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Remote Utilization Review Rn Jobs in Springfield, MA

Varsity Tutors

NCLEX-RN Tutor

Hartford, CT · 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 ...

Varsity Tutors

NCLEX-RN Tutor

Northampton, MA · 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 ...

The Hartford

Nurse Case Manager

Hartford, CT · On-site +1

$69K - $104K/yr

Nurse Case Manager This fully remote role provides telephonic case management for injured workers ... case reviews Required Qualifications * RN with current unrestricted state licensure (CA is ...

DataAnnotation

Registered Nurse - AI Trainer

Hartford, CT · 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 ...

Quest Global

Aftermarket Field Rep- Remote

Windsor, CT · Remote

$29 - $31/hr

Review data discrepancies and gaps across multiple systems. Escalate to appropriate channels. What ... History identifying and resolving part quality and delivery issues - including utilization of ...

DataAnnotation

RN - AI Trainer

Hartford, CT · 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

Springfield, MA · 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 ...

Quest Global

Aftermarket Field Rep- Remote

Windsor, CT · On-site +1

$29 - $31/hr

Review data discrepancies and gaps across multiple systems. Escalate to appropriate channels. What ... History identifying and resolving part quality and delivery issues - including utilization of ...

Quest Global

Aftermarket Field Rep- Remote

Windsor, CT · Remote

$29 - $31/hr

Review data discrepancies and gaps across multiple systems. Escalate to appropriate channels. What ... History identifying and resolving part quality and delivery issues - including utilization of ...

Varsity Tutors

NCLEX-PN Tutor

Hartford, CT · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Springfield, MA

Remote Utilization Review Rn information

See Springfield, MA salary details

$21

$42

$68

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 Springfield, MA is $42.13, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.37 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 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 July 2026, with employment types broken down into 89% Full Time, 8% Part Time, and 3% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $87,639 per year, or $42.1 per hour.
Utilization Review Therapist: Billing and Patient Accts- Masters Required- Remote! 7071

Utilization Review Therapist: Billing and Patient Accts- Masters Required- Remote! 7071

Community Health Resources

Windsor, CT • On-site, Remote

$57K/yr

Full-time

Medical, Retirement, PTO

Posted 12 days ago

Job description

A career can mean different things at different workplaces. Apply now to see what it means to us and 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
PC#: 3146
ABOUT THE POSITION: 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?
Award-Winning Workplace:
  • Proudly recognized as a Top Workplace for 12 consecutive years!

Generous Time Off:
  • Enjoy ample paid time off, including a special day off for your birthday!

Retirement Savings:
  • Benefit from contributions to your 403b Retirement Plan.

Comprehensive Insurance:
  • Competitive premiums with added discounts on pet, auto, and home insurance!

Education & Tuition Support:
  • Tuition reimbursement and professional development programs.
  • Student loan repayment assistance (Public Service Loan Forgiveness, Nurse Corps, NHSC/HRSA at select sites).
  • Exclusive tuition discounts for CHR employees at several local colleges/universities.

Career Development:
  • FREE robust training curriculum, featuring our brand-new Clinical Training Series for interactive learning, practical skill enhancement, and professional growth!
  • Clinical supervision and/or mentoring available at many programs.
  • Internal career fairs: connect with recruiters to discuss your career aspirations and the various opportunities available within our over 80 programs statewide.

Wellness Program:
  • Annual wellness stipend.
  • FREE premium subscription to the Calm app, for employees and their families
  • Fun activities like coloring contests, lunch & learns, office seasonal decorating contests, employee appreciation events, and more!
  • Up to 6 FREE confidential counseling sessions per issue, per year, for individuals, couples, & families through our EAP program

Employee Involvement:
  • Participate in leadership luncheons with our CEO and various agency committees!

Stay Informed:
  • Weekly video updates from our CEO and monthly newsletters to keep you in the loop.

And So Much More:
  • Many benefits are available to all staff, regardless of the hours worked, with some subject to eligibility.

Join us at CHR and be part of an exciting, supportive, and dynamic workplace where your growth and well-being are our top priorities!
COMPENSATION*:
Starting at $57,506.80/yr minimum, and up commensurate upon experience.
*Actual rates are determined at the time of offer and are based off of relevant experience, as well as adherence to our internal equity policy. Many of our positions offer program/location differentials and/or sign-on incentives. (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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