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Remote Utilization Review Rn Jobs in Rome, NY (NOW HIRING)

We streamline the process with quick interviews and efficient remote onboarding, so you can step ... Requirements: · Registered Dietitian (RD) credential and licensure in New York State. · Strong ...

Remote Utilization Review Rn information

See Rome, NY salary details

$20

$40

$65

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

As of Aug 5, 2026, the average hourly pay for remote utilization review rn in Rome, NY is $40.03, 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?

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 Rome, NY? For Remote Utilization Review Rn jobs in Rome, NY, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Rome, NY look for? The top searched job categories for Remote Utilization Review Rn jobs in Rome, NY are:
What cities near Rome, NY are hiring for Remote Utilization Review Rn jobs? Cities near Rome, NY with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Rome, NY as of July 2026, with employment types broken down into 89% Full Time, 9% Part Time, and 2% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $83,268 per year, or $40 per hour.

Health Information Management Technician 2 (NY HELPS), Secure Treatment and Rehabilitation Center...

New York State

Marcy, NY • On-site, Remote

$56K - $72K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 hours ago

Posted today


New York State rating

7.7

Company rating: 7.7 out of 10

Based on 186 frontline employees who took The Breakroom Quiz

26th of 50 rated states


Job description

Duties Description As a Health Information Management Technician 2, you will work under the direction of a Health Information Management Administrator to supervise Health Information Management Technicians 1 and clerical support staff engaged in health information management activities. Duties include: Ensuring the accuracy of clinical progress notes, laboratory reports, and treatment records. Reviewing facility staff medical and clinical services documentation for Medicaid funding.

Transcribing and coding medical, clinical, and mental health services. Maintaining databases for tracking health information disclosures. Providing technical assistance and support to facility and clinical staff on health information management requirements.

Conducting audits for utilization review activities and reporting deficiencies to the Utilization Review Committee. Implementing corrective actions as determined by internal and external audit findings. May supervise Health Information Management Technicians 1 and other support staff.

Minimum Qualifications Candidates from outside State Service can be considered for hire under the Hiring for Emergency Limited Placement - Statewide (HELPS) program if they have a current certification by the American Health Information Management Association as a Registered Health Information Administrator (RHIA) or current certification by the American Health Information Management Association as a Registered Health Information Technician and have one year of full-time professional (post-RHIT) health information management experience. OR Candidates can be considered for a competitive class appointment if they are reachable on the current Health Information Management Technician 2 eligible list. OR Candidates from within State Service can be considered for a competitive class appointment if they have one year of permanent competitive or 55-b/55-c service in a title eligible for transfer under Section 70.1 of the Civil Service Law

Additional Comments All OMH employees receive a generous benefits package including: NYS medical, dental, & vision insurance Access to tuition assistance programs Excellent opportunities for advancement & professional growth Paid time off - 13 paid vacation days in the first year, 5 paid personal days, 13 paid holidays, & paid sick leave NYS Retirement programs Background checks will be required. Notes: 1. If you fail to maintain your certification once you are appointed, action will be taken to remove you from the position.

2. In order to be eligible for appointment and to maintain employment, you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). If you are appointed and subsequently listed as an excluded individual or entity on any of these lists (or excluded from any other Federal or Federally assisted program), you may be terminated from your employment.

3. If appointed you may be required to become an enrolled Medicare provider; obtain and provide to your employer a National Provider Identifier (NPI) number issued by the National Plan and Provider Enumeration System (NPPES); and otherwise actively participate to the degree necessary to allow for your services to be billed through Medicare and Medicaid. If you are appointed and you lose the ability to bill through Medicare and Medicaid, you may be terminated from your employment.

Some positions may require additional credentials or a background check to verify your identity.


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