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Remote Aetna Utilization Review Jobs in Indiana (NOW HIRING)

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · On-site +1

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · On-site +1

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

Harris

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Cayenta

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Indiana University Health

RCS Quality Expert CC

Indianapolis, IN · On-site +1

$17.25 - $23.25/hr

Flexible M-F Remote/Hybrid - Majority remote; on-site for quarterly meetings This position exists ... This position will be responsible for performing various quality reviews, preparing and providing ...

Kainos

Strong knowledge of various Business Processes such as Start Performance Review, Complete Manager ... including in a remote working situation. Sound ability to formally present to senior Client ...

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Remote Aetna Utilization Review information

What are the key skills and qualifications needed to thrive as a remote Aetna Utilization Review nurse?

To thrive as a Remote Aetna Utilization Review nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with Aetna's systems, utilization management software, and knowledge of medical necessity criteria such as MCG or InterQual are typically required. Excellent communication, attention to detail, and time management are vital soft skills for coordinating care and efficiently handling remote assessments. These skills ensure accurate evaluations, regulatory compliance, and optimal resource utilization in a healthcare payer setting.

What are some common challenges faced in a remote Aetna Utilization Review role and how can they be managed?

One common challenge in a remote Aetna Utilization Review position is maintaining effective communication with healthcare providers and internal teams, as much of the coordination happens virtually. To manage this, professionals often rely on secure digital communication tools and establish clear protocols for timely responses. Another challenge is staying updated with changing healthcare regulations and Aetna policies, which requires proactive learning and frequent collaboration with colleagues. Developing strong organizational skills and participating in regular virtual team meetings can help ensure efficient workflow and compliance.

What is the difference between Remote Aetna Utilization Review vs Remote UnitedHealthcare Utilization Review?

AspectRemote Aetna Utilization ReviewRemote UnitedHealthcare Utilization Review
CertificationsTypically requires nursing or healthcare-related licenses, certifications in utilization reviewSimilar licensing and certifications, often requiring nursing or healthcare credentials
Work EnvironmentRemote, healthcare insurance setting, reviewing medical necessity and coverageRemote, healthcare insurance setting, assessing medical claims and coverage appropriateness
Employer & Industry UsageUsed by Aetna insurance providers for member care managementUsed by UnitedHealthcare for claims review and member care decisions

Both Remote Aetna Utilization Review and Remote UnitedHealthcare Utilization Review involve remote assessments of medical necessity and coverage. They require similar healthcare credentials and operate within the health insurance industry, focusing on claims and member care management for their respective providers.

What is a remote Aetna Utilization Review?

Remote Aetna Utilization Review jobs involve evaluating medical necessity, appropriateness, and efficiency of healthcare services provided to Aetna members. Professionals in these roles, often nurses or clinicians, review patient records and claims remotely to ensure treatments meet established guidelines and policies. The goal is to support quality care while managing healthcare costs and preventing unnecessary procedures. These positions require clinical experience, attention to detail, and familiarity with insurance processes.
What are the most commonly searched types of Aetna Utilization Review jobs in Indiana? The most popular types of Aetna Utilization Review jobs in Indiana are:
What are popular job titles related to Remote Aetna Utilization Review jobs in Indiana? For Remote Aetna Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Remote Aetna Utilization Review jobs in Indiana look for? The top searched job categories for Remote Aetna Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Remote Aetna Utilization Review jobs? Cities in Indiana with the most Remote Aetna Utilization Review job openings:
Remote Aetna Utilization Review jobs near you
Infographic showing various Remote Aetna Utilization Review job openings in Indiana as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Cobol/IDMS Developer (Remote)

A.C. Coy

Indianapolis, IN • On-site, Remote

$48 - $65/hr

Other

Re-posted 13 days ago

Job description

Overview
  • Tier One Technologies is looking for a COBOL/IDMS Developer to maintain and support a large payroll application as well as helping in the database environment.
  • This will be a 100% remote Contract-to-Hire position.
  • Must be a US Citizen.
  • SELECTED CANDIDATES WITHOUT REQUIRED CLEARANCE WILL BE SUBJECT TO A FEDERAL GOVERNMENT BACKGROUND INVESTIGATION TO RECEIVE IT.

Responsibilities
  • Design, develop and modify software systems, using scientific analysis and mathematical models to predict and measure outcomes and consequences of design.
  • Coordinate software system installations and monitor equipment functioning to ensure specifications are met.
  • Modify existing databases and database management systems.
  • Write and code logical and physical database descriptions and specify identifiers of database to management system or direct others in coding descriptions.
  • Work as part of a project team to coordinate database development and determine project scope and limitations.
  • Conduct multidisciplinary research and collaborate with equipment designers and/or hardware engineers in the planning, design, development, and utilization of electronic data processing systems for product and commercial software.
  • Determine computer user needs; analyze system capabilities to resolve problems on program intent, output requirements, input data acquisition, programming techniques and controls; prepare operating instructions; design and develop compilers and assemblers, utility programs, and operating systems.
  • Ensure software standards are met. Analyze user needs and software requirements to determine feasibility of design within time and cost constraints.
  • Confer with systems analysts, engineers, programmers and others to design systems and to obtain information on project limitations and capabilities, performance requirements and interfaces.
  • Review project requests describing database users' needs to estimate time and cost required to accomplish project.

Qualifications
  • Bachelor's degree in Computer Science, Software Engineering, or a related field.
  • 4+ years of IBM z/OS-based mainframe experience using COBOL, CICS, JCL, TSO, ISPF, Endevor, and REXX.
  • Strong knowledge of IDMS database.
  • Ability of designing, coding and testing software requirements.
  • Basic knowledge of the full software development lifecycle: from business/systems analysis, through requirements gathering and functional specification authoring, to development, testing and delivery.
  • Knowledge of computer development software as it relates to systems, such as SQL, VisualBasic, etc.
  • Familiarity and knowledge of the Agile methodology is a plus.
  • Strong verbal and written communication skills, problem solving skills, customer service and interpersonal skills.
  • Must be a US Citizen (no dual citizenship).
  • Able to obtain DoD Public Trust clearance.
  • Must not have traveled outside the US for a combined total of 6 months or more in the last 5 years.
  • Must have resided in the US for the last 5 years.
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About A.C. Coy Company- Staffing & Consulting Services

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Since 1986, our mission is to be the “Always on Target” staffing and consulting provider by helping people and companies achieve their hiring goals. The team is dedicated to achieving these goals by attracting and retaining top talent that meets our clients’ culture and environment. We are fully engaged with our people and companies through ongoing communication to ensure expectations are met.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Canonsburg, PA, US

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