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Remote Utilization Management Jobs in Worcester, MA

Thea Pharma Inc.

Director of Payer Strategy

Waltham, MA · Remote

Remote with business travel requirements including visits to the Waltham office for collaboration ... Monitor payer coverage decisions, utilization management policies, prior authorization requirements ...

New

Sanofi EU

Oncology Account Manager

Worcester, MA · Remote

$125K - $208K/yr

Remote, US About the Job The Oncology Area Business Manager (ABM) is accountable for achieving ... Utilization of effective selling techniques and marketing strategies to create and expand product ...

UnitedHealth Group

Customer Service Representative

Auburn, MA · Remote

$16 - $21.75/hr

This position is Remote in Auburn, MA. You will have the flexibility to work remotely* as you take ... Under direct supervision, assists patients through management of incoming calls related to various ...

Brown & Brown Insurance

Consultant

Southborough, MA · On-site +1

$100K - $125K/yr

This role offers flexibility with remote or hybrid work options. As a Consultant, you will manage ... Analyze data and financial metrics , conduct utilization reviews, and perform peer audits to ...

Sanofi EU

Area Business Manager - Dupixent

Worcester, MA · Remote

$125K - $180K/yr

Remote, (geography: El Paso, TX, Albuquerque, NM, Tucson, AZ) About the Job: Sanofi focuses on ... Highly organized with strong account management skills. Why Choose Us? * Bring the miracles of ...

Rocket Software

Director, Benefits

Waltham, MA · Remote

$140K - $196K/yr

Develop and manage benefits budgets, forecasts, and long-range cost projections. * Oversee ... Analyze claims experience, utilization trends, and cost drivers to optimize program effectiveness ...

VIVA USA INC

Nurse Case Manager

Woonsocket, RI · On-site +1

Must have experience working a remote position previously. Must have case management experience. Notes : Monday- Friday 8am - 5pm EST Remote VIVA is an equal opportunity employer. All qualified ...

VIVA USA INC

Nurse Case Manager

Woonsocket, RI · On-site +1

Must have experience working a remote position previously. Must have case management experience. Notes : Monday- Friday 8am - 5pm EST Remote VIVA is an equal opportunity employer. All qualified ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Worcester, MA

Remote Utilization Management information

See Worcester, MA salary details

$21

$42

$68

How much do remote utilization management jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for remote utilization management in Worcester, MA is $42.19, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.46 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

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.

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 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 popular job titles related to Remote Utilization Management jobs in Worcester, MA? For Remote Utilization Management jobs in Worcester, MA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Worcester, MA look for? The top searched job categories for Remote Utilization Management jobs in Worcester, MA are:
What cities near Worcester, MA are hiring for Remote Utilization Management jobs? Cities near Worcester, MA with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Worcester, MA as of July 2026, with employment types broken down into 76% Full Time, 18% Part Time, 1% Temporary, and 5% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $87,755 per year, or $42.2 per hour.
Facility Medical Director

Facility Medical Director

University of Massachusetts Medical School

Worcester, MA • On-site, Remote

$300K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Job description

The University of Massachusetts Chan Medical School (UMass Chan) seeks a board-certified psychiatrist to serve as the Facility Medical Director (FMD) for The Cape Cod and the Islands Community Mental Health Center in Pocasset, MA.

Successful candidates will receive a faculty appointment that includes Department of Psychiatry support for clinical, training and research. There is the option for voluntary night, weekend and holiday coverage with highly competitive reimbursement.


  • Serve as the Facility Medical Director (FMD) for The Cape Cod and Islands Community Mental Health Center, acting as the chief physician and clinical leader for both inpatient and partial hospitalization programs.
  • Oversee the delivery of high-quality clinical care and treatment across all services.
  • Lead the development, implementation, evaluation, and continuous improvement of all clinical programs within the Center.
  • Ensure the maintenance of professional practice standards, including staff composition, performance evaluation, education, and ongoing training.
  • Direct the recruitment, scheduling, and supervision of psychiatrists and advanced practice nurses assigned through this contract, including UMass Chan Medical School clinicians, credentialed per diem providers, and locum tenens staff.
  • Provide medical leadership to ensure compliance with CMS, Joint Commission, DMH, and DPH standards, and support preparation for all licensure and accreditation reviews.
  • Collaborate with DMH service providers and contracted agencies, offering clinical consultation as appropriate.
  • Oversee key operational areas including utilization management, risk management, support of DMH initiatives, and clinical and psychopharmacology services.
  • Participate in research activities, with opportunities for protected time based on experience and organizational goals.

Required: 

  • Board-certified Psychiatrist

This position is eligible for a hybrid/remote schedule combining regularly scheduled on-site time at the facility in Pocasset, MA, and remote/virtual coverage.

Benefits:

  • Access to comprehensive health, dental, and vision insurance.
  • Enroll in either the Massachusetts State Retirement Board pension scheme (defined benefit) or the ORP (defined contribution plan).
  • 14 paid holidays annually, vacation and sick time, and educational days, totaling more than 8 weeks.
  • Annual professional education stipend.

UMass-sponsored J1- Conrad waiver / H1b visa and Green Card applications. This position qualifies for the DMH loan repayment program.

In addition to base pay, UMass Chan offers a comprehensive Total Rewards package, which includes paid time off, medical, dental, and vision coverage, and participation in a 401A retirement plan

Diversity, equity, and inclusion are integral to the commitment of the Department and University. Accordingly, the Department encourages applications from qualified candidates who can contribute to racial equity, diversity, and inclusion through service, mentorship, teaching, and scholarship.

As an equal opportunity and affirmative action employer, UMass Chan recognizes the added value of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.

For additional information about our mission-driven Department of Psychiatry please view our website at https://www.umassmed.edu/psychiatry/hiring-mission/non-facultypositions/

For questions about this position, please contact Brian Daly, MD, Vice Chair, Public Sector Psychiatry (brian.daly@umassmed.edu).


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