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Part Time Remote Utilization Review Jobs in Wisconsin

Remote schedule will be determined at time of hire with the expectation of being in the office as ... Reviews transaction processing internal controls and recommends policies and procedures * Audits ...

Cloud Engineer, Senior

Madison, WI ยท On-site +1

$69K - $158K/yr

Remote Work: Yes Job Number: R0245382 Location: Madison,WI,US Share job via: Share Cloud Engineer ... Review or guide activities of more junior employees. You Have: * Experience with developing and ...

Remote (in Maine) Schedule : Per diem, flexible shifts Are you a licensed clinician looking for ... Support operational needs, including staffing adjustments and quality assurance reviews.

New

Showing results 21-38

Part Time Remote Utilization Review information

What skills and qualifications are needed for a part time remote utilization review?

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 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 is a part time remote utilization review?

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 challenges do part time remote utilization review professionals face, 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.
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Telemedicine Physician - Women's Hormone Expert - Remote (MD/DO only)

Hone Health Medical Roles

Madison, WI โ€ข Remote

Full-time, Part-time

Re-posted 23 days ago


Job description

Telemedicine Physician - Women's Hormone Expert - Remote (MD/DO only)

Work from any location, determine your own schedule, and earn extra income while helping women optimize their health and hormone levels with one of the fastest-growing health companies in the country. Seeking Obstetrics/Gynecology, Internal Medicine, or Family Medicine physicians, and all other physicians with deep knowledge and experience in prescribing for midlife women's healthcare. Please review and respond to the three applicant qualification questions we ask of our applicants at the bottom. We are specifically looking for physicians who specialize in men's health and have experience prescribing testosterone and other hormone-boosting pharmaceuticals. Our services also include men's hormone, weight loss and thyroid treatment and we would prefer to bring on physicians who have experience prescribing for patients in some or all of those categories as well. We are currently looking for physicians nationwide and highly value physicians who are licensed in multiple states.

Who We Are:

We are a modern health company committed to giving our patients confidence as they age. Our goal is to help our patients break through highly stigmatized conditions using education and increasing access by making care more convenient and affordable. From initially only treating men who want to manage their testosterone levels, we have grown our services to support weight loss, thyroid treatments, and now women's health. We are currently seeking part-time and full-time telemedicine physicians who want to be part of the health revolution. You will have the opportunity to leverage emerging technologies and provide digital telemedicine consultations to patients in the states in which you are licensed from the comfort of your home. We provide a training program and a supportive environment to help you improve your video consultation skills, including comprehensive technical support.

Your Responsibilities:

  • Perform telemedicine consultations from our HIPAA-compliant video interface.
  • Provide outstanding service and care to women in midlife navigating perimenopause, menopause, and other common midlife health challenges.
  • Treat men who are looking to optimize their health and hormones, if this is a patient population you also have experience treating.
  • Review lab results with patient and provide treatment options.
  • Educate patients and create individualized treatment plans.
  • Titrate medications based on patient outcomes.
  • Prescribe medications if necessary based on your clinical diagnosis.
  • Provide feedback to us to continually improve the patient experience.

We are currently recruiting nationwide. Experience with telemedicine is a plus. Holding multiple state licenses is a plus.

Requirements:

  • Available at a minimum of 6-8 hours/week for consultations, ideally 8-12 hours or more.
  • You are an MD or DO who holds a valid license, ideally in multiple states.
  • Minimum of 2 years of experience in Obstetrics/Gynecology, Internal Medicine, Family Medicine, and/or Hormone Replacement Therapy is preferred.
  • NCMP (NAMS-certified menopause practitioner) certification is preferred.
  • Possess an unrestricted DEA license and have prescribed Schedule III controlled substances.
  • Excellent communication skills with a focus on physician-patient interaction.
  • Comfortable with technology and video consultations, or the desire to learn.
  • You are not just a pill pusher, but you have a deep profound care for hormone optimization.
  • You are a self-starter who likes to be part of innovative mission-driven environments.
  • You're intellectually curious and are always striving to improve patient outcomes.
  • Available to start soon.