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Remote Utilization Review Rn Jobs in Worcester, MA

DaVita

Director, Clinical Services

Southbridge, MA · On-site +1

... review process and provide reports with analysis as requested * Allocate resources according to divisional priorities * Develop a collaborative and unified team REQUIREMENTS: * Active RN License:

CRH

Technical Sales Rep - Remote

Oxford, MA · On-site +1

$130K - $160K/yr

... utilization * Maintain and grow the current account base through regular customer interaction ... AI tools may be used in certain stages of the employment lifecycle, such as candidate review ...

Varsity Tutors

NCLEX-PN Tutor

Waltham, 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 ...

Varsity Tutors

NCLEX-PN Tutor

Newton, 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 ...

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

Remote Utilization Review Rn information

See Worcester, MA salary details

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

As of Sep 13, 2026, the average hourly pay for remote utilization review rn in Worcester, MA is $42.19, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.46 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 Worcester, MA?

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

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

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

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

Cities near Worcester, 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 Worcester, MA as of September 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, 2% Temporary, and 3% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $87,755 per year, or $42.2 per hour.

Virtual Monitor Tech / Float PCA 36 hrs nights

Newton, MA • On-site, Remote

Mass General Brigham
See more jobs at Mass General Brighamexternal

$20.58 - $25.28/hr

Full-time

Re-posted 19 days ago

Brigham and Women's Hospital rating

8.1

Company rating: 8.1 out of 10

Based on 101 frontline employees who took The Breakroom Quiz

Job description

Site: Newton-Wellesley Hospital
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
$750.00 Sign-On Bonus
Under the direction of a registered/licensed nurse (RN), the Patient Care Associate (PCA) as a member of the interdisciplinary health care team assists in clinical support functions to promote a safe, compassionate patient care environment.
Qualifications
Certification as a CNA, PCT, MA, EMT or commensurate experience required, unless incumbent is currently enrolled in, and successfully completes, the NWH Patient Care Associate Training Program, or is a nursing student who has completed her/his fundamentals of nursing with a clinical component (clinical rotation or simulation lab). For nursing students hired as PCAs, strongly prefer nursing students enrolled in BSN programs or direct-entry Masters' programs.
Additional Job Details (if applicable)
Additional Job Description
Remote Type
Onsite
Work Location
2014 Washington Street
Scheduled Weekly Hours
36
Employee Type
Regular
Work Shift
Night (United States of America)
Pay Range
$20.58 - $25.28/Hourly
Grade
3
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
4100 Newton-Wellesley Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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