2

Remote Utilization Review Rn Jobs in Andover, MA

Senior Nurse Reviewer

Somerville, MA · On-site +1

$79K - $115K/yr

Registered Nurse [RN - MA State License] - required * 3+ years of experience in clinical nursing ... Remote, M-F eastern standard business hours. Requires a quiet, secure, HIPAA-compliant working ...

Senior Nurse Reviewer

Somerville, MA · Remote

$79K - $115K/yr

Registered Nurse [RN - MA State License] - required * 3+ years of experience in clinical nursing ... Remote, M-F eastern standard business hours. Requires a quiet, secure, HIPAA-compliant working ...

Large managed care company is looking for Clinical Review Nurses for a contract to hire position ... FULLY REMOTE but must live in MA PAY: $25.00 CONTRACT DATES: CONTRACT TO HIRE HOURS: M-F, 8am-5pm ...

Large managed care company is looking for Clinical Review Nurses for a contract to hire position ... FULLY REMOTE but must live in MA PAY: $25.00 CONTRACT DATES: CONTRACT TO HIRE HOURS: M-F, 8am-5pm ...

Clinical Appeals RN

Boston, MA · Remote

$28.94 - $51.83/hr

... review of services. Works closely with managers and peers. If you currently reside in the state of ... Utilization Management experience * Appeals Experience * Medicare/Medicaid experience preferred

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 ...

NCLEX-RN Tutor

Lynn, MA · 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 ...

next page

Showing results 1-20

Remote Utilization Review Rn information

See Andover, MA salary details

$21

$42

$69

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

As of Jun 19, 2026, the average hourly pay for remote utilization review rn in Andover, MA is $42.83, according to ZipRecruiter salary data. Most workers in this role earn between $33.85 and $49.18 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 cities near Andover, MA are hiring for Remote Utilization Review Rn jobs? Cities near Andover, MA with the most Remote Utilization Review Rn job openings:
Registered Nurse (Mental Health Substance Treatment)

Registered Nurse (Mental Health Substance Treatment)

Veterans Health Administration

Bedford, MA • On-site, Remote

$90K - $178K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 971 frontline employees who took The Breakroom Quiz

69th of 873 rated healthcare providers


Job description

Summary
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.
Learn more about this agency
Duties
Help
The Registered Nurse Mental Health Substance Treatment Program (STP) is responsible for providing competent, evidence-based care to assigned patients. The Registered Nurse Mental Health Substance Treatment Program (STP) will assist in directing the provision of nursing education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The Registered Nurse Mental Health Substance Treatment Program (STP) gains awareness of the principles and goals of outpatient Mental Health Substance Treatment Program by understanding practices related to patient-centered care, recovery-oriented principles, and self-awareness related to caring for patients living with substance use conditions. The Registered Nurse Mental Health Substance Treatment Program provides direct patient care including substance use disorder (SUD) treatment and clinical support. The Registered Nurse Mental Health Substance Treatment Program provides acute and routine psychiatric assessment and intervention for a variety of psychosocial, SUD, and medical concerns and assists the STP staff in developing a recovery-based plan of care for the patient. This Registered Nurse Mental Health Substance Treatment Program is located in the Nursing Service, Mental Mental Health at the VA Bedford Healthcare System, MA. This position is full-time at 40 hours per week.
Major duties and responsibilities include, but are not limited to, the following:
  • Leads the provision of nursing care to patients with complex care needs utilizing the nursing process in alignment with the ANA Standards of Nursing Practice.
  • Applies clinical knowledge/judgment to lead staff involvement in planning, decision-making, and evaluating outcomes within the immediate practice setting.
  • Effectively functions as a leader, with demonstrated outcomes, for the immediate practice setting.
  • Independently plans and delivers technically competent care to patients with complex needs in alignment with the ANA Standards of Nursing Practice.
  • Manages the care of patients, while organizing and prioritizing patient care needs, and ensuring assigned tasks are completed.
  • Serves as an advocate for patients, families, and caregivers, improving outcomes for the immediate practice setting.
  • Leads the implementation of high reliability principles and I CARE values to increase consistency of care delivered and improve patient outcomes.
  • Demonstrates the ability to improve the effectiveness of communications and interactions with others, to inspire their cooperation and confidence to ensure safe and effective outcomes in the current practice setting.
  • Effectively sets group goals and keeps self and team informed of the latest trends and developments. Inspires the cooperation and confidence of others. Demonstrates a high level of expertise.
  • Functions as an emerging leader in providing direction to staff to identify, implement and evaluate patient care needs.
  • Collaborates with the interdisciplinary team to ensure the plan of care is achieved.
  • Assesses the immediate practice setting to identify efficient, cost-effective care delivery.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards
Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
Work Schedule: Full-Time, 40 hours/week, Day Shift.
Compressed/Flexible: Not Available.
Telework: Available for Ad-hoc.
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized.
EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact Karen.Chapman@va.gov, the EDRP Coordinator for questions/assistance. Learn more
Permanent Change of Station (PCS): Not Authorized.
PCS Appraised Value Offer (AVO): Not Authorized.
Notifications:
  • Current federal employees must submit copies of their most recent SF-50 (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure, and type of service (Competitive or Excepted).
  • The salary is based on the grade and step approved for the selected candidate.
  • Veterans' preference does not apply for internal or other current permanent Federal agency employees.

Requirements
Help
Conditions of employment
  • U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Must pass pre-employment physical examination.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • You may be required to serve a probationary period.
  • Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications
Basic Requirements:
  • English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12978427.
Grade/Level
Scope
Education
Nurse I, Level I
Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies.
An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
Nurse I, Level II
Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.
An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.
Nurse I, Level III
Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.
An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.
Nurse II
Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.
A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.
Nurse III
Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.
MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.
*Note: Foreign education programs/degrees are not creditable as related degrees.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service.
Education
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.The Associate Degree Nursing (ADN), Bachelor of Science degree in Nursing (BSN), or Master of Science degree in Nursing (MSN) must be fully accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission On Collegiate Nursing Education (CCNE). Verification of accreditation may be obtained from http://www.acenursing.us/accreditedprograms/programsearch.htm or https://directory.ccnecommunity.org/reports/accprog.asp.
  • If your school has changed names, or is no longer in existence, you must provide this information in your application.
  • If your school was accredited by ACEN or CCNE at the time of graduation, but is no longer listed on the websites, you must provide documentation of accreditation with your applic...

What Veterans Health Administration employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Veterans Health Administration logo

About Veterans Health Administration

Sourced by ZipRecruiter

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US