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Remote Utilization Review Rn Jobs in Springfield, MA

Varsity Tutors

NCLEX-RN Tutor

Northampton, MA · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Hartford, CT · Remote

$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 ...

Aflac Incorporated

Mgr, Review Services

Windsor, CT · Remote

$100K - $125K/yr

If the role is remote, there may be occasions that you are requested to come to the office based on ... Professional Registered Nurse, Certified Rehabilitation Counselor (CRC), ADA/HR Certification ...

Elara Caring

Clinical Team Specialist

Windsor, CT · Remote

Clinical Team Specialist - RN (Per Diem/Remote) At Elara Caring, we care where you are and believe ... Reviews and approves plan of care and evaluates proposed changes to the plan of care for clinical ...

Elara Caring

Clinical Team Specialist

Windsor, CT · Remote

Clinical Team Specialist - RN (Per Diem/Remote) At Elara Caring, we care where you are and believe ... Reviews and approves plan of care and evaluates proposed changes to the plan of care for clinical ...

Sentara

IT Specialty Analyst (Epic) - Remote

MA · Remote

This role partners closely with clinical leadership, providers, nursing, and operational ... for optimal utilization of applications. Develops system test plans and performs testing of ...

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Remote Utilization Review Rn information

See Springfield, MA salary details

$20

$41

$67

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

As of Sep 11, 2026, the average hourly pay for remote utilization review rn in Springfield, MA is $41.15, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.26 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 are popular job titles related to Remote Utilization Review Rn jobs in Springfield, MA?

For Remote Utilization Review Rn jobs in Springfield, MA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Springfield, MA look for?

The top searched job categories for Remote Utilization Review Rn jobs in Springfield, MA are:

What cities near Springfield, MA are hiring for Remote Utilization Review Rn jobs?

Cities near Springfield, MA 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 Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $85,596 per year, or $41.2 per hour.

Utilization Review Therapist: Billing and Patient Accts- License Eligible Masters Required- Remote!

Windsor, CT • On-site, Remote

Community Health Resources
Offices of Mental Health Practitioners • 501 - 1,000 employees
Learn more about Community Health Resourcesexternal

$57K - $86K/yr

Full-time

Medical, Retirement, PTO

Re-posted 14 days ago

Job description

Recognized as a Top Workplace for 13 consecutive years! Your career can mean different things in different workplaces. Apply with CHR now to see what it's like to work somewhere your voice is heard, your wellness is a priority, and your success matters.
JOB TITLE: Utilization Review Therapist
EMPLOYMENT TYPE: Full-time, 40 hours/wk
SCHEDULED HOURS: Monday-Friday 8:00AM-4:30PM
PROGRAM/LOCATION: Billing & Patient Accounts, Windsor, CT/ Must be a resident of CT, MA, or RI only
PC#: 3146
DUTIES & RESPONSIBILITIES: Utilization Review Therapist
  • Oversees and manages all authorization activities related to IOP and Residential programs.
  • Ensures that all admissions and continued stays meet medical necessity
  • Works with service director to ensure that IOP and Residential documentation and programming meet all relevant regulatory and funder expectations.

QUALIFICATIONS:
Education: Master's degree in behavioral health field
Experience: Experience in providing behavioral health treatment
Licensure/Certification/Registration: Eligible for licensure in behavioral health field
Training: Behavioral health interventions, understanding of documentation and medical necessity expectations, working with insurers
Why Join CHR?
Be part of an exciting, supportive, and dynamic workplace where your growth and well-being are our top priorities!
  • Comprehensive benefits packages include health insurance, ample paid time off (including your birthday!), employer contributions to your 403b Retirement Plan, and competitive insurance premiums with added discounts on pet, home and auto!
  • Tuition reimbursement and professional development programs, including exclusive tuition discounts for CHR employees at several local colleges/universities
  • Career development opportunities! FREE robust training curriculum, featuring our Clinical Training Series for interactive learning, practical skill enhancement, and professional growth! Clinical supervision and/or mentoring offered at several programs
  • Wellness program: Annual wellness stipend, FREE premium subscription to the Calm app, 6 FREE confidential counseling sessions through our Employee Assistance Program
  • Employee appreciation and involvement, including contests, lunch & learns (meet with our CEO!), employee appreciation events, employee-led resource groups open to all, and more!

And so much more! (Many benefits are available to all staff, regardless of the hours worked, with some subject to eligibility)
COMPENSATION*:
$57,506.80/yr minimum- $86,023.39/yr maximum*
*Actual rates within this range are determined at the time of offer and are based on relevant experience, as well as adherence to our internal equity policy. (Please note, for part-time positions this range would be pro-rated based on hours worked)
CHR is an equal opportunity employer, and we encourage all to apply.
Take the first step to a meaningful career and apply to CHR today!
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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