel to Hopewell at least once a month* This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians ...

New

Monogram Health

Market Physician Executive

Trenton, NJ · Remote

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 ...

PONOS MGMT INC

New Jersey-RN Case Manager

Somerset, NJ · Remote

$45 - $60/hr

... emergency department utilization while enhancing quality metrics (HEDIS/STAR) and member ... between remote case management and mobile healthcare delivery, ensuring high-quality, patient ...

PONOS MGMT INC

New Jersey-RN Case Manager

Trenton, NJ · Remote

$45 - $60/hr

... emergency department utilization while enhancing quality metrics (HEDIS/STAR) and member ... between remote case management and mobile healthcare delivery, ensuring high-quality, patient ...

PONOS MGMT INC

New Jersey-RN Case Manager

Warren, NJ · Remote

$45 - $60/hr

... emergency department utilization while enhancing quality metrics (HEDIS/STAR) and member ... between remote case management and mobile healthcare delivery, ensuring high-quality, patient ...

TechData Service Company LLC

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Remote Digital Twin Engineer (Simio)

Raritan, NJ · Remote

$40 - $45/hr

Remote or Hybrid (Raritan, NJ) - Ideally, the manager would like someone who can work HYBRID, but ... Analyze simulation results to identify bottlenecks, optimize resource utilization, and support ...

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Remote Utilization Management information

See Hopewell, NJ salary details

$22

$43

$71

How much do remote utilization management jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for remote utilization management in Hopewell, NJ is $43.78, according to ZipRecruiter salary data. Most workers in this role earn between $34.62 and $50.29 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 job categories do people searching Remote Utilization Management jobs in Hopewell, NJ look for?

The top searched job categories for Remote Utilization Management jobs in Hopewell, NJ are:

What cities near Hopewell, NJ are hiring for Remote Utilization Management jobs?

Cities near Hopewell, NJ with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Hopewell, NJ as of June 2026, with employment types broken down into 1% Internship, 23% Full Time, 73% Part Time, and 3% Contract. Highlights an 47% Physical, 3% Hybrid, and 50% Remote job distribution, with an average salary of $91,056 per year, or $43.8 per hour.

Healthcare - Managed Care Coordinator

Northpointe Staffing Professionals

Hopewell, NJ • Remote

$20/hr

Temporary

This job post has expired today. Applications are no longer accepted.

Job description

*Remote role but requires travel to Hopewell at least once a month*


This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.
Responsibilities:

·       Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.

·       Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.

·       Prepare, document and route cases in appropriate system for clinical review.

·       Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.

·       Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.

·       Reviewing professional medical/claim policy related issues or claims in pending status.

·       Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening

·       Perform other relevant tasks as assigned by Management.

Qualifications:

·       Education: - High School Diploma required. Some College preferred.

·       Prefer 1-2 years customer service or medical support related position.

·       Requires knowledge of medical terminology

·       Requires Good Oral and Written Communication skills

·       Requires ability to make sound decisions under the direction of Supervisor

·       Prefer knowledge of contracts, enrollment, billing & claims coding/processing

·       Prefer knowledge Managed Care principles

·       Prefer the ability to analyze and resolve problems with minimal supervision

·       Prefer the ability to use a personal computer and applicable software and systems

·       Team Player, Strong Analytical, Interpersonal Skills