Remote Utilization Review Rn Jobs in Philadelphia, PA

At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care—clinical, behavioral, and social—by partnering with organizations deeply connected to the communities we serve.

We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.

Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.

We're one of the largest care management providers in California and are expanding into Texas and other states to continue supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.

At Pair Team, we're not just delivering care—we're building the future of more equitable, community-driven healthcare.

Our Values:

• Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
• Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
• Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
• Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
• Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.

Pair Team is hiring a Family Nurse Practitioner to support the launch of our Medicare ACCESS program across multiple states. This role will provide virtual care to Medicare patients with chronic, complex, and often overlapping medical, behavioral health, and social needs.

You will work as part of a centralized, multi-state clinical team, partnering closely with RNs, Lead Care Managers, and clinical leadership to complete patient assessments, guide care plans, support escalations, and help build a scalable care model for older adults. This role is 100% remote, but candidates must be comfortable working across EST and PST time zones as needed.

• Provide virtual care and clinical assessments for Medicare patients across multiple ACCESS markets
• Support initial patient assessments, care plan direction, and ongoing clinical oversight
• Manage chronic conditions, acute concerns, medication-related questions, and routine follow-ups through telemedicine
• Partner with RNs, Community Health Workers, and clinical leadership to close care gaps and ensure timely follow-up
• Provide clinical guidance during case reviews, escalations, and complex patient situations
• Support patients with conditions common in Medicare populations, including hypertension, diabetes, CKD, cardiovascular disease, chronic pain, depression, and anxiety
• Build trusted relationships with patients who may have limited access to consistent care
• Collaborate with operations and product teams to improve care delivery workflows, documentation, and patient engagement
• Maintain timely, accurate, and compliant clinical documentation
  

• 2+ active Nurse Practitioner licenses in Pair Team's planned ACCESS launch and expansion states, including California, Nevada, Pennsylvania, New York, Maryland, Georgia, West Virginia, Texas, Florida, or North Carolina
• Willingness and ability to obtain additional state NP licenses as Pair Team expands into new ACCESS markets
• Board certification as a Family Nurse Practitioner or Adult-Gerontology Nurse Practitioner required
• 2+ years of clinical experience as a Nurse Practitioner
• Experience caring for Medicare, geriatric, or medically complex adult populations
• Comfort managing chronic conditions such as hypertension, diabetes, CKD, cardiovascular disease, chronic pain, depression, or anxiety
• Comfort delivering telemedicine and working across multiple digital platforms
• Comfort working across EST and PST time zones as needed
• Ability to care for adult and older adult populations
• Experience working within a multidisciplinary care model
• Access to a quiet, HIPAA-compliant, internet-connected remote workspace
  

• Base salary: $115,000 – $130,000
• Comprehensive medical, dental, and vision coverage
• 401(k)
• Flexible vacation policy
• Monthly work-from-home stipend
• Company-provided equipment
• Fully remote work environment