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Director Remote Utilization Review Jobs in Racine, WI

Brightline

Clinical Director

Milwaukee, WI · Remote

$81K - $111K/yr

... utilization/capacity, people retention and development, and growth. * Design and oversee peer ... Meet 1:1 with every direct report at least biweekly to review clinical care, documentation ...

State of Wisconsin

Associate Medical Director

Sturtevant, WI · On-site +1

$99.74 - $141.45/hr

This position has the flexibility of a hybrid in-office and remote work schedule of up to 3 days ... Supervising, leading, and/or overseeing the work of others (e.g. training, advising, reviewing work ...

Sikich

Tax Director

Brookfield, WI · Remote

$200K - $231K/yr

Tax Director - (US - Milwaukee,WI - Remote) What to expect when you join Sikich Team members at ... Conduct performance reviews and contribute to performance feedback for all levels of staff ...

Sikich

Tax Director

Brookfield, WI · Remote

Tax Director - (US - Milwaukee, WI - Remote ) What to expect when you join Sikich Team members at ... Conduct performance reviews and contribute to performance feedback for all levels of staff ...

PERFECTUS LABS LLC

Director of AEO

Milwaukee, WI · Remote

Remote (Central or Eastern Time Zone Required) Schedule: Mon-Fri, 8 AM - 5 PM EST or 9 AM - 6 PM ... Confident in client-facing settings, including strategy presentations and performance reviews.

Johnson Controls

Associate Legal Director

Milwaukee, WI · On-site +1

$145K - $195K/yr

Draft, review interpret and negotiate employment related agreements, including employment ... For details, pleasevisit the About Us tab on the Johnson Controls Careers site at #LI-Remote ...

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All JobsUtilization Review JobsDirector Remote Utilization Review JobsDirector Remote Utilization Review Jobs in Racine, WI

Director Remote Utilization Review information

See Racine, WI salary details

$20

$39

$64

How much do director remote utilization review jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for director remote utilization review in Racine, WI is $39.65, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $45.53 per hour, depending on experience, location, and employer.

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

AspectDirector Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, advanced degree, and management experienceRegistered Nurse (RN) license, relevant clinical experience
Work EnvironmentOversees teams remotely, strategic planning, policy developmentConducts patient reviews, collaborates with healthcare providers, often remote or onsite
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare facilities

The main difference is that the Director Remote Utilization Review focuses on managing teams and policies remotely, while the Utilization Review Nurse performs clinical reviews directly related to patient care. The director has a broader strategic role, whereas the nurse role is more clinical and operational.

What is a Director of Remote Utilization Review?

A Director of Remote Utilization Review is a healthcare leader responsible for overseeing teams that assess the necessity, appropriateness, and efficiency of medical services, typically from a remote or virtual environment. This role ensures compliance with regulatory guidelines, optimizes resource use, and helps manage healthcare costs while maintaining quality patient care. Directors collaborate with physicians, nurses, and insurance providers to review clinical cases and develop utilization review strategies. They also monitor performance metrics and implement process improvements for remote teams.

How does a Director of Remote Utilization Review typically collaborate with clinical and administrative teams to ensure effective patient care management?

A Director of Remote Utilization Review plays a pivotal role in bridging clinical staff, case managers, and administrative teams to optimize patient care and resource utilization. This is often achieved through regular virtual meetings, data sharing, and cross-departmental strategy sessions to review utilization trends and address barriers to care. The director ensures that remote teams adhere to regulatory standards and organizational goals, fostering open communication to streamline workflows and resolve complex cases efficiently. Successful collaboration enhances patient outcomes, reduces unnecessary costs, and maintains compliance, all while supporting a positive remote team environment.

What are the key skills and qualifications needed to thrive as a Director of Remote Utilization Review, and why are they important?

To thrive as a Director of Remote Utilization Review, you need in-depth knowledge of healthcare regulations, utilization management processes, and a relevant clinical background, typically supported by an RN or other clinical licensure and experience in case management. Familiarity with utilization review software, electronic health records (EHR), and certifications such as CCM or UM are often required. Leadership, analytical thinking, and strong communication skills are vital for guiding teams and collaborating with stakeholders. These skills ensure effective oversight of remote teams, regulatory compliance, and optimal patient care outcomes.
Director Remote Utilization Review jobs near you

Utilization Review Specialist-Remote

Wellbrook Recovery

Brookfield, WI • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Job description

Utilization Review Specialist – Behavioral Health Facility

We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing clinical documentation, ensuring medical necessity, managing insurance authorizations, and collaborating with providers to support appropriate and timely care for our clients.

Responsibilities:

  • Conduct utilization reviews and obtain prior authorizations from insurance companies

  • Monitor continued stay and discharge criteria for clients

  • Communicate effectively with clinical and administrative teams

  • Maintain accurate and up-to-date documentation

  • Ensure all documentation meets insurance and regulatory compliance standards and is completed accurately and on time.

Qualifications:

  • Background or experience in social work, counseling, or behavioral health is preferred

  • Experience in utilization review or case management for behavioral health is preferred

  • Strong communication and organization skills

  • Ability to work efficiently in a fast-paced environment

  • Confident, proactive, and dedicated work ethic

Benefits: Competitive salary Opportunities for professional development and career advancement Supportive and collaborative work environment Fulfilling work helping individuals with mental health or substance abuse issues

Benefits:

  • 401(k)

  • Dental insurance

  • Flexible schedule

  • Health insurance

  • Life insurance

  • Paid time off

  • Vision insurance