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Remote Aetna Utilization Review Jobs in Kansas (NOW HIRING)

Archera

Lead Quarterly Business Reviews, presenting utilization trends, realized savings, and optimization ... Remote-first culture * Opportunity to shape and scale a category-defining FinTech platform

Finite State

$99K - $100K/yr

Manages utilization across the team to balance billable engagement work, capability development ... review, and continuous learning; fosters psychological safety in a fully remote operating ...

Archera

Lead Quarterly Business Reviews, presenting utilization trends, realized savings, and optimization ... Remote-first culture * Opportunity to shape and scale a category-defining FinTech platform

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 ...

Locatee AG

Lead technical reviews for identity, access, auditability, logging, change management, and incident ... Flexible Work Environment Whether remote, hybrid, or in-office, we support work arrangements that ...

Locatee Ag

Lead technical reviews for identity, access, auditability, logging, change management, and incident ... Flexible Work Environment Whether remote, hybrid, or in-office, we support work arrangements that ...

InfoSync

HRIS SPECIALIST II (REMOTE)

Wichita, KS · Remote

... utilization of UKG access and self-service capabilities. * Analyze current systems and processes ... Participate in the review, analysis, implementation, and testing of UKG software releases for a ...

InfoSync

HRIS SPECIALIST II (REMOTE)

Wichita, KS · On-site +1

... utilization of UKG access and self-service capabilities. * Analyze current systems and processes ... Participate in the review, analysis, implementation, and testing of UKG software releases for a ...

All JobsAetna Utilization Review JobsRemote Aetna Utilization Review JobsRemote Aetna Utilization Review Jobs in Kansas

Remote Aetna Utilization Review information

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 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.

Does Aetna have remote jobs?

Aetna offers remote positions, including roles like Remote Utilization Review, which often require healthcare knowledge and familiarity with medical records. These jobs typically involve working from home with flexible schedules and may require relevant certifications or experience in healthcare or insurance industries.

Is remote Aetna utilization review work from home?

Remote Aetna utilization review jobs are often performed from home, allowing employees to review medical cases and authorization requests remotely. These roles typically require strong computer skills, familiarity with healthcare software, and adherence to confidentiality standards, with many positions offering flexible or full-time remote schedules.

What are the most commonly searched types of Aetna Utilization Review jobs in Kansas?

The most popular types of Aetna Utilization Review jobs in Kansas are:

What are popular job titles related to Remote Aetna Utilization Review jobs in Kansas?

For Remote Aetna Utilization Review jobs in Kansas, the most frequently searched job titles are:

What job categories do people searching Remote Aetna Utilization Review jobs in Kansas look for?

The top searched job categories for Remote Aetna Utilization Review jobs in Kansas are:

What cities in Kansas are hiring for Remote Aetna Utilization Review jobs?

Cities in Kansas 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 Kansas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Revenue Cycle Financial Analyst

Kansas City, KS • On-site, Remote

The University of Kansas Health System
Health Care and Social Assistance • 5 - 10K employees

7.4

Company rating: 7.4 out of 10

Based on 178 frontline employees who took The Breakroom Quiz

268th of 893 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about The University of Kansas Health Systemexternal

Full-time

Posted 5 days ago

Job description

Position Title
Revenue Cycle Financial Analyst
Days - Full Time
Remote
Position Summary / Career Interest:
The Revenue Cycle Financial Analyst is responsible for identifying, tracking and resolving trends for over and under payments with EMR. This position educates external and internal customers on policies and procedures to improve process flow and decrease denials, over payments and under payments.
Responsibilities and Essential Job Functions
  • Reviews Explanation Of Benefit's & Remittance Advisement's for denied claims.
  • Works with manage care organizations to identify and/or resolve claim submission requirements. Evaluates and resolves issues related to revenue cycle including charge capture, charge master, coding, claim submission or information system.
  • Prepares and maintains statistical and financial reports supporting areas of performance improvement.
  • Identifies areas of improvements utilizing financial - statistical indicators related to revenue cycle performance.
  • Reviews intradepartmental and interdepartmental processes for improvements that will decrease denials and underpaid claims that occur due to a variety of reasons related to: Authorization, Eligibility, Medical Necessity, Utilization Review, Documentation
  • Analyzes situations and makes recommendations that will achieve financial objectives related to revenue cycle.
  • Provides training to external and internal customers to educate and improve revenue cycle processes.
  • Provides input in analysis of aging trends. Submits ticket requests with Hospital Systems on systems changes to ensure billing accuracy.
  • Prepares third party appeals as appropriate.
  • Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
  • These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience
  • High School Graduate or GED.
  • Associates Degree in related field, OR Associate's Degree equivalent of 4 years of experience in claims, denials, chargemaster, coding or insurance processing.
  • 4 or more years of experience in financial reporting, processing over and under payments, claims, denials, chargemaster, coding or insurance processing.

Preferred Education and Experience
  • Bachelors Degree in related field from an accredited college or university.
  • Epic experience.

Time Type:
Full time
Job Requisition ID:
R-53429
Important information for you to know as you apply:
  • The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion.
  • The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu.
  • Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

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About University of Kansas Health System

Sourced by ZipRecruiter

Operating within the healthcare industry, The University of Kansas Health System is a renowned medical institution located in Kansas City, KS, United States. Established in 1905, this not-for-profit health system has evolved to offer an extensive range of products and services, which spans across a variety of specialist areas such as cancer care, neurology, cardiology, and organ transplants, among others. The core mission of The University of Kansas Health System is to enhance the health and wellness of individuals and communities by providing world-class healthcare services, quality education and conducting advanced research. They are also known for their unwavering commitment to academic medicine, which sets them apart from their peers.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Kansas City, KS, US

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What University Of Kansas Health System employees say

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Hours and flexibility

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