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Remote Utilization Review Rn Jobs in Springfield, MA

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 ...

AVP, Pharmacy Operations & Strategy

Hartford, CT ยท Remote

$130.10K - $172K/yr

Coordinate performance reviews, trend analysis, operational updates, and improvement plans across ... Remote or HybridRequirements * 12+ years of experience in health plan pharmacy, PBM, or related ...

Director Client Development

Hartford, CT ยท On-site +1

$120.95K - $205.03K/yr

All remote positions are based in the United States, and candidates must reside within the U.S. to ... Conduct quarterly and annual performance reviews tied to sales outcomes, including win rates, deal ...

Pharmacist (Part-Time, Overnight)

Hartford, CT ยท Remote

$58.75 - $70.50/hr

Remote order entry and CPOE order evaluation and verification * Physician and nursing consultations * Clinical medication dosing services * Review and monitoring of profiles and lab values for ...

Director Client Development

Hartford, CT ยท Remote

$120.95K - $205.03K/yr

All remote positions are based in the United States, and candidates must reside within the U.S. to ... Conduct quarterly and annual performance reviews tied to sales outcomes, including win rates, deal ...

NCLEX Tutor

Northampton, MA ยท Remote

$40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

NCLEX Tutor

Hartford, CT ยท Remote

$40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

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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 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:
Manager, Professional Services

Manager, Professional Services

Insurity

Hartford, CT โ€ข On-site, Remote

Full-time

Medical, Retirement, PTO

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Please note that Insurity will only reach out to interview, make an offer of employment, or conduct onboarding activities for candidates who have applied through our careers site. When interviewing for a position, the candidate experience will include live interaction, such as a video or telephone call, with a Recruiter and/or company employee(s). We will never ask for any money or payments from applicants at any point in the recruitment process. Recruiters will only reach out from an insurity.com email address; no other email addresses will be used. Examples of fraudulent email addresses that have been used end with @insurityjobs.us.ย ย  Be aware of suspicious recruitment activity. If you think you are a victim of an employment scam, you may contact your local law enforcement agency and/or visit the Federal Trade Commission website here: https://consumer.ftc.gov/articles/job-scams.ย 

Who We Are

Insurity empowers insurance organizations to quickly capitalize on new opportunities by delivering the worldโ€™s most configurable, cloud-native, easy-to-use, and intuitively analytical insurance software. Just as importantly, we empower our peopleโ€”providing the tools, support, and opportunities they need to grow and succeed.

We donโ€™t just make bold promisesโ€”we deliver results. As the largest cloud-based software provider for the Property & Casualty market, Insurity is trusted by 22 of the top 25 P&C carriers and 7 of the top 10 wholesale brokers in the MGA space. Behind that trust is a team that delivers exceptional value and deep industry expertise.

While our technology sets us apart, itโ€™s our people who truly make the difference. At Insurity, youโ€™ll collaborate with some of the most creative and knowledgeable minds in insurance techโ€”in a culture that fosters innovation, teamwork, and continuous learning. Our award-winning onboarding experience welcomes and supports you from the moment you accept our offer.

Ready to grow your career with an industry leader? Apply todayโ€”weโ€™re excited to welcome you. #UatInsurity

Insurityโ€™s Nextย Manager, Professional Services - Application Development

This role leads a team of developers delivering client-facing implementations of Insurityโ€™s Sure Commercial platform, owning technical design, integrations, and development quality through go-live in a billable Professional Services model. The ideal candidate is a hands-on technical leader with deep experience in enterprise SaaS and system integrations who can guide teams through complex implementations, partner effectively with client stakeholders, and balance delivery quality, utilization, and continuous improvement of our development practices.ย 

What Ourย Manager, Professional Services โ€“ Application Development Will Do

  • Lead, coach, and mentor a high-performing, highly engaged team of individual contributors, typically performing similar functions
  • Interview, hire, onboard, and retain exceptional talent
  • Provide input to departmental goals and ensure goals are met
  • Adopt and reinforce company policies, processes, and programs
  • Lead team members using the companyโ€™s performance management and development process
  • Support a culture that emphasizes the strategy, guiding principles and core values
  • Communicate effectively & regularly with team members, peers, and leaders
  • Manage financial responsibilities and activities
  • Develop and maintain trusted customer relationships
  • Effectively engage with internal and external stakeholders
  • Drive utilization across team
  • Communicate financial and goal results, and KPIs to direct reports
  • Perform tasks as an individual contributor to support the team as neededย 

Who Weโ€™re Looking Forย 

  • 5+ years of experience in software development, including 2+ years of team leadership or management experience
  • Experience supporting external, client-facing software implementations (SaaS and/or enterprise platforms preferred) in a Professional Services or consulting environment (billable/utilization model)
  • Strong understanding of object-oriented programming, system integrations (APIs, data interfaces), and common integration patterns
  • Ability to translate business and functional requirements into effective technical designs and implementation plans
  • Demonstrated experience driving code quality through reviews, testing practices, and use of modern SDLC/CI/CD tools
  • Proven ability to manage priorities and deliver in a fast-paced, multi-project environment
  • Bachelorโ€™s degree in Computer Science, Engineering, or equivalent experience

Nice to Have

  • Experience with enterprise SaaS platforms (e.g., PAS, ERP, CRM)
  • Background in Commercial Insurance or Policy Administration Systems
  • Familiarity with cloud environments (e.g., Azure)
  • Experience with proprietary or domain-specific platforms/languages
  • Agile or hybrid delivery experience
  • Experience working with offshore/distributed teams

Whatโ€™s In It For Uย 

Work Where You Thrive
Find the work environment that supports your bestโ€”whether thatโ€™s remote, in-office, or hybridโ€”depending on your role and location. Our Flex First Workforce approach offers many fully remote opportunities, while some teams follow hybrid or in-office schedules to stay connected and collaborative.

Take Time When You Need It
We trust our team to manage their time with our Open PTO Policy, empowering you to recharge when it matters most.

Benefits That Start on Day One
Enjoy comprehensive health coverage and employer-matched retirement savings right from your first dayโ€”because we know how important these are to you.

Living Our Values Every Day
Our core values are more than words on a wallโ€”they guide how we hire, grow, and retain the very best talent.

Award-Winning Onboarding
From your first day to your first anniversary, our onboarding program is designed to set you up for success and help you make an immediate impact.

Grow Your Career from Within
We believe in promoting from within. In fact, over 20% of our open roles are filled by internal candidates.

Mentorship That Matters
Our mentorship program connects you with experienced leaders who are committed to helping you grow both personally and professionally.

Stay Connected with Coffee for Two
Our unique internal networking program helps you build meaningful connections across teams and departmentsโ€”one virtual coffee chat at a time.

Keep Learning, Always
Fuel your growth with full access to LinkedIn Learning and Kaplanโ€”because continuous development is key to success.

Invest in Your Futureโ€”And Your Familyโ€™s
Through our partnership with the University of Arizona Global Campus, you and your family can access discounted tuition and pursue educational goals affordably.

Earn When You Refer
Love where you work? Invite others to join us! Our Employee Referral Bonus program rewards you for bringing great people on board.

We have five Core Values at Insurity; one of which is to Act with Integrity.ย  Providing pay transparency helps you make the best decision for you.ย  We continuously analyze and update our salary ranges for our roles according to market trends to not only ensure our employees are paid fairly, but also help close gender, race, and disability wage gaps. Along with the benefits listed above, the career level salary range for this role is $80,000 to $166,000. We share a career level salary as a guideline; however, actual salary may vary based on your experience and qualifications. If your application advances, your recruiter will review these details with you during a video interview.

Languages for Quรฉbec candidates: The knowledge of French is required for positions permanently located in Quebec. The English language is required for this position in order to communicate with clients, partners, and colleagues, who are strictly located outside of Quรฉbec. French-language training will be offered to candidates who do not have a good knowledge of French.ย 

Insurity is proud to be an Equal Opportunity Employerย 

We are dedicated to creating an exceptional work environment for all our employees by extending a culture of diversity, equity, inclusion, and belonging into the very fabric of our organization.ย  We embrace differences and diversity of identity, experience, and thought, and actively strive for inclusive behaviors across our company.ย 

ย We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application and/or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.ย  Please contact us to request accommodation.ย 

Thank you for your interest in Insurity!ย  Please understand that due to the volume of applicants we receive, only selected candidates will be contacted.ย 

ย #LI-Remote ย  #innovateatinsurity