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Entry Level Utilization Review Remote Jobs (NOW HIRING)

Centene

Utilization Review Clinician - Behavioral Health

OR · Remote

$27.02 - $48.55/hr

Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular ... Knowledge of mental health and substance abuse utilization review process preferred. Experience ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

CHPW

Utilization Management Clinician I

Seattle, WA · On-site +1

$35.92 - $55.67/hr

This position is remote in Washington state. Who we are Community Health Plan of Washington is an ... Conduct review of hospital notification or prior authorization care requests against established ...

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Entry Level Utilization Review Remote information

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How much do entry level utilization review remote jobs pay per hour?

As of Jul 17, 2026, the average hourly pay for entry level utilization review remote in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Entry Level Utilization Review Remote vs Entry Level Medical Coder Remote?

AspectEntry Level Utilization Review RemoteEntry Level Medical Coder Remote
Required CertificationsUtilization Review Certification, possibly a healthcare or insurance-related licenseCertified Coding Associate (CCA) or Certified Professional Coder (CPC)
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare facilities, or coding companies
Industry UsageHealthcare insurance, utilization managementMedical billing, coding, healthcare documentation
Common Search/ComparisonYesYes

Entry Level Utilization Review Remote and Entry Level Medical Coder Remote both operate in healthcare but focus on different tasks. Utilization reviewers assess medical necessity for services, requiring certifications in utilization review. Medical coders translate medical records into codes, requiring coding certifications. Both roles are remote and essential in healthcare administration, but they serve distinct functions within the industry.

More about Entry Level Utilization Review Remote jobs
What cities are hiring for Entry Level Utilization Review Remote jobs? Cities with the most Entry Level Utilization Review Remote job openings:
What states have the most Entry Level Utilization Review Remote jobs? States with the most job openings for Entry Level Utilization Review Remote jobs include:
What job categories do people searching Entry Level Utilization Review Remote jobs look for? The top searched job categories for Entry Level Utilization Review Remote jobs are:
Entry Level Utilization Review Remote jobs near you
Infographic showing various Entry Level Utilization Review Remote job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 86% Full Time, 12% Part Time, and 1% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Clinician - Behavioral Health

Utilization Review Clinician - Behavioral Health

Centene

OR • Remote

$27.02 - $48.55/hr

Full-time

Medical, Retirement, PTO

Re-posted 14 days ago

Centene rating

8.5

Company rating: 8.5 out of 10

Based on 396 frontline employees who took The Breakroom Quiz

15th of 886 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular holiday rotation required. Must be licensed in state of WA.

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

  • Evaluates member's treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
  • Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
  • Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
  • Analyzes BH member data to improve quality and appropriate utilization of services
  • Provides education to providers members and their families regrading BH utilization process
  • Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
  • Engages with medical directors and leadership to improve the quality and efficiency of care
  • Formulates and presents cases in staffing and integrated rounds
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience.
License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master's degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.
License/Certification:

  • LCSW- License Clinical Social Worker required or
  • LMHC-Licensed Mental Health Counselor required or
  • LPC-Licensed Professional Counselor required or
  • Licensed Marital and Family Therapist (LMFT) required or
  • Licensed Mental Health Professional (LMHP) required or
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular holiday rotation required. Must be licensed in state of WA.

Pay Range: $27.02 - $48.55 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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