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Remote Utilization Review Rn Jobs in Rio Rancho, NM

firsthand Health

Remote Triage Nurse

Albuquerque, NM · On-site +1

$80K/yr

... are utilization. Together with our health plan partners, we are changing the way our society ... The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support ...

firsthand Health

Remote Triage Nurse

Albuquerque, NM · Remote

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is ...

Varsity Tutors

NCLEX-RN Tutor

Albuquerque, NM · 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 ...

DataAnnotation

Registered Nurse - AI Trainer

Rio Rancho, NM · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

Scribe-X

Medical Scribe (Remote)

Albuquerque, NM · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

DataAnnotation

RN - AI Trainer

Rio Rancho, NM · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN - AI Trainer

Albuquerque, NM · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

BetterHelp

Licensed Psychologist- Remote

Albuquerque, NM · Remote

$650/wk

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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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Rio Rancho, NM

Remote Utilization Review Rn information

See Rio Rancho, NM salary details

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$40

$65

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

As of Jul 11, 2026, the average hourly pay for remote utilization review rn in Rio Rancho, NM is $40.01, according to ZipRecruiter salary data. Most workers in this role earn between $31.63 and $45.96 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 Rio Rancho, NM? For Remote Utilization Review Rn jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Rio Rancho, NM look for? The top searched job categories for Remote Utilization Review Rn jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Remote Utilization Review Rn jobs? Cities near Rio Rancho, NM 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 Rio Rancho, NM as of July 2026, with employment types broken down into 86% Full Time, 11% Part Time, and 3% Contract. Highlights an 40% Physical, 4% Hybrid, and 56% Remote job distribution, with an average salary of $83,222 per year, or $40 per hour.
Remote Triage Nurse

Remote Triage Nurse

firsthand Health

Albuquerque, NM • On-site, Remote

$80K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Job description

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.
firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.
We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job-it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is primarily a day-shift role (8 hours/day, 8:30-4:30 PST), with occasional potential for nights or weekends. When not managing acute issues, Triage Nurses focus on care coordination, training, and related administrative tasks.
Responsibilities of a Triage Nurse include:
  • Triage and Escalation: Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately and escalate emergencies immediately.
  • Collaboration: Work closely with peer mental health workers, social workers, and APPs to address acute issues comprehensively.
  • Coordination: Coordinate care with patients' other providers to ensure seamless health management.
  • Training: Develop and deliver training on basic medical topics for peer mental health workers and social workers.
Triage Nurses should have:
  • Strong triage and prioritization skills, with the ability to rapidly assess and determine the appropriate level of care.
  • Problem-solving expertise with a creative, patient-centered approach.
  • Ability to provide condition-specific patient education and self-management guidance.
  • Adaptability to varying team cultures and processes.
  • Empathy, compassion, and approachability in patient and team interactions.
Required experience includes:
  • Active RN license through a Nurse Licensure Compact (NLC) state and willingness to obtain licensure in non-compact states.
  • Bachelor of Science in Nursing (BSN) or Associates of Nursing (ASN)
  • At least 3 years of Emergency Room (ER) experience
  • Experience working with populations facing challenges such as serious mental illness, behavioral health conditions, and/or substance use disorders
  • Care management and coordination experience.
Bonus Points for:
  • Psychiatric-Mental Health Nursing Certification (PMH-BC)
  • Washington state RN license

Base salary range:
$80,000-$80,000 USD
We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.
BenefitsFor full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.
Vaccination Policy
Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law.
New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.
Unfortunately, we are not able to offer sponsorship at this time.
firsthand Health will only contact candidates from email addresses ending in @firsthandcares.com. Any communication from another domain claiming to represent firsthand is fraudulent. We will never ask for payment or sensitive financial information during the hiring process. If you receive suspicious outreach, please do not respond.

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