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Remote Utilization Review Rn Jobs in York, PA (NOW HIRING)

Clarvida - Pennsylvania

Behavior Analyst

York, PA · On-site +1

$57/hr

... development and review of preference assessments, reinforcement strategies, and other ... registered nurse practitioner • Licensed in the Commonwealth of Pennsylvania with scope of ...

Varsity Tutors

NCLEX Tutor

Harrisburg, PA · Remote

$25 - $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 ...

Lancaster Bible College

Online Student Success Coach

PA · On-site +1

Remote Work: Yes Supervisory Responsibilities: * None. Physical Requirements: * Prolonged periods ... Coaches students through utilization of appropriate campus services such as meetings with faculty ...

Bertelsmann-Jobs

Credit Card Associate

Westminster, MD · On-site +1

$38K - $40K/yr

Review and process credit-held orders throughout the day. * Process manual credit card payments ... Remote position with potential hybrid work opportunities. * Collaborative and supportive team ...

Clark National Accounts

Account Coordinator

Lititz, PA · On-site +1

$55K - $60K/yr

The ideal candidate will possess qualities in alignment with CNA's Core Values: -Lead with ... Remote Work Qualifications * Access to a reliable and secure high-speed internet connection. Cable ...

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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 Sep 6, 2026, the average hourly pay for remote utilization review rn in York, PA is $41.61, according to ZipRecruiter salary data. Most workers in this role earn between $32.88 and $47.79 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 York, PA?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in York, PA are:

What cities near York, PA are hiring for Remote Utilization Review Rn jobs?

Cities near York, PA 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 York, PA as of August 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% Remote job distribution, with an average salary of $86,554 per year, or $41.6 per hour.

Behavioral Healthcare Manager

American Telehealth LLC

Harrisburg, PA • Remote

$66K/yr

Full-time

This job post has expired 3 days ago. Applications are no longer accepted.

Job description

Overview:
Seniority Healthcare is seeking a dedicated and compassionate Behavioral Healthcare Manager (BHCM) to join our collaborative and innovative team. This full-time role is integral to delivering evidence-based mental health care to seniors residing in Senior Living Communities, in alignment with the Centers for Medicare & Medicaid Services (CMS) Collaborative Care Model (CoCM).

As a BHCM, you will work closely with our Primary Care Providers (PCPs) and Consulting Psychiatrist to coordinate mental health care, focusing on conditions such as depression, anxiety, dementia, and other behavioral health concerns. This is a meaningful opportunity to make a real difference in the lives of vulnerable older adults while working in a high-support, team-based environment.

Key Responsibilities:

  • Collaborative Care Delivery: Serve as the linchpin of the Collaborative Care Model team, coordinating behavioral health services with PCPs and psychiatric consultants, and tracking treatment progress using measurement-based care.
  • Psychiatric Assessment & Care Planning: Conduct comprehensive assessments of behavioral health symptoms, functional status, and psychiatric needs. Develop individualized, evidence-based care plans that address both mental and physical health.
  • Care Coordination: Act as a liaison among patients, families, primary care teams, psychiatrists, and senior living community staff to ensure timely and coordinated care.
  • Monitoring & Measurement: Use validated tools (e.g., PHQ-9, GAD-7) to monitor clinical outcomes and proactively adjust care plans based on patient progress.
  • Documentation & Reporting: Maintain accurate and timely clinical records and participate in regular case review sessions with the consulting psychiatrist.
  • Team Integration: Foster a compassionate and team-oriented approach in collaboration with community caregivers and facility staff to promote holistic well-being.
  • Travel: Routine travel between assigned senior living communities is required.

Required Qualifications:

  • Bachelor’s or Master’s degree in Social Work, Nursing, Psychology, or a related clinical field.
  • At least 3 years of direct clinical experience in behavioral health, including experience in psychiatric assessment and care planning.
  • Experience working with geriatric populations or in integrated primary care settings.
  • Proficiency in using standardized clinical screening tools (e.g., PHQ-9, GAD-7, MoCA).
  • Excellent interpersonal, organizational, and written communication skills.
  • Ability to function both independently and as a core member of a multidisciplinary team.
  • Valid driver’s license and willingness to travel regularly between sites.

Preferred Qualifications:

  • Master’s degree in Clinical Social Work (LCSW), Psychiatric Nursing (PMH-RN or PMHNP), Counseling, or related behavioral health field.
  • Strong working knowledge of the Collaborative Care Model (CoCM) and its core components (care coordination, psychiatric consultation, measurement-based care).
  • Experience working in senior living settings, skilled nursing facilities, or long-term care environments.
  • Training or certification in motivational interviewing, problem-solving therapy, or brief behavioral interventions.
  • Familiarity with electronic health records (EHR) and collaborative care registries (e.g., Care Management Tracking Systems).
  • Bilingual or multilingual abilities (e.g., Spanish, Mandarin, etc.).

Location: In person at facilities in the Harrisburg, PA area.


Monday-Friday 8am-4pm, facility based and in-person.