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Part Time Remote Utilization Review Jobs in Wisconsin

Rogers Behavioral Health

Care Advocate

Oconomowoc, WI · On-site +1

... • Remote; candidate must be local to Wisconsin to be able to visit onsite for training or ... Communicate with utilization review (UR), admitting and clinical leadership regarding the quality ...

BetterHelp

Psychiatrist - Remote

Milwaukee, WI · Remote

$119 - $242/hr

Flexible commitment: Part-time, 1099 contract position What You'll Do * Conduct video consultations ... utilization of add-on codes (such as 90833) when clinically appropriate and properly documented

ChenMed

$76.33/hr

... systems through the utilization of data demonstrating program effectiveness and success ... Remote

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Part Time Remote Utilization Review information

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

To thrive as a Part Time Remote Utilization Review Nurse, you need a current RN license, strong clinical judgment, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and systems such as InterQual or MCG is typically required. Excellent communication, critical thinking, and self-motivation are vital soft skills for coordinating care and making independent decisions remotely. These skills ensure accurate case evaluations, regulatory compliance, and effective collaboration with healthcare teams while working from a remote setting.

What are the typical challenges faced by part-time remote utilization review professionals, and how can they be managed?

Part-time remote utilization review professionals often face challenges such as balancing a variable workload, ensuring timely communication with healthcare providers, and staying current with changing insurance guidelines. Since much of the work is done independently, strong time management and self-motivation are essential to meet review deadlines. Regularly scheduled check-ins with the team and utilizing digital collaboration tools can help maintain connectivity and support. Staying organized and proactive in seeking clarification when needed can mitigate common challenges and lead to a successful experience in this role.

What is a Part Time Remote Utilization Review position?

A Part Time Remote Utilization Review position involves evaluating medical records and healthcare services to ensure they are necessary and appropriate, typically for insurance companies or healthcare providers. This job is performed remotely, allowing professionals to work from home or another location outside of a traditional office setting. Part-time roles generally require fewer hours than full-time positions, making them suitable for those seeking flexible schedules. Professionals in this role often have backgrounds in nursing or healthcare and use their expertise to review patient care for quality and cost-effectiveness.

What is the difference between Part Time Remote Utilization Review vs Part Time Remote Claims Reviewer?

AspectPart Time Remote Utilization ReviewPart Time Remote Claims Reviewer
CredentialsTypically requires healthcare licenses (e.g., RN, MD) and utilization review certificationsUsually requires insurance or claims processing experience, with some industry-specific certifications
Work EnvironmentRemote, healthcare-focused, reviewing medical necessity and appropriateness of careRemote, insurance or healthcare claims processing, verifying coverage and claims accuracy
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsInsurance companies, third-party administrators, healthcare payers

Part Time Remote Utilization Review and Part Time Remote Claims Reviewer both operate remotely but focus on different aspects of healthcare administration. Utilization reviewers assess medical necessity, while claims reviewers verify insurance claims. Understanding these differences helps job seekers find roles aligned with their skills and credentials.

What are the most commonly searched types of Remote Utilization Review jobs in Wisconsin? The most popular types of Remote Utilization Review jobs in Wisconsin are:
What are popular job titles related to Part Time Remote Utilization Review jobs in Wisconsin? For Part Time Remote Utilization Review jobs in Wisconsin, the most frequently searched job titles are:
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Part Time Remote Utilization Review jobs near you
Enterprise Sales Executive - Part-Time, Remote 100%, Project Based

Enterprise Sales Executive - Part-Time, Remote 100%, Project Based

Kopp Consulting

Madison, WI • Remote

$45/hr

Part-time

Posted 23 days ago

Job description

Enterprise Sales Executive - Project Based, 100% Remote, Part Time

Internal Title: Door Opener

Job Type: Project-Based, Part-Time, 100% Remote, Flexible Hours

Description:

We are one of the best sales teams in the country providing a service that is critical to the growth, profit, and success of most businesses. Known as Door Openers, our main focus is booking meetings with the right prospects. We laser focus on securing the best prospect meetings for our clients.

The right candidates enjoy the thrill of booking meetings and have at least 10 years of experience making outbound calls booking meetings with new prospects. Potential to earn full-time pay while working remotely, part-time/flexible hours. As a sales unicorn, you succeed at booking meetings with senior-level executives across any industry. As long as KPIs are met, you have the freedom to make your own schedule with vacation.

You Should Apply:

If you are a senior-level, enterprise sales executive who is looking for a remote and flexible schedule. You have a high track record of consistently achieving new business goals. Are a self-starter, very organized, and comfortable with daily use of CRM.

Required skills and experience:

  • 10+ years' experience securing meetings with new executive-level prospects (C-level, SVP, VP, Director)
  • Strong ability to engage prospects and their assistants in dialogue, quickly build rapport, actively listen and maneuver conversations to achieve the maximum number of meetings possible
  • Self-motivated, disciplined, methodical, superior attention to detail
  • Advanced computer proficiency with CRM, MS-Office, file sharing, and Zoom
  • Bachelor's degree in business, marketing, or related discipline preferred

Responsibilities:

  • Secure and schedule initial meetings with high-level decisions makers on behalf of our clients
  • Articulate the value proposition with a prospect by phone, voicemail, and/or email to maximize the number of meetings
  • Maintain daily CRM activity data and utilize CRM reports to strategize activity level for best results
  • Ability to learn, understand and communicate complex information gained to prepare clients for prospect meetings
  • Confirm meetings, write meeting reports and bi-weekly reviews, track performance and report to clients and management
  • Attend internal and external meetings via videoconferencing
  • Work with prospecting and research tools and with our research department on the refining prospect list
  • Provide clients, prospects, and team members (at all levels) with superior support, service, and respect
  • Provide consultative sales advice to our clients and peers

Additional information:

  • Salesforce aptitude test and Role Play are required in our interview process.
  • Must have access to a reliable full operating PC or Mac and stable Wifi
  • Kopp Consulting is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, sexual orientation, national origin or nationality, ancestry, age, disability, gender identity or expression, marital status, veteran status, or any other category protected by law.

About Kopp Consulting:

The Door Opener® Service has helped thousands of business leaders and salespeople secure initial meetings with executive-level decision-makers, opening new doors to large sales, in medium size as well as Fortune 500 companies. During a period of time when gaining new customers has become almost impossible, Kopp has developed a business model that helps clients fill their pipelines and achieve the growth their competitors only dream about. Kopp Consulting has been on the Inc. 5000 list of fastest-growing U.S. companies for two consecutive years and won the Stevie award for Sales Outsourcing Provider of the Year.