Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
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Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
Dallas, TX · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
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Dallas, TX · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
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Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ... Work From Home (Up to 2 days per week upon eligibility) * Onsite Gym * Garage Parking * Within ...
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ... Work From Home (Up to 2 days per week upon eligibility) * Onsite Gym * Garage Parking * Within ...
Kingston, PA · On-site
$25 - $35/hr
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
Kingston, PA · On-site
$25 - $35/hr
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
Tempe, AZ · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
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Tempe, AZ · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... While your daily work will be completed from your home office, occasional travel may be required ...
$25 - $35/hr
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
Quick apply
$25 - $35/hr
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
... experienced full-time Utilization Review Representative to our growing Utilization Review ... Benefit from a wide range of options, including dental, health, vision, and disability insurance ...
Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... from many other treatment facilities, and our tenured team includes seasoned medical staff. The ...
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... from many other treatment facilities, and our tenured team includes seasoned medical staff. The ...
Omaha, NE · On-site
... Utilization Review Specialist in Omaha to join its Medical Management team ... The individual ensures that medical treatment requests from providers are medically appropriate and ...
Omaha, NE · On-site
... Utilization Review Specialist in Omaha to join its Medical Management team ... The individual ensures that medical treatment requests from providers are medically appropriate and ...
... Utilization Review Specialist in Omaha to join its Medical Management team ... The individual ensures that medical treatment requests from providers are medically appropriate and ...
... Utilization Review Specialist in Omaha to join its Medical Management team ... The individual ensures that medical treatment requests from providers are medically appropriate and ...
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... from many other treatment facilities, and our tenured team includes seasoned medical staff. The ...
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... from many other treatment facilities, and our tenured team includes seasoned medical staff. The ...
Miami, FL · On-site
... LTACH), home health, DME, and outpatient services. * Applies evidence-based criteria (e.g ... Graduate from an accredited Nursing program. Experience * 2-4 years of experience in healthcare ...
Miami, FL · On-site
... LTACH), home health, DME, and outpatient services. * Applies evidence-based criteria (e.g ... Graduate from an accredited Nursing program. Experience * 2-4 years of experience in healthcare ...
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to limit possible recoupment from third party pay sources including Medicare, Medicaid, HMO or private ...
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to limit possible recoupment from third party pay sources including Medicare, Medicaid, HMO or private ...
Greenville, NC · On-site
$65K - $95K/yr
Position Summary The Utilization Review Specialist will ensure regulatory compliance with CMS ... If ADN must have 5 + years experience in an acute care hospital; home health agency; commercial ...
Greenville, NC · On-site
$65K - $95K/yr
Position Summary The Utilization Review Specialist will ensure regulatory compliance with CMS ... If ADN must have 5 + years experience in an acute care hospital; home health agency; commercial ...
... apart from many other treatment facilities, and our tenured team includes seasoned medical staff ... Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ...
... apart from many other treatment facilities, and our tenured team includes seasoned medical staff ... Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ...
Augusta, AR · On-site
Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... That mission drives everything we do, from accepting every patient, regardless of insurance status ...
Augusta, AR · On-site
Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... That mission drives everything we do, from accepting every patient, regardless of insurance status ...
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
| Aspect | From Home Optum Utilization Review | From Home Medical Coder |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical reviewer credentials) | Certification in medical coding (e.g., CPC, CCS) often required |
| Work Environment | Remote, healthcare insurance or managed care setting | Remote, healthcare billing and coding environment |
| Industry Usage | Common in health insurance, managed care, and utilization management | Common in medical billing, coding, and healthcare documentation |
From Home Optum Utilization Review and From Home Medical Coder roles both operate remotely within the healthcare industry. However, utilization review focuses on assessing medical necessity and approving or denying services, requiring clinical credentials. Medical coders translate healthcare documentation into standardized codes, primarily needing coding certifications. Both roles are essential in healthcare operations but differ in responsibilities and required qualifications.
6.9
Based on 6 frontline employees who took The Breakroom Quiz
251st of 303 rated insurance
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.
About the role:
You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.
You will report into the Supervisor, Utilization Review.
Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.
Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.
Responsibilities:
Requirements:
Bonus points:
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.
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Sourced by ZipRecruiter
Insurance services
1,001 - 5,000 Employees
New York, NY, US
2012
