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Remote Utilization Management Jobs in Williamstown, NJ

PONOS MGMT INC

New Jersey-RN Case Manager

Camden, 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 ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Williamstown, NJ

Remote Utilization Management information

See Williamstown, NJ salary details

$21

$41

$68

How much do remote utilization management jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for remote utilization management in Williamstown, NJ is $41.84, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.03 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 Williamstown, NJ look for?

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

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

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

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Williamstown, NJ as of August 2026, with employment types broken down into 17% As Needed, and 83% Full Time. Highlights an 100% Remote job distribution, with an average salary of $87,029 per year, or $41.8 per hour.

Medical Director (MD) - remote (PA/NJ/DE)

Independence Blue Cross

Philadelphia, PA • On-site, Remote

Full-time

Re-posted 11 days ago

Independence Blue Cross rating

8.8

Company rating: 8.8 out of 10

Based on 26 frontline employees who took The Breakroom Quiz

55th of 311 rated insurance

Job description

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
Schedule: 5 days (Mon-Fri, 8:30-5p), ** on-call requirement: Saturday and Sunday full workday, approx. every 12 weeks, depending on number of MDR's.
The Medical Director serves as a physician leader responsible for promoting the delivery of safe and effective medical care in the most cost-effective way for the health plans offered by Independence Blue Cross and subsidiaries. There are multiple elements of discrete work that may fall under the role including:
Utilization Management
The physician directly supports Utilization Management and Care Management and other business activities where involvement of a physician is determined to be in the best interest of Independence. The Medical Director will be responsible for rendering coverage and payment determinations based on the terms and conditions of the health plans for which Independence serves as claims administrator, and on the terms and conditions of contracts executed between Independence and networks of participating health care providers.
The Medical Director will exercise sound decision making based on clinical guidelines for best practices, a strong knowledge of clinical medicine, the practical realities of the delivery of health care in the state of Pennsylvania, and a thorough understanding of the principles of population health, quality management, patient safety and health insurance. The Medical Director will be expected to effectively collaborate with professional staff, senior leadership, management and associates and with external partners to promote the delivery of cost-effective health care across all lines of business.
Required Qualifications and Experience:
  • We require a Medical Doctor or Doctor of Osteopathy degree from a medical school or osteopathic medical school recognized by the American Association of Medical Colleges (AAMC), the American Osteopathic Association (AOA), or the World Health Organization (WHO).
  • Has an unrestricted and unencumbered Pennsylvania license to practice clinical medicine or osteopathic medicine.
  • Current Board Certification by ABMS or AOBMS - family medicine, internal medicine or pediatrics board certification preferred
  • Ability to successfully complete Independence Blue Cross credentialing process

Fully Remote:
This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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