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Remote Utilization Review Rn Jobs in Exeter, NH (NOW HIRING)

Registered Nurse

North Andover, MA ยท Remote

$40 - $42/hr

Registered Nurse (RN) Job Summary Provides professional services within the scope of nursing ... Performs physical examination and review of all body systems and documents such accordingly.

Core - APC Remote Primary Care Inbox

Exeter, NH ยท On-site +1

$104K - $142K/yr

Board-certified APRN, PA-C * DEA * NH License Major Responsibilities: * Respond to patient calls ... Review and refill medication refill requests. * Coordinate patient care with triage and care ...

NCLEX-RN Tutor

Lawrence, MA ยท 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 ...

The Care Manager (RN/SW) assists members appropriate for care management and care coordination ... Work Arrangement: Fully Remote with frequent travel within Kent and Sussex counties ...

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

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Remote Utilization Review Rn information

See Exeter, NH salary details

$21

$43

$70

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

As of Aug 7, 2026, the average hourly pay for remote utilization review rn in Exeter, NH is $43.02, according to ZipRecruiter salary data. Most workers in this role earn between $33.99 and $49.42 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 cities near Exeter, NH are hiring for Remote Utilization Review Rn jobs? Cities near Exeter, NH with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Exeter, NH as of July 2026, with employment types broken down into 76% Full Time, 13% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,486 per year, or $43 per hour.

Registered Nurse

Crossway Homecare

North Andover, MA โ€ข Remote

$40 - $42/hr

Full-time

Posted 14 days ago


Job description

Registered Nurse (RN)
Job Summary
Provides professional services within the scope of nursing practice standards in collaboration with primary care physicians, teaches and educates patients and their families.
Organizational Relationship:
Reports to the Director of Clinical Services or Administrator Qualifications:
  • Graduate of an approved professional nursing program (RN).
  • Currently, licensed “in good standing” in Massachusetts.
  • Minimum of one (1) year of experience as a professional nurse, preferably in home care.
  • Must have a criminal background check.
  • Must have current CPR certification.

Responsibilities:
  • Receives the intake referral information and prepares paperwork/tools necessary for the visit.
  • Obtains all pertinent medical history from patient, family or significant others.
  • Performs home safety check and environmental assessment of the patient’s home environment.
  • Performs the socio-psychological evaluation of the support systems available to the patient and documents necessary emergency contacts etc.
  • Performs assessment visit and documents timely. (i.e. OASIS/ Skilled Nursing Note etc).
  • Performs physical examination and review of all body systems and documents such accordingly.
  • Develops an appropriate and effective Plan of Care (POC) to be submitted to the physician for approval and implementation.
  • Determines medical necessity for other services that could enhance the positive outcome desirable for the case.
  • Evaluated the patient’s ADL and iADL abilities and therefore the need of support services such as a home health aide.
  • Develops and implements the HHA plan of care when HHA services are ordered. Revises and signs this care plan the beginning of each certification period.
  • Supervises the HHA in accordance with state/federal requirements and documents the supervision without having to be directed to do so.
  • Orders “other” professional services that are effective and is willing to adjust frequency of these services as outcome progresses and the patient’s condition warrants.
  • Reviews billing processes with patient and/or family, advising patient and/or family when co-pay or Medicare is not likely to pay for services (ABN).
  • Effectively communicates with patient and family the POC and progression of such. Keeps the patient informed ongoing. Effectively communicates with other disciplines in the case (case conferencing) to effectively and appropriately problem solve as situations arise.
  • Communicates effectively with the Director of Clinical Services or Nursing Supervisor, scheduled visits planned and changes to the schedule on a weekly basis. Caseload is self scheduled but communication of the clinician’s schedule is essential.