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Remote Utilization Review Nurse Jobs in Rochester, NH

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Remote Utilization Review Nurse information

See Rochester, NH salary details

$20

$41

$67

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

As of Jul 6, 2026, the average hourly pay for remote utilization review nurse in Rochester, NH is $41.38, according to ZipRecruiter salary data. Most workers in this role earn between $32.69 and $47.50 per hour, depending on experience, location, and employer.

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

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 to make $300,000 as a nurse online?

A remote utilization review nurse can potentially earn $300,000 annually by gaining specialized certifications, gaining extensive experience, and working for high-paying healthcare organizations or as a contractor. Building a strong reputation and handling complex cases can also increase earning potential, often through overtime or consulting opportunities. However, reaching this income level typically requires advanced skills, a flexible schedule, and continuous professional development.

How do I become a utilization review nurse?

To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing or case management. Many employers prefer candidates with knowledge of healthcare policies, insurance processes, and utilization review procedures, and some roles may require certification such as the Certified Professional in Healthcare Quality (CPHQ).

What does a remote utilization review nurse do?

A remote utilization review nurse evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They work remotely, often using electronic health records and communication tools, to ensure that patient care aligns with insurance or healthcare guidelines. Certification in case management or utilization review is typically required for this role.

How to become a remote nurse reviewer?

To become a remote utilization review nurse, candidates typically need a registered nurse (RN) license, relevant clinical experience, and knowledge of insurance or healthcare policies. Additional certifications such as Certified Case Manager (CCM) or Utilization Review Certification (URAC) can enhance prospects, and strong communication skills are essential for reviewing medical records and making determinations remotely.

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 job categories do people searching Remote Utilization Review Nurse jobs in Rochester, NH look for? The top searched job categories for Remote Utilization Review Nurse jobs in Rochester, NH are:
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Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Rochester, NH as of July 2026, with employment types broken down into 2% As Needed, 57% Full Time, 23% Part Time, 1% Temporary, 16% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $86,075 per year, or $41.4 per hour.

Telephonic Nurse Care Associate

Advanced Monitored Caregiving Inc.

Concord, NH • Remote

Full-time

Posted yesterday

Job description

At AMC Health, we are transforming healthcare through advanced remote patient monitoring and virtual care solutions that help patients manage chronic conditions safely at home. Our care teams play a critical role in improving outcomes, enhancing patient engagement, and reducing avoidable hospitalizations.

We are seeking a Telephonic Nurse Care Associate (LPN/LVN) who is passionate about patient engagement, chronic care support, and using technology to improve healthcare delivery.

What You’ll Do

  • Conduct telephonic clinical outreach to patients enrolled in Remote Patient Monitoring (RPM) and chronic care programs.
  • Review biometric alerts and identify out-of-range readings; escalate clinical concerns according to protocols.
  • Provide patient education and coaching to support adherence to care plans and lifestyle recommendations.
  • Accurately document patient encounters in EMR/RPM systems in compliance with clinical and regulatory standards.
  • Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams to coordinate patient care.
  • Support patient engagement initiatives designed to improve monitoring compliance and clinical outcomes.

What You Bring

  • Active LPN/LVN license in good standing.
  • 5+ years of clinical experience, including 3+ years in care coordination, telehealth, home care, or chronic disease management.
  • Experience supporting patients with conditions such as CHF, COPD, diabetes, or hypertension preferred.
  • Strong telephonic communication, patient education, and motivational interviewing skills.
  • Experience using EMR/EHR systems and comfort working in a technology-enabled care environment.
  • Ability to work independently in a structured remote clinical workflow.

Why AMC Health

  • Fully remote clinical role supporting patients nationwide
  • Opportunity to work at the forefront of virtual care innovation
  • Collaborative interdisciplinary care teams
  • Meaningful work improving patient outcomes every day
  • Growth opportunities within expanding virtual care programs

Work Environment Requirements

  • Private, secure, distraction-free home workspace
  • Reliable high-speed internet connectivity
  • Ability to work schedules aligned with assigned patient populations or client time zones

Apply