2

Assistant Remote Utilization Review Jobs in Ohio

Esrun Health is seeking Medical Assistants to work part-time from their home office as independent ... Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ...

Esrun Health is seeking Medical Assistants to work part-time from their home office as independent ... Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ...

Remote Tax Manager

Columbus, OH · On-site +1

$135K - $195K/yr

Prepare and review: * Individual (1040), business (1120S, 1065), and basic corporate returns ... * Assist with year-end planning and projections * Ensure compliance with federal and state tax ...

$40K - $50K/yr

At Wing, we give growing businesses access to the top tier of global remote talent supercharged by ... These tools assist our recruitment team but do not replace human judgment. Final hiring decisions ...

$40K - $50K/yr

At Wing, we give growing businesses access to the top tier of global remote talent supercharged by ... These tools assist our recruitment team but do not replace human judgment. Final hiring decisions ...

$40K - $50K/yr

At Wing, we give growing businesses access to the top tier of global remote talent supercharged by ... These tools assist our recruitment team but do not replace human judgment. Final hiring decisions ...

Showing results 21-40

Assistant Remote Utilization Review information

What is the difference between Assistant Remote Utilization Review vs Utilization Review Nurse?

AspectAssistant Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certification in case management or utilization reviewRegistered Nurse (RN) license, often with additional certifications in case management or utilization review
Work EnvironmentRemote, administrative setting, telehealth or telecommutingRemote or hospital/clinic settings, primarily telehealth or administrative
Employer & IndustryHealth insurance companies, managed care organizations, healthcare providersHospitals, insurance companies, healthcare organizations

Both roles involve reviewing patient cases to determine appropriate care and resource utilization. The Assistant Remote Utilization Review typically supports the process with administrative tasks and basic review, while the Utilization Review Nurse performs more in-depth clinical assessments. Both require nursing credentials and often work remotely within healthcare or insurance industries.

What are the most commonly searched types of Remote Utilization Review jobs in Ohio? The most popular types of Remote Utilization Review jobs in Ohio are:
What cities in Ohio are hiring for Assistant Remote Utilization Review jobs? Cities in Ohio with the most Assistant Remote Utilization Review job openings:
Physician / Surgery - Orthopedics / Ohio / Permanent / Associate Medical Director - Orthopedic Surge

Physician / Surgery - Orthopedics / Ohio / Permanent / Associate Medical Director - Orthopedic Surge

eviCore healthcare

Columbus, OH • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago


Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.
Participates in strategic planning for and evaluation of the Care Management
The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Surgery - Orthopedics, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).
Must have a minimum of 5 years clinical experience, beyond residency/fellowship
Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is required
No nights, no weekends, not call.
Predictable work schedule
Full and part time opportunities
Salaried position with benefits
Supportive organization with collaborative culture
eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:
Flexible scheduling and work/life balance with remote and work from home opportunities
4 weeks of PTO(starting) per year plus paid holidays
One week of CME
Education assistance, tuition reimbursement and professional certifications
Health, dental, vision, and life benefits with employer funded HSA
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee contributions up to 6%
eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation