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Flex Schedule Remote Utilization Review Jobs in Appleton, WI

Network Health WI

RN Care Manager

Menasha, WI · On-site +1

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Schedule visits with the individual and participates in facility-based care conferences as ...

Katch

Recovery Specialist

Green Bay, WI · On-site +1

Participate in case reviews and strategy discussions * Mentor other team members in subrogation ... Remote work options available for many roles * Flexible schedules in select positions For more ...

FindTalent

Solar Project Manager

Green Bay, WI · Remote

While this position offers remote flexibility, regular travel to active project sites is required ... Review and interpret contract terms, drawings, and technical specifications to ensure compliance.

Network Health, Inc

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Schedule visits with the individual and participates in facility-based care conferences as ...

Network Health

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Schedule visits with the individual and participates in facility-based care conferences as ...

DataAnnotation

FP&A Manager - AI Trainer

Green Bay, WI · Remote

$50 - $100/hr

Enjoy the flexibility of remote work and the freedom to set your own schedule. This is an ... Review and improve AI Assistant answers to questions about macro trends, corporate finance, and ...

DataAnnotation

M&A Associate - AI Trainer

Green Bay, WI · Remote

$50 - $100/hr

Enjoy the flexibility of remote work and the freedom to set your own schedule. This is an ... Review and improve AI Assistant answers to questions about macro trends, corporate finance, and ...

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Showing results 21-40

All JobsUtilization Review JobsFlex Schedule Remote Utilization Review JobsFlex Schedule Remote Utilization Review Jobs in Appleton, WI

Flex Schedule Remote Utilization Review information

See Appleton, WI salary details

$20

$41

$67

How much do flex schedule remote utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for flex schedule remote utilization review in Appleton, WI is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.36 per hour, depending on experience, location, and employer.

What is the difference between Flex Schedule Remote Utilization Review vs Flex Schedule Remote Case Manager?

AspectFlex Schedule Remote Utilization ReviewFlex Schedule Remote Case Manager
Primary RoleReview healthcare services for medical necessity and appropriatenessCoordinate patient care, develop care plans, and facilitate services
CredentialsTypically requires nursing, medical, or healthcare-related certificationsOften requires nursing, social work, or healthcare certifications
Work EnvironmentRemote, independent review setting, often within insurance or healthcare companiesRemote or hybrid, involving direct patient interaction and care coordination
Industry UsageCommon in insurance, healthcare, and utilization management sectorsCommon in healthcare, insurance, and patient advocacy sectors

Flex Schedule Remote Utilization Review focuses on evaluating medical necessity remotely, while Flex Schedule Remote Case Manager involves coordinating patient care and services. Both roles often require healthcare certifications and are performed remotely, but their core responsibilities differ in review versus patient management.

What are popular job titles related to Flex Schedule Remote Utilization Review jobs in Appleton, WI? For Flex Schedule Remote Utilization Review jobs in Appleton, WI, the most frequently searched job titles are:
What job categories do people searching Flex Schedule Remote Utilization Review jobs in Appleton, WI look for? The top searched job categories for Flex Schedule Remote Utilization Review jobs in Appleton, WI are:
What cities near Appleton, WI are hiring for Flex Schedule Remote Utilization Review jobs? Cities near Appleton, WI with the most Flex Schedule Remote Utilization Review job openings:
Flex Schedule Remote Utilization Review jobs near you

RN Care Manager - Condition/Disease Management Focus

Network Health WI

Menasha, WI • On-site, Remote

Full-time

Posted 2 days ago

New

Job description

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager advocates for options and services to meet an individual's and family's comprehensive health needs through communication and coordination of available resources to promote quality, cost-effective outcomes.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day.
Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
  • Screen candidates for case management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines. Evaluate and determine member needs based on clinical or behavioral information such as diagnosis, disease progression, procedures and other related therapies
  • Review results from medical or behavioral tests and procedures and updates care plan to reflect progress towards goals; close cases when expected goals/outcomes are achieved
  • Provide information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
  • Evaluate and process member referrals from physicians to other specialty providers
  • Assess, plan, facilitate and advocate for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
  • Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
  • Educate the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
  • Facilitate the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
  • Schedule visits with the individual and participates in facility-based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
  • Stay abreast of current best practices and new developments
  • Other duties as assigned

Job Requirements:
  • Graduation from accredited school of nursing
  • Bachelor's degree in Nursing preferred
  • RN licensure in the State of Wisconsin
  • Case Management certification preferred
  • Four years of clinical health care experience as a RN required
  • Chronic condition management experience preferred, especially:
    • Diabetes
    • Cardiac
    • Pulmonology
  • Previous experience in case management, utilization management, insurance, or managed care preferred
  • Experience with Medicare, Medicaid preferred

Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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