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Remote Utilization Management Jobs in Philadelphia, PA

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Remote Utilization Management information

See Philadelphia, PA salary details

$21

$42

$69

How much do remote utilization management jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote utilization management in Philadelphia, PA is $42.67, according to ZipRecruiter salary data. Most workers in this role earn between $33.70 and $48.99 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 Philadelphia, PA?

The most popular types of Utilization Management jobs in Philadelphia, PA are:

What cities near Philadelphia, PA are hiring for Remote Utilization Management jobs?

Cities near Philadelphia, PA with the most Remote Utilization Management job openings:

Infographic showing various Remote Utilization Management job openings in Philadelphia, PA as of August 2026, with employment types broken down into 71% Full Time, and 29% Part Time. Highlights an 100% Remote job distribution, with an average salary of $88,746 per year, or $42.7 per hour.

Full-Time Licensed Clinical Social Worker (LCSW) for Remote Detox Center

Sunny Valley Psychotherapy Center

Haverford, PA • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago


Key responsibilities

  • Conduct thorough assessments to determine clients' counseling needs and formulate appropriate therapeutic interventions.

  • Utilize the DSM for accurate substance abuse diagnostics and develop treatment plans that incorporate substance abuse counseling, monitoring progress and adjusting plans as necessary.

  • Prepare discharge and continuum of care plans, document all sessions and assessments, and manage a caseload to ensure organized updates for case management and referrals.


Job description

Position Overview

Sunny Valley Psychotherapy Center is actively seeking a dedicated and experienced Licensed Clinical Social Worker (LCSW) to join our compassionate team. This full-time position offers the flexibility of a remote work setting while playing an integral role in our detox center, where you will provide vital counseling services to individuals struggling with substance use and co-occurring disorders.

About the Organization

Sunny Valley Psychotherapy Center is a national leader in addiction treatment services, committed to transforming the lives of individuals and families impacted by substance use disorders. Our mission revolves around eliminating barriers to recovery and delivering effective treatment to over 25,000 patients daily across the United States. We pride ourselves on fostering an environment of inclusivity, support, and professionalism, enabling our employees to contribute to a better world through comprehensive care.

Work Environment

This role will be conducted in a fully remote environment, allowing for flexibility and work-life balance. As part of our detox center’s team, you will collaborate closely with a network of dedicated professionals, including the Clinical Director and Executive Director, to maintain a therapeutic atmosphere conducive to recovery.

Key Responsibilities
  • Conduct thorough assessments to determine clients’ counseling needs and formulate appropriate therapeutic interventions.
  • Utilize the DSM (Diagnostic and Statistical Manual) for accurate substance abuse diagnostics to ensure each client receives the most suitable level of care according to ASAM (American Society of Addiction Medicine) criteria.
  • Develop comprehensive treatment plans that incorporate substance abuse counseling, monitor progress, and adjust plans as necessary to meet client needs.
  • Prepare discharge and continuum of care plans that facilitate smooth transitions to appropriate treatment venues, ensuring ongoing support for clients post-discharge.
  • Document all counseling sessions, assessments, and referrals meticulously in the clients’ clinical records, maintaining compliance with regulatory standards.
  • Manage a caseload effectively, ensuring timely and organized updates for case management and utilization reviews.
  • Coordinate support services for clients and their families, recording all interactions and services provided in clinical documentation.
  • Engage with referral sources such as legal entities, educational institutions, and employers to create a comprehensive support network for clients.
  • Facilitate crisis interventions using a multi-disciplinary approach to ensure immediate and effective responses to client needs.
Patient Population / Client Focus

The ideal candidate will work directly with a diverse client population that includes individuals dealing with substance use disorders and co-occurring mental health issues. You will provide individualized care that considers the unique circumstances surrounding each client, aiming to guide them towards long-term recovery and improved quality of life.

Qualifications
  • Master’s degree from an accredited institution in Social Work (MSW) and a valid LCSW license in Pennsylvania.
  • Strong understanding of substance abuse treatment methodologies, along with a commitment to continued professional development.
  • Demonstrated excellence in establishing therapeutic relationships, with a focus on cultural competency and ethical standards in practice.
  • Ability to work autonomously while exhibiting strong organization and time management skills in a remote setting.
Preferred Experience
  • At least two years of experience in a clinical setting, specifically in addiction counseling or in a detox environment.
  • Familiarity with electronic health record (EHR) systems and telehealth platforms for documenting client interactions and treatment plans.
  • Experience in working with co-occurring disorders, including mental health and substance use issues.
Compensation and Benefits

Sunny Valley Psychotherapy Center offers a competitive annual salary ranging from USD 70,000 to 100,000, commensurate with experience and qualifications. A comprehensive benefits package includes:

  • 18 days of Paid Time Off (PTO) annually for work-life balance.
  • A 401(k) retirement plan with company matching contributions to help secure your financial future.
  • Company-sponsored ongoing training and certification opportunities, promoting personal and professional growth.
  • Comprehensive health benefits, including medical, dental, vision, short-term disability, long-term disability, and accident insurance.
  • Access to the Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) to help manage educational debt.
  • Discounted tuition and scholarships at Capella University for continued education and skill enhancement.
Career Growth Opportunities

At Sunny Valley Psychotherapy Center, we recognize and nurture the potential of our employees. You will have access to numerous opportunities for professional advancement, including leadership roles, specialized training, and involvement in community outreach initiatives that further enhance your professional credentials.

Why Join Our Team

By joining the Sunny Valley Psychotherapy Center, you become part of a passionate and highly skilled team dedicated to making a positive impact on individuals and communities affected by addiction. Your contributions as an LCSW will play a critical role in saving lives and helping individuals achieve long-term recovery. Experience a supportive work environment that champions your professional journey while providing rewarding opportunities to make a difference.

Application Information

If you are ready to elevate your career and make a meaningful impact as an LCSW in a remote capacity, we invite you to apply. Please submit your resume along with a cover letter outlining your qualifications and motivations for joining our team at Sunny Valley Psychotherapy Center. We look forward to hearing from you!