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Remote Utilization Review Rn Jobs in Lumberton, NJ

Elevance Health

Nurse Case Mgr I (contract)

Trenton, NJ · Remote

... utilization review, or managed care experience; or any combination of education and experience, which would provide an equivalent background. - Preferred. * Current active, valid and unrestricted RN ...

Elevance Health

Nurse Case Mgr I (contract)

Trenton, NJ · Remote

... utilization review, or managed care experience; or any combination of education and experience, which would provide an equivalent background. - Preferred. * Current active, valid and unrestricted RN ...

Dane Street

Radiology - Imaging Physician

Philadelphia, PA · Remote

$322K - $403K/yr

... Record Reviews. This is a fully remote opportunity offering flexible scheduling, allowing you to ... Enhanced industry expertise in medical necessity, utilization review, and claims support * Expanded ...

Oshi Health

GI- Nurse Practitioner

Philadelphia, PA · Remote

Preferred RN compact License Required Location: We are only hiring from the following states ... Remote-first -- work from home anywhere in the US within our approved states * Growth: Advanced ...

InfoMC

Clinical Business Analyst

Conshohocken, PA · On-site +1

... utilization management (UM) and care management (CM) applications, acting as a trusted advisor to payer clients. This role requires candidates who are a Registered Nurse (RN) or licensed healthcare ...

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

Remote Utilization Review Rn information

See Lumberton, NJ salary details

$21

$42

$70

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

As of Aug 1, 2026, the average hourly pay for remote utilization review rn in Lumberton, NJ is $42.99, according to ZipRecruiter salary data. Most workers in this role earn between $33.99 and $49.38 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 Lumberton, NJ? For Remote Utilization Review Rn jobs in Lumberton, NJ, the most frequently searched job titles are:
What cities near Lumberton, NJ are hiring for Remote Utilization Review Rn jobs? Cities near Lumberton, 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 Lumberton, NJ as of July 2026, with employment types broken down into 72% Full Time, 8% Part Time, and 20% Contract. Highlights an 43% Physical, 3% Hybrid, and 54% Remote job distribution, with an average salary of $89,417 per year, or $43 per hour.

Fully Remote Registered Nurse (RN) Care Manager

The CKHobbie Group

Philadelphia, PA • On-site, Remote

Full-time

Re-posted 22 days ago

Job description


Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity to work closely with individuals who have complex medical, behavioral, and social needs, helping them navigate the healthcare system while improving their overall well-being. As an RN Care Manager, you will play a vital role in delivering holistic, patient-centered care that addresses not only physical health, but also the underlying factors that influence long-term outcomes.
In this role, you will engage members both over the phone and through occasional in-person visits in community or hospital settings. You will conduct comprehensive assessments that evaluate medical, behavioral, functional, and social determinants of health, and use this information to develop individualized care plans that align with each member's unique needs, goals, and preferences. By applying active listening and motivational interviewing techniques, you will help members better understand their health conditions, identify personal goals, and take meaningful steps toward positive behavior change.
The RN Care Manager serves as both an advocate and an educator, guiding members through complex healthcare decisions and ensuring they have access to the right resources at the right time. You will help members overcome barriers to care by identifying challenges, offering practical solutions, and connecting them with appropriate community-based services. In cases where urgent or high-risk situations arise, you will use your clinical judgment to escalate concerns appropriately and ensure members receive timely interventions.
Collaboration is a key component of this position. You will work alongside an interdisciplinary care team, presenting complex cases and contributing valuable clinical insight to support care planning and decision-making. Simultaneously, you will operate with a high level of autonomy, managing your own caseload in a structured virtual environment while meeting established performance goals. This balance of independence and collaboration allows you to fully utilize your clinical expertise while continuing to grow professionally.
This role is well-suited for nurses who are passionate about making a meaningful difference in patients' lives and who are seeking a more flexible and strategic approach to care delivery. It offers the opportunity to build strong, lasting relationships with members, develop expertise in case management and population health, and play a direct role in improving healthcare outcomes on a broader scale. Candidates must hold an active, unrestricted RN license in Pennsylvania, have either an associate's or bachelor's degree in nursing, and reside in the Philadelphia region. A strong passion for working with complex populations, along with the ability to work independently in a home-based setting with occasional travel, is essential.
Preferred candidates will have prior experience in case management, care coordination, or managed care environments, particularly with high-risk or medically complex populations. Additional qualifications such as a Certified Case Manager (CCM) credential, experience with utilization review or risk management, technical proficiency with Microsoft Office applications, and bilingual capabilities are considered valuable assets.

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