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Remote Utilization Review Rn Jobs in Butler, PA (NOW HIRING)

Carease Health - PA

Nurse Practitioners

Brackenridge, PA · Remote

$19K - $21K/yr

... remote work from home. Responsibilities: • Provide preventive care to residents in skilled ... review • Excellent communication, collaboration, and teamwork skills About Us: Carease Health ...

POCKET NURSE

Digital Media Coordinator

Monaca, PA · On-site +1

... Nurse provides solutions and services that create hands-on learning experiences for the next ... Paid time off, personal time, paid holidays, and flexible hybrid onsite/remote work schedules.

Excela Health

PHYSICIAN - NEURORADIOLOGIST

Butler, PA · Remote

This position is fully remote but must live in Pennsylvania.This position reviews and diagnoses ... of nursing practice. · Strong ability to communicate complex and/or controversial topics and ...

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Butler, PA

Remote Utilization Review Rn information

See Butler, PA salary details

$19

$38

$62

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

As of Jul 26, 2026, the average hourly pay for remote utilization review rn in Butler, PA is $38.12, according to ZipRecruiter salary data. Most workers in this role earn between $30.14 and $43.80 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 Butler, PA? For Remote Utilization Review Rn jobs in Butler, PA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Butler, PA look for? The top searched job categories for Remote Utilization Review Rn jobs in Butler, PA are:
What cities near Butler, PA are hiring for Remote Utilization Review Rn jobs? Cities near Butler, PA 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 Butler, PA as of July 2026, with employment types broken down into 70% Full Time, 13% Part Time, and 17% Contract. Highlights an 43% Physical, 3% Hybrid, and 54% Remote job distribution, with an average salary of $79,286 per year, or $38.1 per hour.
Mobile RN / Medical Case Manager Beaver & Lawrence Counties - Pennsylvania

Mobile RN / Medical Case Manager Beaver & Lawrence Counties - Pennsylvania

Novus Group

Beaver, PA • Remote

$48.21/hr

Full-time

Retirement, PTO

Posted 23 days ago

Job description

Mobile RN / Medical Case Manager – Beaver & Lawrence Counties - Pennsylvania

To qualify for this role, applicants must have one or more of the following: Master’s degree in a health or human services field PLUS active Pennsylvania professional licensure, OR An active Registered Nurse (RN) license (BSN preferred), OR Active Paramedic/EMT certification with 6–8 years of progressive experience.

Role Type: Full-Time, Regular Employee of the Company (Not a temp or contract assignment)

Shift: Day Job (Flexible hours, Monday through Friday; occasional evening hours based on member needs)

Work Arrangement: Remote / Community-Based (Primarily field-based traveling within the community, with remaining administrative work completed from home)

Location: Beaver & Lawrence Counties (Field travel required; mileage reimbursement included)

New Hire Starting Salary Range: $29.29 – $34.02 per hour (After hire, pay increases can be earned, see below).

About the Opportunity

This job is a permanent, full-time career opportunity within a dedicated behavioral health managed care organization. If selected, you will be hired directly as a regular employee of the organization we represent. You will be on their payroll and eligible for their full suite of benefits from your start date. This is not a temporary, contract, or "temp-to-hire" role. This position features a highly autonomous, community-based layout, offering an excellent fit for professionals seeking field-based clinical practice paired with remote home-office flexibility.

Purpose

The Mobile RN / Medical Case Manager assists members who require comprehensive care coordination by conducting vital face-to-face assessments within their communities, residences, and clinical facilities. Operating as a critical link across the continuum of care, this professional identifies behavioral, clinical, social, and environmental barriers to wellness. This role is crucial for developing integrated service plans, facilitating communication between primary physical care and behavioral health providers, and establishing essential social service linkages to reduce clinical recidivism and crises.

Responsibilities

  • Member Assessment & Coordination: Conduct face-to-face, on-site member assessments in home or facility settings; coordinate directly with facility staff on complex discharge planning and collaborate with outpatient physicians to ensure timely follow-up.
  • Patient Navigation & Comfort: Greet and engage members and families within their environment, guiding them through complex clinical conditions and providing direct health education to enhance their self-management skills.
  • Safe Patient Handling: Implement targeted clinical interventions and specific community outreach plans for high-risk or disengaged members to ensure personal safety, prevent frequent crises, and reduce hospital readmissions.
  • Clerical & Phone Triage: Receive and respond immediately to complex clinical and behavioral crisis calls, triaging immediate needs and stabilizing care scenarios through established emergency protocols.
  • Data Entry & Systems: Perform precise, routine data entry of assessments, case notes, and integrated care plans into the internal care management tracking systems under strict departmental compliance timeframes.
  • Interpersonal Excellence: Maintain highly cooperative, collaborative, and professional working relationships with members, family caregivers, physicians, behavioral health clinicians, and governmental social service agencies.
Minimum Essential Requirements

  • Education & Experience Pathways:
    • Master’s degree in a health or human services field PLUS active Pennsylvania professional licensure.
    • OR An active Registered Nurse (RN) license (BSN preferred).
    • OR Active Paramedic/EMT certification with 6–8 years of progressive experience.
  • Core Experience: Minimum of three (3) years of progressive professional experience in behavioral health, clinical care, utilization management, home care, discharge planning, or case management. (Prior exposure to substance use disorders/SUD is highly preferred).
  • Technical Compliance: Excellent verbal and written communication skills required to lead interagency case conferences, participate in provider treatment planning, and interface with management. Strong PC skills for remote database entry.
  • Driving Requirements: Active PA Driver’s License and valid automotive insurance.
  • Certification Requirement: CPR/BLS certification required based on American Heart Association (AHA) standards—must include both a didactic and hands-on skills demonstration component—within 30 days of hire. Ability to clear all mandatory child and federal background clearances (Act 33, Act 34, Act 73).
Performance-Based Earning Potential

This role offers a structured path for financial advancement. Through consistent high performance, leadership development, and continuous learning over time, employees have the opportunity to earn up to $48.21 per hour.

Premier Benefits

  • Exceptional Retirement Package: Retirement plans with employer matching. Combined, the organization contributes up to 8% of your eligible pay toward your future.
  • World-Class Healthcare: Access preventive care and specialty services through an exclusive provider network.
  • Generous Paid Time Off: Enjoy up to 5.5 weeks of PTO per year, plus 7 paid holidays, with unique options to buy or sell PTO days to fit your lifestyle.
  • Tuition Assistance: Benefit from up to $6,000 per academic year in tuition reimbursement, plus exclusive tuition discounts at over 30 partner colleges and universities.