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Remote Utilization Review Jobs in Union, NJ (NOW HIRING)

HURC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

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All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Union, NJ

Remote Utilization Review information

See Union, NJ salary details

$21

$43

$70

How much do remote utilization review jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote utilization review in Union, NJ is $43.09, according to ZipRecruiter salary data. Most workers in this role earn between $34.04 and $49.47 per hour, depending on experience, location, and employer.

What is a remote utilization review?

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 does a remote utilization review do?

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 are the key skills and qualifications needed to thrive in remote utilization review?

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 are the most commonly searched types of Utilization Review jobs in Union, NJ?

The most popular types of Utilization Review jobs in Union, NJ are:

What are popular job titles related to Remote Utilization Review jobs in Union, NJ?

For Remote Utilization Review jobs in Union, NJ, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review jobs in Union, NJ look for?

The top searched job categories for Remote Utilization Review jobs in Union, NJ are:

What cities near Union, NJ are hiring for Remote Utilization Review jobs?

Cities near Union, NJ with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Union, NJ as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $89,621 per year, or $43.1 per hour.

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Provider Resources, LLC

New York, NY • Remote

Other

Re-posted 2 days ago

Job description

Provider Resources, LLC (PRI) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation’s Veterans.
As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.
What Should I Expect?
  • Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations
  • Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise
  • Maintain compliance with all regulation changes as they impact medical and utilization review practices
  • Document all review information as instructed
  • Communicate report results to the appropriate supervisor
  • Access electronic health information, as assigned/granted
Do I Qualify?
  • Must hold a current medical license
  • Must be board certified within their clinical specialty (as appropriate)
  • Currently works a minimum of 20 hours per month within their area of clinical specialty
  • Must have a minimum of 5 years full-time experience in direct care
  • Must be actively seeing patients within the last 3 years
Website: https://www.provider-resources.com/vareviews • Email: pripanel@provider-resources.com

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