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

Varsity Tutors

NCLEX-PN Tutor

Albuquerque, NM · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Intercare Therapy

Behavior Analyst

Albuquerque, NM · Remote

$45/hr

Starting at $45  This is a full time hourly remote position. Hours will be scheduled based on ... Supervise and train Registered Behavior Technicians (RBTs) and other support staff * Collect and ...

Intercare Therapy

Behavior Analyst

Albuquerque, NM · Remote

$45/hr

Starting at $45  This is a full time hourly remote position. Hours will be scheduled based on ... Supervise and train Registered Behavior Technicians (RBTs) and other support staff * Collect and ...

Novartis

$138K - $257K/yr

Summary #LI-Remote The Access & Reimbursement Manager, NPS Immunology - Indianapolis, IN. This is a ... Review patient-specific information in cases where the site has specifically requested assistance ...

New

Magellan Health, Inc.

Care Coordinator - NM

Albuquerque, NM · On-site +1

$17.50 - $23.75/hr

This position is remote within New Mexico. Coordinates care of individual clients with application ... RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt Salary Range ...

Cardinal Health

Evaluate and optimize distribution center operating layouts to maximize space utilization, improve ... To read and review this privacy notice click here

Argenx

$140K - $192K/yr

Effective utilization of market tools and resources * Timely submission of account plans and ... A. degree required #LI-Remote For applicants in the United States: The annual base salary hiring ...

Varsity Tutors

NCLEX Tutor

Albuquerque, NM · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

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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 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.
Remote PRN IP Facility PCS/ICD Coder

Remote PRN IP Facility PCS/ICD Coder

Presbyterian Healthcare Services

Santa Fe, NM • On-site, Remote

$22.79 - $34.80/hr

Other

Medical, Dental, Vision, Life

Posted 11 days ago

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 $22.79Maximum Offer $34.80Now Hiring: Remote PRN IP Facility PCS/ICD Coder
Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote PRN IP Facility PCS/ICD Coder to join our team.Type of Opportunity: PRNJob Exempt: NoJob is based: Remote Workers New MexicoWork Shift: Varied Days and Hours (United States of America)
Responsibilities:
Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Ensures adherence to Hospital and Departmental Policies and Procedures
Some key responsibilities include:
  • Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
  • Abstracts data essential to the QI department in determining patient care issues as well as providing information to The Joint Commission.
  • Accesses several systems via the computer to research the medical record when needed to complete the coding in a timely manner. Takes responsibility for accounts receivable by looking for lost documents to insure all encounters are coded, including the generation of appropriate queries, as needed.
  • Responsible for resolving any and all pre-bill edits, denials, etc for assigned accounts.
  • Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9/10 CM, CPT-4, HCPCS, DRG, APC and/or HHRG updates and changes.
  • Participates in all departmental in-services and updates to stay current with the accepted coding guidelines and improve personal knowledge of medicine and treatment.
  • Communicates issues to the EW Clinical Coding Manager & Supervisor, as appropriate.
  • Must demonstrate knowledge of coding multiple areas of service and/or specialties.
  • Maintains at least a 95% accuracy rate.
  • Maintains average to high productivity based on PHS Productivity Standards.
  • Maintains continuing education (CE) requirements per PHS policy

Qualifications:
  • High school diploma/GED required.
  • Must have any one of the following coding certifications at time of hire: HCS-D, CCS, CCS-P, CPC-H or CPC, or RHIT/RHIA with achievement of one of the coding credentials above within one year of hire.
  • One-three years experience as a coder required.
  • Must possess computer skills including, but not limited to, Word, Excel, PowerPoint.
  • Experience with an encoder preferred.
  • Experience with an Electronic Medical Record preferred.
  • Must be able to use the internet and other electronic resources for the purpose of research

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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