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Remote Utilization Review Rn Jobs in Springfield, MA

Veterans Health Administration

Practical Nurse

Leeds, MA · On-site +1

$52.65K - $84.22K/yr

... review of the EDRP application. Learn more about this agency Duties Help VA Careers - Licensed ... The LPN assists the registered nurse with the care of patients with acute and rapidly changing ...

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 ...

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

$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 ...

Varsity Tutors

NCLEX-PN Tutor

Northampton, MA · Remote

$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 ...

Insurity

Manager, Professional Services

Hartford, CT · On-site +1

Drive utilization across team * Communicate financial and goal results, and KPIs to direct reports ... Demonstrated experience driving code quality through reviews, testing practices, and use of modern ...

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Remote Utilization Review Rn information

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

As of May 30, 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 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 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 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 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
Psychiatric Nursing Assistant

Psychiatric Nursing Assistant

Veterans Health Administration

Leeds, MA • On-site, Remote

$43.64K - $71.25K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 954 frontline employees who took The Breakroom Quiz

71st of 864 rated healthcare providers

Job description

Summary
This Nursing Assistant position is within the Nursing, Operations service at VA Central Western Massachusetts Healthcare System in Leeds, MA.
Learn more about this agency
Duties
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Total Rewards of a Allied Health Professional
The Nursing Assistant (NA) performs basic nursing duties under close supervision in a variety of health care settings such as inpatient, outpatient, Community Living Center (CLC), Acute Mental Health/Detox, and Resident Rehabilitation Treatment Programs (RRTP). The NA will care for patients/residents with acute to chronic conditions.
  • Becoming proficient with maintaining positive therapeutic relationships by displaying respect for human dignity with patient, families, and/or significant others utilizing communication skills.
  • Utilize observation skills for data collection, reporting, and recording.
  • Participate in patient centered conferences/shift reports, and contributing information for the development and review of the nursing care plan.
  • Maintain a therapeutic environment for patients according to established procedures and policies by reporting actual or potential accidents, fire hazards, and faulty equipment.
  • Competent with performing aspects of nursing care to meet patients/residents needs for:
    • Personal Hygiene
    • Physical Comfort
    • Activity, Exercise, Rest
    • Nutrition
    • Elimination
    • Prevention of Skin Breakdown
    • Rehabilitative Aspects of Care
  • Performing and documenting prescribed medical treatment and interventions for patients, such as diabetic urine testing and blood testing, simple dressing changes.
  • Learning to be proficient with the utilizing rehabilitative principles to promote patient independence and recovery, encouraging and guiding patient/resident in bowel and bladder training.
  • Monitors patients according to levels of observation i.e. (one to one, continuous observation, Q 15-minute checks, and safety rounding).
  • Monitor Veterans who may be at risk for harming themselves and or others according to established policies and procedures and appropriately refers issues to the charge nurse or other healthcare professionals.
  • Reports patient status to the RN and documents pertinent observations in the medical record according to established procedures.
  • Sets up patient care related equipment, such as respiratory/oxygen delivery systems, portable and wall suction and assisting in monitoring proper function of equipment.
  • Utilizes glucose monitoring machine to collect glucose values on veterans when needed and refer deviations to appropriate nursing staff or other health care professionals.
  • Utilize Bladder Scanner to collect information for RN and Provider as ordered.
  • Utilize ECG to collect information for RN and Provider as ordered.- Organizing and obtaining routine supplies and equipment.
  • Safeguarding the patient's right to privacy by judiciously protecting information of a confidential nature.
  • Utilizes principles of proper body mechanics whiling caring for patients and follows procedures for use of patient care equipment to prevent injury.
  • Performs other duties as assigned by a supervisor/manager within their scope of work.

Work Schedule: 7:30am to 4:00pm with rotating days off, holidays and weekends
Recruitment Incentive (Sign-on Bonus): Not authorized
Permanent Change of Station (Relocation Assistance): Not authorized
Pay: Competitive salary and regular salary increases When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade).
Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.
Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.
Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Telework: Not available
Virtual: This is not a virtual position.
Functional Statement #: 631-F08228
Permanent Change of Station (PCS): Not authorized
Requirements
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Conditions of employment
  • You must be a U.S. Citizen to apply for this job.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Must be proficient in written and spoken English.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Must pass pre-employment physical examination.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Qualifications
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.
Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • Experience or Education or Training.
    • Six months of general experience. Experience must demonstrate the ability to acquire the knowledge and skills to perform the work of a NA; OR
    • One year of education above high school with courses related to the NA occupation; OR
    • Completion of an intensive, specialized, occupation-related training course of study or program of less than one year as a NA may also meet in full the experience requirements for GS-3
  • English Language Proficiency. NAs must be proficient in spoken and written English in accordance with VA Handbook 5005, part II, chapter 3, section A, paragraph 3j.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).
Grade Requirements.
  • Creditable Experience.
    • Knowledge of Current Practice. To be creditable, the experience must have required the use of knowledge, skills, and abilities associated with the current practice.
    • Quality of Experience. To be creditable, NA experience must be documented on the application or resume and verified in an employment reference, or through other independent means.
    • Part-Time Experience. Part-time experience as a NA is creditable according to its relationship to the full-time workweek. For example, a NA employed 20 hours a week, or on a 1/2-time basis, would receive 1 full time workweek of credit for each 2 weeks of service.

Grade Determinations: In addition to the basic requirements for employment, the following criteria must be met when determining the grade of candidates.
  • GS-3 NA (Entry Level)
    • Experience and Education. None beyond the basic requirements.
    • Assignments. Individuals assigned as GS-3 NAs are considered to be at the entry level and are closely supervised
  • GS-4 NA (Intermediate or Developmental Level)
    • Experience. One year of specialized experience as a NA or experience in another medical field (licensed practical nurse, health technician, hospital corpsman, etc.), performing technical and nursing skills requiring knowledge of the human physical and emotional states, therapeutic communication, and technical skills required for basic and intermediate treatments; OR
    • Education. Successful completion of 2 years above high school in an accredited institution with courses related to nursing care, health care or in a field of study appropriate to the specialization of the position, such as education in a program for psychology, psychiatric, or operating room technicians; AND
    • Demonstrated Knowledge, Skills, and Abilities (KSAs). In addition, the candidate must demonstrate the following KSAs:
      • Ability to provide a range of patient/resident care and contribute to the completion of the nurse care plan and recovery of patients/residents.
      • Ability to observe patients/residents' or resident's physical or emotional status and refer deviations and/or problems to supervisor in a timely manner.
      • Ability to properly use equipment, materials and supplies in simple diagnostic and treatment procedures such as bladder scan, continuous passive motion device, blood glucose monitoring machine, specimen collection, etc.
      • Ability to communicate effectively with patients/residents, their families and other health professionals.
    • Assignment.
      • Individuals assigned as GS-4 NAs are considered to be at the intermediate or developmental level and are closely supervised. NAs at this grade level function as a member of the nursing care team and assist higher graded NAs, licensed nursing staff, and other members of the care team in the care of patients/residents receiving outpatient care, home or community living care or other patients/residents who are in acute, sub-acute, or chronic states of illness.
  • GS-5 NA (Full Performance Level).
    • Experience. One year of progressively responsible assignments and experience equivalent to the GS-4 level which demonstrates knowledge, skills, and abilities that are directly related to the specific assignment. In addition, the candidate must demonstrate the professional KSAs listed; OR
    • Education. Successful completion of a 4-year course of study above high school leading to a bachelor's degree that included 24 semester hours of courses related to health care or possession of a bachelor's degree; AND
    • Demonstrated KSAs.
      • Ability to assist in the full range of nursing care to patients/residents with physical and/or behavioral problems in a hospital, long-term care or outpatient setting under the direction of a Registered Nurse and/or Licensed Vocational Nurse/Licensed Practical Nurse.
      • Ability to communicate orally with patients/residents, families, interdisciplinary team and other personnel. This includes serving as a preceptor to new NAs by assisting with the coordination of their orientation and overseeing/assessing their practical experience while in a clinical setting.
      • Ability to recognize and react to emergent patient/resident care situations and intervene while waiting for assistance. For example, recognizing need for basic life support, controlling bleeding and assisting with behavior crisis, etc.
    • Assignment.
      • This is the full performance level for NAs. NAs at this grade level function as a member of the nursing care team and assist licensed nursing staff in the care of patients/residents receiving outpatient care, home or community living care or other patients/residents who are in acute, sub acute or chronic states of illness.

Preferred Experience: Mental Health Psychiatric Nursing Assistant experience preferred.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
The full performance level of this vacancy is GS5. The actual grade at which an applicant may be selected for this vacancy is in the range of GS3 to GS5.
Physical Requirements: Work involves varying periods of sitting, standing and walking. Working with Veterans/residents requires bending, stooping, teaching, lifting, balancing, kneeling, pushing, i.e., wheelchairs, geri-chairs, litters and similar activities. Also, it may be necess...

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About Veterans Health Administration

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US

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