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Internship Remote Utilization Review Jobs in Missouri

Centene

Supervisor, Utilization Management (RN)

Saint Louis, MO · On-site +1

$75K - $135K/yr

  • Medical

  • Retirement

  • PTO

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Supervisor, Utilization Management (RN)

Kansas City, MO · On-site +1

$75K - $135K/yr

  • Medical

  • Retirement

  • PTO

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Supervisor, Utilization Management (RN)

Columbia, MO · On-site +1

$75K - $135K/yr

  • Medical

  • Retirement

  • PTO

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Supervisor, Utilization Management (RN)

Florissant, MO · On-site +1

$75K - $135K/yr

  • Medical

  • Retirement

  • PTO

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Mosaic Life Care

Remote - Inpatient Coder II

Saint Joseph, MO · On-site +1

$21 - $25.25/hr

  • Medical

  • Vision

  • Life

This assignment is based on evaluation of the documentation in the medical record and utilization ... Reviews and appeals coding denials. * Educates/Communicates with providers, querying providers to ...

Jobgether

You will work in a remote, agile environment alongside engineers, product teams, QA specialists ... Participate in code reviews and contribute to consistent quality standards across development ...

ChenMed

$107K - $136K/yr

... systems through the utilization of data demonstrating program effectiveness and success ... record review by the respective delegating physician. * If supporting patients in Tennessee ...

Harris

Associate Technical Writer

Louisiana, MO · Remote

Review and edit content for clarity, consistency, grammar, and adherence to our style standards ... Fully remote team with flexible working hours * Mentorship and growth opportunities within a ...

Mosaic Life Care

Remote - Inpatient Coder II

Saint Joseph, MO · On-site +1

$21 - $25.25/hr

  • Medical

  • Vision

  • Life

... utilization of coding guidelines, Coding Clinic, knowledge of clinical disease processes and treatments. This position completes analysis and follow-up record reviews. Responsibilities * Codes ...

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All JobsUtilization Review JobsInternship Remote Utilization Review JobsInternship Remote Utilization Review Jobs in Missouri

Internship Remote Utilization Review information

What are the main challenges interns face when working remotely in utilization review, and how can they overcome them?

Remote Utilization Review interns often encounter challenges in balancing independent work with effective communication, especially when collaborating with clinical teams or supervisors. Staying organized and proactively reaching out for guidance can help bridge gaps caused by remote settings. Utilizing available digital tools, attending virtual meetings, and participating in team chats fosters connection and learning. Setting a structured daily schedule and seeking regular feedback ensures that interns stay aligned with team goals and develop their review skills efficiently.

What is a remote utilization review internship?

A Remote Utilization Review Internship is a temporary position, often for students or recent graduates, that allows individuals to work remotely while learning about utilization review processes in healthcare. Interns assist in evaluating medical records, ensuring that healthcare services provided to patients are medically necessary and meet established guidelines. They work under the supervision of licensed professionals, gaining experience in medical documentation, insurance policies, and healthcare regulations. This role is ideal for those interested in healthcare administration, nursing, or case management.

What is the difference between Internship Remote Utilization Review vs Utilization Review Specialist?

AspectInternship Remote Utilization ReviewUtilization Review Specialist
CredentialsTypically pursuing or holding relevant certifications (e.g., CCM, RN)Requires active certification and experience in utilization review
Work EnvironmentRemote, internship setting, often part-time or supervisedFull-time, remote or onsite, with more independent responsibilities
Industry UsageEntry-level, training phase within healthcare and insurance sectorsProfessional role with established responsibilities in healthcare management

In summary, an Internship Remote Utilization Review is a training position for individuals gaining experience in utilization review, often with supervision and limited responsibilities. A Utilization Review Specialist is a fully qualified professional responsible for evaluating healthcare services, requiring certifications and more independence in their role.

What are the key skills and qualifications needed to thrive as a remote utilization review intern?

To thrive as a Remote Utilization Review Intern, you need a foundational understanding of healthcare processes, medical terminology, and insurance guidelines, often supported by a relevant degree or coursework in nursing, health administration, or a related field. Familiarity with electronic medical record (EMR) systems, utilization review software, and HIPAA compliance is typically required. Strong attention to detail, analytical thinking, and effective written communication are standout soft skills in this role. These abilities are crucial for accurately reviewing patient cases, ensuring regulatory compliance, and supporting efficient healthcare delivery from a remote setting.

What are the most commonly searched types of Remote Utilization Review jobs in Missouri?

The most popular types of Remote Utilization Review jobs in Missouri are:

What are popular job titles related to Internship Remote Utilization Review jobs in Missouri?

For Internship Remote Utilization Review jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Internship Remote Utilization Review jobs in Missouri look for?

The top searched job categories for Internship Remote Utilization Review jobs in Missouri are:

What cities in Missouri are hiring for Internship Remote Utilization Review jobs?

Cities in Missouri with the most Internship Remote Utilization Review job openings:

Internship Remote Utilization Review jobs near you

Supervisor, Utilization Management (RN)

Centene

Jefferson City, MO • On-site, Remote

$75K - $135K/yr

Full-time

Medical, Retirement, PTO

Posted 25 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 402 frontline employees who took The Breakroom Quiz

23rd of 887 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 Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
  • Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
  • Collaborates with utilization management team to resolve complex care member issues
  • Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
  • Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
  • Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
  • Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
  • Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
  • Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
  • Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
  • Assists with onboarding, hiring, and training utilization management team members
  • Leads and champions change within scope of responsibility
  • 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 4+ years of related experience.
Knowledge of utilization management principles preferred.
License/Certification:

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  • CA RN LICENSE REQUIRED
Pay Range: $75,300.00 - $135,400.00 per year

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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