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Remote Utilization Review Nurse Jobs in Delaware

ChristianaCare

NP/PA - Virtual Swingternist

Newark, DE · On-site +1

$2.7K/wk

The selected virtual swingternist candidate will provide remote clinical management to patients at ... Assesses health status of assigned patients through complete medical history and chart review

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All JobsUtilization Review Nurse JobsRemote Utilization Review Nurse JobsRemote Utilization Review Nurse Jobs in Delaware

Remote Utilization Review Nurse information

See Delaware salary details

$21

$42

$69

How much do remote utilization review nurse jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for remote utilization review nurse in Delaware is $42.32, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $48.61 per hour, depending on experience, location, and employer.

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

To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.

How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?

As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.

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

AspectRemote Utilization Review NurseRemote Case Manager
CertificationsRN license, possibly CCM or UR certificationsRN license, CCM or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, telehealthInsurance companies, healthcare organizations, telehealth
Job FocusReview medical necessity, approve or deny servicesCoordinate patient care, arrange services, discharge planning

Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.

What is a remote utilization review nurse?

A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.

What does a remote utilization review nurse do?

As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.

More about Remote Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Delaware? The most popular types of Utilization Review Nurse jobs in Delaware are:
What are popular job titles related to Remote Utilization Review Nurse jobs in Delaware? For Remote Utilization Review Nurse jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Nurse jobs in Delaware look for? The top searched job categories for Remote Utilization Review Nurse jobs in Delaware are:
What cities in Delaware are hiring for Remote Utilization Review Nurse jobs? Cities in Delaware with the most Remote Utilization Review Nurse job openings:
Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Delaware as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $88,022 per year, or $42.3 per hour.

Nurse, Virtual RN *$5000 Signing Bonus*

Westside Family Healthcare, Inc.

New Castle, DE • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

Job description

Job Type
Full-time
Description
WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM!
SIGN ON BONUS OFFERED!
LOAN PAYOFF PROGRAMS AVAILABLE!
Join our dedicated healthcare team as a nurse, where each day presents a new opportunity to make a significant difference in the lives of our patients.
The Virtual RN is an experienced Registered Nurse (RN) working as part of a multidisciplinary team supporting general care processes, providers, and patients in an ambulatory community-based setting. The RN is responsible for evaluating and assessing patient's health care needs based on nurse assessment, clinical judgment, nurse process and evidence-based clinical support tools. The RN will provide appropriate disposition and timely follow up, per telephone triage policy. The RN must meet minimum quality and productivity standards as defined by Westside Family Healthcare.
Since opening our doors in 1988, Westside has been driven by our mission to improve the health of our communities by providing equal access to quality healthcare, regardless of ability to pay. With 240 team members, five health centers, one mobile health unit and over 27,000 patients all across Delaware, Westside is committed to improving health, one patient, one family, one community at a time.
Our Mission: To improve the health of our communities by providing equal access to quality healthcare, regardless of ability to pay
Our Vision: Achieve health access for all
Our Values:
  • Compassion: Lead with compassion
  • Service: Serve with humility
  • Excellence: Be exceptional
  • Empowerment: Empower all people

OUR BENEFITS: Our benefit package includes medical insurance, dental insurance, vision insurance, life and disability insurance, a 401(k) retirement plan with a match, and supplemental insurances. We offer a generous PTO package and flexibility to provide work/life balance. Westside Family Healthcare is an Equal Opportunity Employer that values diversity.
RESPONSIBILITIES of the Virtual RN Nurse role
1. Provide telephonic clinical assessment, health education and utilization management services across the life span,
2. Care coordination for patients, including prior authorization; identifying and seeking solutions for barriers to care
3. Provide telephonic triage for patients seeking care with multiple complaints
4. Assessment and provision of care using telecommunication devices
5. Application of the nursing process in telehealth care
6. Delivery of culturally sensitive, age-specific care to identified populations
7. Use of clinical decision support tools
8. Provide effective therapeutic communication, counsel and crisis management
9. Handle multiple in bound calls and ability to complete out-bound calls
10. Other duties as assigned.
Requirements
  1. Graduate of an accredited college or school of nursing with an Associates' degree in nursing
  2. Active, unencumbered Registered Nurse licensure in the State of Delaware or compact state
  3. Proficient with technology
  4. Two years of work experience in an ambulatory care, emergency services, med/surg, and/or pediatrics

Westside Family Healthcare is currently registered to employ remote workers in the following states: Arizona, Delaware, Maryland, North Carolina, Nebraska, New Jersey, Pennsylvania, Puerto Rico, Rhode Island, Texas, Virginia and West Virginia.

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