ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs in Nassau County, NY

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 ...

previous pagenext page

Showing results 21-40

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Nassau County, NY

Remote Utilization Review Rn information

See Nassau County, NY salary details

$22

$43

$70

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

As of Sep 6, 2026, the average hourly pay for remote utilization review rn in Nassau County, NY is $43.48, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $49.95 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 job categories do people searching Remote Utilization Review Rn jobs in Nassau County, NY look for?

The top searched job categories for Remote Utilization Review Rn jobs in Nassau County, NY are:

What cities near Nassau County, NY are hiring for Remote Utilization Review Rn jobs?

Cities near Nassau County, NY 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 Nassau County, NY as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $90,440 per year, or $43.5 per hour.

Physician Reviewer

MedReview

Manhattan, NY • On-site, Remote

Full-time

Re-posted 29 days ago

Job description

Position Summary:
We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. 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 review complex hospital cases to ensure accurate DRG assignment, validate clinical documentation, and support evidence-based determinations that directly impact healthcare quality and reimbursement integrity.
Responsibilities:
  • Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant
  • Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines
  • Produce clear, concise clinical summaries and determinations within established turnaround times
  • Identify opportunities for improved documentation, coding accuracy, and cost containment
  • Conduct readmission and level of care reviews, including outlier and appeal cases
  • Collaborate with internal teams and, when needed, engage with providers to support clinical findings
  • Contribute to quality assurance initiatives and ongoing program development
Qualifications:
  • MD/DO required with active, unrestricted U.S License
  • Board Certification required (ABMS or AOA)
  • 5+ years of clinical practice experience
  • REQUIRED: Strong utilization review experience (UM, DRG Validation, or clinical documentation review)
  • Experience with DRG Validation, CDI, or claims review strongly preferred
  • Proven ability to interpret complex clinical data and apply guidelines objectively
  • Strong written communication skills with the ability to clearly justify clinical decisions
Why This Role Stands Out:
  • 100% remote - work from anywhere in the U.S
  • High-impact role influencing clinical accuracy and healthcare outcomes
  • Join a growing, mission-driven team at the intersection of clinical care and healthcare analytics
  • Consistent, structured workflow with meaningful case variety
Compensation: 230K

Apply