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Remote Utilization Review Manager Jobs in Hampden, MA

Robert Half

Accounting Manager

Springfield, MA · Remote

$75K - $85K/yr

Manager Accounting & Bookkeeping services - Small CPA firm Hybrid and potential for local Remote ... Review and Compilation experience. CPA or CPA in process are big pluses. The firm will consider ...

The Hartford

Nurse Case Manager

Hartford, CT · On-site +1

$69K - $104K/yr

Nurse Case Manager This fully remote or hybrid role provides telephonic case management for injured ... case reviews Required Qualifications * RN with current unrestricted state licensure * Associate ...

Finalsite

Program Manager

Glastonbury, CT · Remote

LOCATION 100% Remote - Anywhere within the US RESPONSIBILITIES * Coordinate and manage cross ... Support post-mortem reviews and lessons learned to refine operational strategies * Develop and ...

Finalsite

Program Manager

Glastonbury, CT · On-site +1

LOCATION 100% Remote - Anywhere within the US RESPONSIBILITIES * Coordinate and manage cross ... Support post-mortem reviews and lessons learned to refine operational strategies * Develop and ...

Dutch

Virtual Care Veterinarian (Remote)

Springfield, MA · Remote

$50 - $80/hr

Review medical history, symptoms, and treatment concerns shared through Dutch's digital platform ... Comfort using telehealth tools and managing consults independently What to Expect This is a 1099 ...

Dutch

Virtual Care Veterinarian (Remote)

Springfield, MA · Remote

$50 - $80/hr

Review medical history, symptoms, and treatment concerns shared through Dutch's digital platform ... Comfort using telehealth tools and managing consults independently What to Expect This is a 1099 ...

Santander

Workout Associate - Remote

Hartford, CT · On-site +1

$76K - $135K/yr

Workout Associate - Remote Country: United States of America It Starts Here: Santander is a global ... Prepare and present credit memoranda and risk assessments for management review. * Negotiation ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Hampden, MA

Remote Utilization Review Manager information

See Hampden, MA salary details

$39.5K

$92.2K

$169.6K

How much do remote utilization review manager jobs pay per year?

As of Sep 4, 2026, the average yearly pay for remote utilization review manager in Hampden, MA is $92,179.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,300.00 and $110,900.00 per year, depending on experience, location, and employer.

What is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What are popular job titles related to Remote Utilization Review Manager jobs in Hampden, MA?

For Remote Utilization Review Manager jobs in Hampden, MA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Manager jobs in Hampden, MA look for?

The top searched job categories for Remote Utilization Review Manager jobs in Hampden, MA are:

What cities near Hampden, MA are hiring for Remote Utilization Review Manager jobs?

Cities near Hampden, MA with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Benefits Coordinator (Fully Remote)

McQuade Organization

Springfield, MA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 10 days ago

Job description

In this role, you’ll support clients in understanding their benefit options and ensure they receive an exceptional experience from start to finish. This position focuses on client support, benefits guidance, and clear communication in a fully remote environment.

  • Serve as a primary point of contact for clients regarding their employee benefits
  • Explain benefit options including health, dental, vision, life, and supplemental plans in a clear, easy-to-understand way
  • Recommend solutions tailored to clients’ needs and help them make informed decisions
  • Host virtual meetings to review benefits, plan updates, and enhancements
  • Build strong client relationships and identify opportunities to expand the services they use
  • Provide responsive support to ensure a smooth and positive client experience
  • Collaborate with internal teams to ensure accurate information and timely responses
  • Act as the main point of contact for clients regarding their employee benefits, including health, dental, vision, life, disability, and retirement plans.
  • Help clients understand their benefit options, explain costs and features, and recommend solutions tailored to their organizational goals.
  • Lead individual client onboarding, ensuring smooth plan setup and seamless enrollment
  • Stay up to date on benefits offerings, company processes, and industry trends
  • Strong communication and presentation skills—you can explain complex information clearly
  • Comfortable speaking with clients via phone and video (Zoom)
  • Organized and detail-oriented, able to manage multiple client needs
  • Basic experience with CRM systems or willingness to learn (e.g., Salesforce, Ease, Gusto)
  • Self-motivated and able to work independently in a remote setting
  • Positive attitude and willingness to learn

Apply