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Remote Utilization Review Rn Jobs in New Jersey (NOW HIRING)

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

National Nurse Triage Inc

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over ... Registered Nurse; preferably in the ICU, ED, Mother/Baby unit, Peds, Home Health & Hospice ...

National Nurse Triage Inc

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over ... Registered Nurse; preferably in the ICU, ED, Mother/Baby unit, Peds, Home Health & Hospice ...

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

As of Aug 31, 2026, the average hourly pay for remote utilization review rn in New Jersey is $42.93, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $49.28 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 New Jersey?

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

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

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

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

Cities in New Jersey 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 New Jersey as of August 2026, with employment types broken down into 61% Full Time, 28% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,286 per year, or $42.9 per hour.

Remote Registered Nurse - Utilization Review - RRNUR 26-10215

Princeton, NJ • Remote

Compu-Vision - Healthcare
See more jobs at Compu-Vision - Healthcareexternal

$1.9K/wk

Full-time

Posted 6 days ago

Job description

Remote Registered Nurse – Utilization Review

Location: Fort Myers, FL 33916
Work Arrangement: Remote
Duration: Contract - 13 Weeks
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Radius Requirement: 50-mile radius rule applies — travelers only

Position Overview

We are seeking an experienced Registered Nurse – Utilization Review for a remote Utilization Management position. The ideal candidate will have strong provider-side Utilization Management experience, along with hands-on experience using Dragonfly and Epic.

This role requires an experienced RN who can independently perform utilization review activities in a remote environment and effectively collaborate with providers and healthcare teams.

Key Responsibilities
  • Perform Utilization Review and Utilization Management activities in a provider-side healthcare environment.
  • Review clinical documentation to determine medical necessity and appropriate levels of care.
  • Apply established clinical criteria, policies, and guidelines to utilization decisions.
  • Collaborate with providers, physicians, case management teams, and other healthcare professionals.
  • Review patient records and clinical information using Epic EMR.
  • Utilize Dragonfly for utilization management activities.
  • Identify potential gaps in care and escalate issues appropriately.
  • Maintain accurate and timely documentation of utilization review activities.
  • Communicate effectively with clinical and administrative teams.
  • Support organizational quality, compliance, and utilization management objectives.
  • Float to sister campuses when required.
Required Qualifications
  • Active Registered Nurse (RN) license.
  • Minimum 2 years of relevant experience.
  • Provider-side Utilization Management experience required.
    • Payer-only Utilization Management experience does not qualify.
  • Dragonfly experience required.
  • Epic EMR experience required.
  • CCM or CMCN certification required.
  • Strong clinical assessment, analytical, and documentation skills.
  • Comfortable working independently in a remote environment.
  • Strong computer skills and ability to work effectively with remote technology.
  • Must have access to a personal computer/laptop; equipment is not provided.
  • Prior travel nursing experience highly preferred.
  • Degree accreditation verification required, or 5 years of qualifying experience.
Additional Requirements
  • Must be willing to participate in an every 5th weekend rotation.
  • Must meet the 50-mile radius rule and qualify as a traveler.
  • Floating to sister campuses may be required.
  • Must be comfortable working remotely with minimal supervision.
  • Excellent communication and organizational skills required.