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Remote Utilization Review Rn Jobs in Lynn, MA (NOW HIRING)

Sedgwick

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Boston, MA · On-site +1

$62.25 - $75.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

York Risk Services

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Cambridge, MA · On-site +1

$62.25 - $75.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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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 Jun 26, 2026, the average hourly pay for remote utilization review rn in Lynn, MA is $43.61, according to ZipRecruiter salary data. Most workers in this role earn between $34.47 and $50.10 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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 Lynn, MA are hiring for Remote Utilization Review Rn jobs? Cities near Lynn, MA with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Psychiatric Nurse Practitioner PMHNP /Clinical Consultant

FIDELIA COUNSELING SERVICES INC

Woburn, MA • Remote

Full-time

Posted 22 days ago

Job description


  • Position Type: Independent Contractor (1099)
  • Hours: Begins at 4 hours per month (Highly Flexible / Evenings or Weekends acceptable)
  • Location: Hybrid / Remote (Metro Boston Region / Virtual Meetings)
Position Overview
Fidelia Counseling Services, Inc. is seeking a qualified, ANCC-certified Psychiatric-Mental Health Nurse Practitioner (PMHNP) or Child Psychiatrist to serve as a Clinical Consultant for our growing outpatient and intensive community-based behavioral health programs. This role focuses on high-level clinical consultation, program quality control, and providing psychiatric oversight for our clinical team. This is an ideal position for a prescriber looking for a highly flexible, low-hour monthly commitment.
Key Responsibilities
  • Clinical Consultation: Provide case consultation and psychiatric guidance to staff clinicians regarding complex child, adolescent, and adult behavioral health cases.
  • Quality Assurance: Participate in a monthly, 1-hour virtual Quality Assurance and Clinical Control meeting to review program outcomes and ensure alignment with best practices.
  • Staff Support: Provide clinical supervision or medication-management consultation to the multidisciplinary team on an as-needed basis.
  • Network Alignment: Maintain active credentialing with major health plans (MBHP/Fallon) via an updated CAQH profile to ensure program compliance.
Qualifications
  • Masters or Doctoral degree in Nursing with a Psychiatric-Mental Health specialty (PMHNP-BC), or an MD/DO specializing in Psychiatry.
  • Active, unrestricted Advanced Practice Registered Nurse (APRN) and prescribing license in the state of Massachusetts.
  • Valid DEA registration and Massachusetts Controlled Substances Registration (MCSR).
  • Experience: 2+ years of post-master's practice as a PMHNP is highly preferred (enabling fully independent practice authority under Massachusetts law).
  • Active enrollment in MassHealth (or willingness to complete a non-billing/billing enrollment).
  • Up-to-date and attested CAQH profile.
  • Strong collaborative spirit and experience with child/adolescent demographics preferred.
  • Bilingual Applicants strongly encouraged to apply

This is a remote position.