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Remote Utilization Review Jobs in Springfield, MA

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 · 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 ...

ReSource Pro

Director Client Development

Hartford, CT · Remote

$120K - $205K/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 ...

ReSource Pro

Director Client Development

Hartford, CT · On-site +1

$120K - $205K/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 ...

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 ...

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

Remote Utilization Review information

See Springfield, MA salary details

$21

$42

$68

How much do remote utilization review jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for remote utilization review 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 in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are popular job titles related to Remote Utilization Review jobs in Springfield, MA? For Remote Utilization Review jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Springfield, MA look for? The top searched job categories for Remote Utilization Review jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Remote Utilization Review jobs? Cities near Springfield, MA with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
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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