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

firsthand Health

Remote Triage Nurse

Albuquerque, NM · Remote

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is ...

Ourhrconnect

... Registered Nurse, including two years in the following specialty area(s): Outpatient Surgical, Pain Management, Cosmetic Surgery, Prior Authorization, Medical Review, Medicare Part A, or Utilization ...

Ourhrconnect

... Registered Nurse, including two years in the following specialty area(s): Outpatient Surgical, Pain Management, Cosmetic Surgery, Prior Authorization, Medical Review, Medicare Part A, or Utilization ...

Varsity Tutors

NCLEX-RN Tutor

Albuquerque, NM · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Albuquerque, NM · On-site +1

$55.50 - $67.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Albuquerque, NM · On-site +1

$55.50 - $67.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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Remote Utilization Review Rn information

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

As of Jun 12, 2026, the average hourly pay for remote utilization review rn in New Mexico is $40.97, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.07 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

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

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 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 is the meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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 are the most commonly searched types of Utilization Review Rn jobs in New Mexico? The most popular types of Utilization Review Rn jobs in New Mexico are:
What are popular job titles related to Remote Utilization Review Rn jobs in New Mexico? For Remote Utilization Review Rn jobs in New Mexico, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in New Mexico look for? The top searched job categories for Remote Utilization Review Rn jobs in New Mexico are:
What cities in New Mexico are hiring for Remote Utilization Review Rn jobs? Cities in New Mexico with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Remote Triage Nurse

firsthand Health

Albuquerque, NM • Remote

Other

Posted 9 days ago

Job description

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is primarily a day-shift role (8 hours/day, 8:30-4:30 PST), with occasional potential for nights or weekends. When not managing acute issues, Triage Nurses focus on care coordination, training, and related administrative tasks.

Responsibilities of a Triage Nurse include:
  • Triage and Escalation: Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately and escalate emergencies immediately.
  • Collaboration: Work closely with peer mental health workers, social workers, and APPs to address acute issues comprehensively.
  • Coordination: Coordinate care with patients' other providers to ensure seamless health management.
  • Training: Develop and deliver training on basic medical topics for peer mental health workers and social workers.
Triage Nurses should have:
  • Strong triage and prioritization skills, with the ability to rapidly assess and determine the appropriate level of care.
  • Problem-solving expertise with a creative, patient-centered approach.
  • Ability to provide condition-specific patient education and self-management guidance.
  • Adaptability to varying team cultures and processes.
  • Empathy, compassion, and approachability in patient and team interactions.
Required experience includes:
  • Active RN license through a Nurse Licensure Compact (NLC) state and willingness to obtain licensure in non-compact states.
  • Bachelor of Science in Nursing (BSN) or Associates of Nursing (ASN)
  • At least 3 years of Emergency Room (ER) experience 
  • Experience working with populations facing challenges such as serious mental illness, behavioral health conditions, and/or substance use disorders
  • Care management and coordination experience.
Bonus Points for:
  • Psychiatric-Mental Health Nursing Certification (PMH-BC)
  • Washington state RN license

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