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Cvs Health Utilization Management Remote Jobs in Utah

Imh

Manager Utilization and Care Management

Murray, UT · On-site +1

$44.99 - $69.44/hr

The Clinical Manager at Select Health leads and supervises a team of Utilization Review and Care ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

MRIoA

Business Intelligence Analyst (Remote)

Salt Lake City, UT · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Founded in 1983, we're a clinically-driven, tech-enabled utilization management company offering ... Benefits include healthcare, vision, and dental insurance * A generous 401(k) match * Paid vacation ...

MRIoA

Quality Assurance Engineer (Remote)

Salt Lake City, UT · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Founded in 1983, we're a clinically-driven, tech-enabled utilization management company offering ... Benefits include healthcare, vision, and dental insurance * A generous 401(k) match * Paid vacation ...

MRIoA

Senior Azure Cloud Engineer (Remote)

Salt Lake City, UT · On-site +1

$54 - $72/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Founded in 1983, we're a clinically-driven, tech-enabled utilization management company offering ... Benefits include healthcare, vision, and dental insurance, a generous 401 (k) match, paid vacation ...

Imh

Medicare Market Operations Partner

Murray, UT · On-site +1

$59.50 - $91.84/hr

... utilization management, and care coordination * Ensure operational readiness for CMS audits ... Background in payer operations, health plans, or value-based care organizations * Knowledge of ...

MRIoA

Clinical Pharmacy Coordinator (Remote)

Salt Lake City, UT · On-site +1

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Founded in 1983, we're a clinically-driven, tech-enabled utilization management company offering ... Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation ...

APR

Commercial Lines Account Manager | Remote

UT · Remote

$70K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

Proven ability to consult on risk management and provide expert advice to management. * Strong ... Our comprehensive benefits package includes health, dental, and vision insurance, a 401(k) plan ...

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Cvs Health Utilization Management Remote information

What is the difference between Cvs Health Utilization Management Remote vs Cvs Health Medical Reviewer?

AspectCvs Health Utilization Management RemoteCvs Health Medical Reviewer
CredentialsRN, LPN, or other healthcare licensesRN, MD, or DO licenses
Work EnvironmentRemote, home-basedRemote or onsite, depending on role
Employer & Industry UsageUtilization management for insurance approvalsMedical review for claims and authorizations

Both roles involve healthcare assessments, often requiring similar licenses. Utilization Management Remote focuses on reviewing medical necessity for insurance purposes, while Medical Reviewers may handle detailed case evaluations. Both are remote-friendly and integral to healthcare insurance processes, but differ slightly in scope and responsibilities.

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For Cvs Health Utilization Management Remote jobs in Utah, the most frequently searched job titles are:

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The top searched job categories for Cvs Health Utilization Management Remote jobs in Utah are:

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Cvs Health Utilization Management Remote jobs near you

Behavioral Health Utilization Management Specialist

Row Partners

Draper, UT • On-site, Remote

$60K - $70K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 2 days ago

Job description

Behavioral Health Utilization Management Specialist

Location: Utah (Hybrid & Remote Options Available)

Job Type: Full-time

Department: Behavioral Health / Utilization Management

Who We Are

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team.

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day.

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you.

The Role

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes.

What You’ll Do

  • Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services.
  • Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
  • Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
  • Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
  • Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
  • Stay ahead of industry standards, insurance requirements, and treatment protocols.
  • Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers.
  • Document with precision for utilization reviews, audits, and compliance needs.

What You Bring

Proven Success

  • A history of professional growth, creative problem-solving, and a commitment to excellence.
  • Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike.

Preferred Experience

  • 2+ years in utilization management, case management, or behavioral health services
  • Familiarity with mental health and substance use disorder diagnoses.
  • Understanding of insurance coding, billing, and behavioral health authorization procedures.

Preferred Skills

  • Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
  • Comfort with utilization management tools (ASAM, MCG, InterQual).
  • Excellent communication and relationship-building skills.
  • Ability to multitask in a fast-paced environment.
  • EHR system proficiency.

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.)

Work Location

  • Based in Sandy, Utah — remote work available for those living more than 50 miles from the office.

Why You’ll Love Working With Us

  • Competitive salary & comprehensive benefits (health, dental, vision).
  • Paid time off, sick leave, and paid holidays.
  • Opportunities for growth, training, and continuing education.
  • Supportive, team-first culture where your contributions matter.
  • The chance to impact lives and improve care outcomes every single day.

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.