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Remote Utilization Review Rn Jobs in Elizabeth, NJ

CVS Health

Case Manager, Registered Nurse

New York, NY · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...

MedReview

Physician Reviewer

Manhattan, NY · On-site +1

This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced, data-driven environment. In this role, you will ...

MedReview

Physician Reviewer

Manhattan, NY · Remote

This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced, data-driven environment. In this role, you will ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Elizabeth, NJ

Remote Utilization Review Rn information

See Elizabeth, NJ salary details

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$42

$69

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

As of Aug 23, 2026, the average hourly pay for remote utilization review rn in Elizabeth, NJ is $42.55, according to ZipRecruiter salary data. Most workers in this role earn between $33.61 and $48.85 per hour, depending on experience, location, and employer.

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 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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Elizabeth, NJ?

For Remote Utilization Review Rn jobs in Elizabeth, NJ, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Elizabeth, NJ look for?

The top searched job categories for Remote Utilization Review Rn jobs in Elizabeth, NJ are:

What cities near Elizabeth, NJ are hiring for Remote Utilization Review Rn jobs?

Cities near Elizabeth, NJ 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 Elizabeth, NJ as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $88,511 per year, or $42.6 per hour.

Inpatient Nursing Expert - Clinical Evaluator

Mercor

New York, NY • Remote

$55 - $65/hr

Full-time

Posted 13 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Adult Inpatient Nurses (RN)
Type: Contract
Compensation: $55–$65/hour
Location: Remote

Role Responsibilities

  • Review and evaluate AI-generated clinical outputs based on nursing flowsheet documentation.
  • Validate accuracy, completeness, and adherence to current documentation standards.
  • Annotate and structure inpatient nursing assessment data for AI training datasets.
  • Provide expert feedback on nursing assessments and documentation practices.
  • Identify gaps, inconsistencies, or risks in AI-generated responses.
  • Collaborate with technical teams to improve model performance.

Qualifications

Must-Have

  • Active RN license (U.S., outside California).
  • Recent adult acute care inpatient bedside experience.
  • Experience within the last 5–10 years with current workflows and documentation practices.
  • Comfortable performing and documenting comprehensive nursing assessments.
  • Comfortable following detailed annotation guidelines consistently.
  • Excellent written communication skills and responsiveness to feedback.
  • Ability to work independently and meet deadlines.

Preferred

  • Epic EHR experience.
  • Comfortable learning new annotation tools and web-based platforms.
  • Able to navigate transcripts efficiently and use AI-assisted tools appropriately.
  • Experience reviewing charts for quality improvement, utilization review, CDI, or clinical informatics.
  • Previous annotation, chart abstraction, or healthcare AI experience.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.