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Remote Utilization Review Rn Jobs in Buffalo, NY

Varsity Tutors

NCLEX-RN Tutor

Buffalo, NY · Remote

$18 - $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 ...

Veterans Health Administration

Nurse

Buffalo, NY · On-site +1

$92K - $122K/yr

Learn more about this agency Duties Help The Nurse II Progressive Care Registered Nurse (RN) is ... utilization consultation. Duties include: * Demonstrating leadership in delivering and improving ...

Addison Group

Forensic Medical Coder

Niagara Falls, NY · Remote

$25 - $30/hr

Remote (EST or CST Preferred; candidates located in NY, NJ, or FL are highly encouraged to apply ... Nursing background (RN) is a plus but not required. * Experience reviewing Workers' Compensation ...

CSAA

Marketing Engagement Partner - Remote

Alabama, NY · Remote

Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements

Harris

(Remote) Application Consultant

Alabama, NY · Remote

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Cayenta

(Remote) Application Consultant

Alabama, NY · Remote

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Highmark Health

Intake Coordinator

Buffalo, NY · Remote

$27.42/hr

JOB SUMMARY This job captures all inbound inquires for utilization management review from providers ... Remote-based Teaches / trains others Occasionally Travel from the office to various work sites 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 Aug 5, 2026, the average hourly pay for remote utilization review rn in Buffalo, NY is $40.96, according to ZipRecruiter salary data. Most workers in this role earn between $32.36 and $47.02 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

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 Buffalo, NY? For Remote Utilization Review Rn jobs in Buffalo, NY, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Buffalo, NY look for? The top searched job categories for Remote Utilization Review Rn jobs in Buffalo, NY are:
What cities near Buffalo, NY are hiring for Remote Utilization Review Rn jobs? Cities near Buffalo, 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 Buffalo, NY as of July 2026, with employment types broken down into 88% Full Time, 6% Part Time, and 6% Contract. Highlights an 6% In-person, and 94% Remote job distribution, with an average salary of $85,191 per year, or $41 per hour.

Remote RN Telephone Triage (NYS license required)

Virtual Medical

Buffalo, NY • Remote

Full-time

Re-posted 17 days ago

Job description

*****MUST LIVE WITHIN 2 HOURS DRIVING TIME OF THE WNY AREA*****
(4) 10 hour shifts, afternoons 3p-130a, rotating weekends.   Salary:  $34/$35 an hour, overtime available (excellent medical benefit package and more)
REMOTE TRAINING 6-8 WEEKS MONDAY-FRIDAY.  TRAINING TIMES MAY VARY DURING TRAINING PERIOD FROM 8a-430p - 12p-830p
We are looking for qualified Registered Nurse's to join our team.  We are a fully remote 24-hour On Call Center where we received incoming calls for our clients/individuals in need of immediate medical attention.  We provide assessment, guidance, and disposition to the appropriate level of care.  We work closely with our team of RN's and providers to determine Right Care, Right Place and Right Time disposition, which may be care instructions, tele medicine visit with a provider or advise, Urgent Care, ER or 911 level of care required.
Primary Responsibilities:

  • Receives incoming calls from contracted clients
  • Assess patient's current health status and recommends appropriate level of care based on clinical judgment, evidenced based guidelines and clinical protocols
  • Develops plan(s) of nursing service appropriate to the patients’ health care needs
  • Demonstrates knowledge of medications.
  • Telephone communication skills with appropriate phone etiquette necessary
  • Must have the ability to make critical independent decisions and prioritize appropriately.
  • Document all calls and actions taken into the patient’s medical record
  • Utilizes technology as appropriate to meet the requirements of the job functions.
  • Communicates to the health care team members the outcome of the assessment/reassessment to ensure appropriate follow up occurs based on the needs of the patient care.
  • Displays an exemplary level of patience, courtesy, and flexibility.
  • Interacts with patients, physicians, and staff in a manner conducive to maintain positive relationships and to meet the goals and objectives of the agency.
  • Adheres to ethical, legal/regulatory and accreditation standards
  • Assumes responsibility for his/her own education, using formal and informal resources that contribute to professional self‐growth.
  • Consult with administrator for issues or requested services outside scope of practice or requiring assistance in performing
  • Must be detail oriented and able to multitask
  • Performs other duties as assigned.

Qualifications:

  • AAS in Nursing, Bachelor’s Degree in Nursing or related fields preferred, not required
  • Unrestricted New York State Licensed RN with a minimum of two years of experience as a clinical hospital nurse in an emergency room, critical care or med/surg, OR a minimum of two years’ experience in RN telephone triage in a primary care setting.
  • Knowledge of OPWDD regulations recommended, not required
  • Current BCLS required
  • Current Infection Control Certificate required
  • Must be proficient in using computer applications and using the internet.

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