ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs in Delaware (NOW HIRING)

SerKy Consulting, LLC

Nurse Practitioner

Lewes, DE · Remote

$135K/yr

Provide comprehensive care management for medically complex Medicaid and Dual Eligible (D-SNP) populations through telehealth and remote monitoring * Collaborate with physicians, registered nurses ...

Amerihealth Caritas

Care Manager II

Dover, DE · Remote

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Work Arrangement: Remote with up to 50% required travel throughout the state of Delaware.

Amerihealth Caritas

Care Manager IDD

Dover, DE · Remote

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Fully Remote with required weekly travel within Kent and Sussex counties. Responsibilities:

Amerihealth Caritas

Care Manager IDD

Dover, DE · Remote

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Fully Remote with required weekly travel within Kent and Sussex counties. Responsibilities:

HHS LLC

Registered Dietitian

Dover, DE · On-site +1

$31.25 - $42/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

HHS LLC

Registered Dietitian

Wilmington, DE · On-site +1

$30 - $35/hr

Build relationships with physicians and nurses to support patient satisfaction and achieve quality ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

Nouri

Registered Dietitian

Wilmington, DE · On-site +1

$30.25 - $40.75/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

Nouri

Registered Dietitian

Milford, DE · On-site +1

$30.25 - $40.50/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

HHS LLC

Registered Dietitian

Milford, DE · On-site +1

$30.25 - $40.50/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

HHS LLC

Registered Dietitian

Wilmington, DE · On-site +1

$30.25 - $40.75/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

Nouri

Registered Dietitian

Dover, DE · On-site +1

$31.25 - $42/hr

Hybrid-Remote schedule available! Opportunity to work across a diverse group of settings, from ... Review and approve patients'/residents' daily menu, snack, and supplement programs * Communicate ...

Amerihealth Caritas

Care Manager

Millsboro, DE · Remote

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Fully Remote with required weekly travel within Sussex county and required travel though out ...

Amerihealth Caritas

Care Manager

Millsboro, DE · Remote

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Fully Remote with required weekly travel within Sussex county and required travel though out ...

next page

Showing results 1-20

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

Remote Utilization Review Rn information

See Delaware salary details

$21

$42

$69

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

As of Sep 1, 2026, the average hourly pay for remote utilization review rn 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 is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

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

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Delaware?

For Remote Utilization Review Rn jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Delaware look for?

The top searched job categories for Remote Utilization Review Rn jobs in Delaware are:

What cities in Delaware are hiring for Remote Utilization Review Rn jobs?

Cities in Delaware with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Delaware as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $88,022 per year, or $42.3 per hour.

Remote Nurse Practitioner

Purposelink Recruitment

Wilmington, DE • Remote

Full-time

Posted 26 days ago

Job description

Qualifications

Required: 2 Years Triage experience AND leadership experience.
  • Master's degree or higher in Nursing or a related clinical field
  • 2+ years of experience in any of the following:
    • Telemedicine Care
    • Care Management
  • Active clinical licensure — any of the following:
    • Nurse Practitioner (NP) – Delaware (DE)
    • Family Nurse Practitioner (FNP) – Delaware (DE)
  • OR any of the following nationally recognized NP certifications:
    • Family Nurse Practitioner (FNP)
    • Nurse Practitioner (NP)
    • Gerontological Nurse Practitioner (GNP)
Preferred
  • 1+ years of Medicaid or Dual Eligible (D‑SNP) populations
  • Experience working in interdisciplinary care teams
  • Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures
  • Background in home‑based care, transitional care, or chronic disease management
Overview

Join our client's innovative healthcare team to deliver virtual, physician‑led care for medically complex Medicaid and Dual Eligible patients across Delaware. This role offers flexibility, autonomy, and the opportunity to help launch a new market focused on proactive, home‑based care that improves patient outcomes and reduces avoidable hospitalizations.

Key Responsibilities
  • Provide comprehensive care management for medically complex Medicaid and D‑SNP patients through telehealth and remote monitoring
  • Collaborate with physicians, RNs, social workers, therapists, caregivers, PCPs, managed care organizations, and community partners
  • Guide patients and caregivers through care transitions, including hospital‑to‑home coordination and advance care planning
  • Support quality initiatives through accurate clinical documentation, including HCC coding, risk adjustment, and closure of STAR/HEDIS gaps
  • Contribute to the development of care pathways, workflows, and best practices as the Delaware program expands
  • Build strong, trusting relationships with patients, families, caregivers, and interdisciplinary team members
Schedule & Shift Details
  • Participate in a shared 24/7 clinical triage rotation to prevent avoidable emergency department visits and hospitalizations