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

As of Jul 13, 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 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 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 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
Infographic showing various Remote Utilization Review Rn job openings in New Mexico as of July 2026, with employment types broken down into 87% Full Time, 9% Part Time, and 4% Contract. Highlights an 50% Physical, 2% Hybrid, and 48% Remote job distribution, with an average salary of $85,227 per year, or $41 per hour.
Expert EPIC Configuration Analyst / HIM - Remote Eligible

Expert EPIC Configuration Analyst / HIM - Remote Eligible

Presbyterian Healthcare Services

Santa Fe, NM • On-site, Remote

$100K - $156K/yr

Full-time

Medical, Dental, Vision, Life

Posted 6 days ago

New

Presbyterian Healthcare Services rating

7.2

Company rating: 7.2 out of 10

Based on 160 frontline employees who took The Breakroom Quiz

328th of 882 rated healthcare providers

Job description

Location Address:
Remote OfficeSanta Fe, NM 87501
Compensation Pay Range:
Minimum Offer $100,152.00Maximum Offer $156,832.00Now Hiring: Expert EPIC Configuration Analyst / HIM - Remote Eligible
Summary:
This position is responsible for in-depth knowledge of assigned Epic System software. This position conducts regular day-to-day communication, reviews software, demonstrates a deeper understanding of business operations, and works with Epic, Subject Matter Experts, and end users to tailor the system to fit the organization's needs.Type of Opportunity: Full timeJob Exempt: YesJob is based: Remote Workers New MexicoWork Shift: Days (United States of America)
Responsibilities:
This position routinely performs in-depth analysis of workflows, data collection, and other technical issues associated with the use of Epic software; is responsible for design, build, testing, and maintain those solutions
  • Provide tier-2 support of application incidents reported through the help desk; including 24/7 on call coverage as required.
  • Perform analysis to resolve application incidents, maintenance items, enhancement requests, upgrades / updates, and projects, collaborating with colleagues and across teams.
  • Develop and maintain requirements / specifications and test cases for new or enhanced functionality to department applications. Ensure the test scripts have been created, reviewed, and updated to reflect workflow solutions.
  • Modify Epic records, tables, and master files to support the application design, additions, and changes.
  • Implement changes using documented procedures that are compliant with departments policies and procedures.
  • Actively participate and contribute in team and cross-team meetings and maintain appropriate meeting records.
  • Have expert understanding of your supported application, integration and general understanding of most all other Epic applications.
  • Work independently 100% of the time
  • Anticipate add on work and accomplish both within schedule. Role model for projects.
  • Promote teamwork within and with other teams
  • Role model for others, is well respected by team and customer
  • Make recommendations, review and test changes, enhancements, and each new release as assigned.
  • Ensure the test scripts have been created, reviewed, and updated to reflect workflow solutions.
  • Support the training team by keeping trainers abreast of new functionality and system changes.

Certifications Required:
  • HIM Deficiency Tracking Certificate
  • HIM Release of Information Certificate
  • Identity Certificate

Additional certification preferred:
  • HIM Hospital Coding

Hybrid: In office expected for individuals within 60 Miles of Albuquerque every Tues, Wed, Thurs.
Remote: Open to remote applicants in the United States, except for the following states: California, Illinois, North Dakota, New York, Ohio, Washington and Wyoming
Qualifications:
  • Bachelor's degree plus 3 years of IT or business experience.
  • 3 years of Epic specific experience. 6 years' of additional experience can be substituted in lieu of degree. Epic certified in supporting application plus additional proficiency/certification/badges in related application area

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

Sourced by ZipRecruiter

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

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