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Remote Utilization Review Rn Jobs in Albany, NY (NOW HIRING)

aptihealth

RN, Case Manager (NY | Remote)

Clifton Park, NY · Remote

$33.65 - $38.46/hr

The RN Case Manager ensures high-quality, patient-centered care while maintaining compliance with ... Conduct medical reviews and gather additional patient history as needed * Obtain and manage ...

aptihealth

RN, Case Manager (NY | Remote)

Clifton Park, NY · Remote

$33.65 - $38.46/hr

The RN Case Manager ensures high-quality, patient-centered care while maintaining compliance with ... Conduct medical reviews and gather additional patient history as needed * Obtain and manage ...

NFP Corp

Broker/Senior Broke, Commercial Insurance

Albany, NY · On-site +1

$97K - $115K/yr

To support hybrid/remote work, candidates must have access to a reliable, confidential, and ... Oversee the review of binders and policies to ensure terms and conditions are accurately reflected

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Albany, NY

Remote Utilization Review Rn information

See Albany, NY salary details

$21

$41

$68

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

As of Jul 27, 2026, the average hourly pay for remote utilization review rn in Albany, NY is $41.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 popular job titles related to Remote Utilization Review Rn jobs in Albany, NY? For Remote Utilization Review Rn jobs in Albany, NY, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Albany, NY look for? The top searched job categories for Remote Utilization Review Rn jobs in Albany, NY are:
What cities near Albany, NY are hiring for Remote Utilization Review Rn jobs? Cities near Albany, NY 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 Albany, NY as of July 2026, with employment types broken down into 75% Full Time, and 25% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,319 per year, or $42 per hour.
RN, Case Manager (NY | Remote)

RN, Case Manager (NY | Remote)

aptihealth

Clifton Park, NY • Remote

$33.65 - $38.46/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Job description

Life at aptihealth
aptihealth is a fast-growing health tech company transforming behavioral healthcare. Our digital platform and affiliated medical group make it easier for people to access high-quality care when and where they need it. You’ll join a mission-driven team that’s curious, collaborative, and passionate about improving lives through technology and care innovation. Here, ideas turn into action and learning happens every day. We’re proud to be named one of the world’s top health tech companies of 2025, recognized for advancing digital behavioral healthcare. Together, we’re building a better, more accessible future for mental health.

What We Offer

  • The chance to make life better for millions of people
  • Smart, supportive colleagues who care about what they do
  • A place where new ideas quickly turn into real results
  • A culture that values curiosity, collaboration, and inclusion
  • A team built on trust, accountability, and continuous learning


Your Role

The Registered Nurse Case Manager is a key member of AptiHealth’s Case Management and Medication Management programs, supporting both patients and providers across the care continuum. This role assesses patient needs, develops and implements care plans, coordinates care and medications, triages urgent patient concerns, and supports clinical operations in collaboration with the multidisciplinary care team. The RN Case Manager ensures high-quality, patient-centered care while maintaining compliance with company policies and regulatory requirements.

Responsibilities

  • Complete case management assessments and develop care plans
  • Collaborate with the care team to identify patient needs and coordinate care
  • Document all patient interactions and care coordination activities
  • Triage patient calls and electronic communications, escalating concerns as appropriate
  • Support prescribers with prior authorizations, refills, pharmacy coordination, and scheduling based on clinical need
  • Conduct medical reviews and gather additional patient history as needed
  • Obtain and manage required patient consents and releases of information
  • Educate and onboard patients into AptiHealth’s Medication Management Program
  • Assess patient response to treatment and medications
  • Connect patients with community resources and support services to address social determinants of health
  • Conduct proactive telephonic outreach to patients based on clinical needs

Requirements

  • Active Registered Nurse (RN) license in New York required
  • Graduate of an accredited nursing program; BSN preferred
  • Certified Case Manager (CCM) certification preferred
  • Behavioral health or psychiatric care experience strongly preferred
  • Experience supporting care coordination and case management workflows
  • Proficiency with Electronic Medical Record (EMR) systems and Microsoft Office applications
  • Strong organizational, communication, and clinical triage skills
  • Ability to work collaboratively within a multidisciplinary care team
  • Comfortable working in a fast-paced, patient-centered virtual care environment

Benefits

  • Comprehensive Medical, Dental, and Vision plans available
  • Paid Time off, Sick Time and Paid Company Holidays
  • 401k Retirement Savings Program with 2% Company matching
  • Voluntary Life Insurance
  • Employee Assistant Program (EAP)
  • Competitive Salary
  • Work from home

Job Type: Full-time / Hourly (40 hours / week)
Working Hours: Monday – Friday 8am – 4:30pm
Location: Remote / NY
Pay Rate: $33.65- $38.46/hr

About aptihealth
aptihealth, inc. is a behavioral health engagement company that seamlessly integrates physical and behavioral healthcare. Our platform connects medical providers, behavioral health specialists and patients with our proprietary assessment and treatment management protocols to get and keep patients healthier faster. aptihealth’s structured therapy programs are centered on its proprietary 15 Life Domain Clinical Framework© that efficiently provides collaborative care teams with the most thorough understanding of a patient’s behavioral health needs. For more information, please visit www.aptihealth.com

To all recruitment agencies: aptihealth does not accept agency resumes. Please do not forward resumes to us, our employees or any other organization location. aptihealth is not responsible for any fees related to unsolicited resumes.

aptihealth, inc. | 1785 Route 9, Clifton Park, NY 12065