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Remote Aetna Utilization Review Jobs in Utah (NOW HIRING)

Imh

Manager Utilization and Care Management

Murray, UT · On-site +1

$44.99 - $69.44/hr

The Clinical Manager at Select Health leads and supervises a team of Utilization Review and Care ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Aston Carter

Medical Coder - Remote

Salt Lake City, UT · On-site +1

$75/hr

In this fully remote role, you'll leverage your industry knowledge to review AI-generated responses ... Experience in utilization review, case management, prior authorization, or revenue cycle functions.

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... We will be reviewing applications on a rolling basis with the opportunity tentatively closing on ...

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... We will be reviewing applications on a rolling basis with the opportunity tentatively closing on ...

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... We will be reviewing applications on a rolling basis with the opportunity tentatively closing on ...

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... We will be reviewing applications on a rolling basis with the opportunity tentatively closing on ...

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... We will be reviewing applications on a rolling basis with the opportunity tentatively closing on ...

Imh

RN Care Manager PRN

Murray, UT · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

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

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 Utah?

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

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

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

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

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

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

Cities in Utah 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 Utah as of August 2026, with employment types broken down into 84% Full Time, 10% Part Time, and 6% Contract. Highlights an 100% Remote job distribution.

International Radiology Utilization Review- Remote - 1099

MRIoA

Salt Lake City, UT • On-site, Remote

Contractor

Posted 24 days ago

Job description

Description
Flexible Independent Contractor (1099) Opportunity
Interventional Radiology Contract Reviews - Remote - Any State Medical License
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in International Radiology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPPA Regulations patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.

California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current STATE unencumbered medical license
  • Current Board Certification in Radiology, IR/DR certified
  • Must have 5 years of clinical experience residency to be included
  • Daytime availability is required for peer-to-peer conversations

Apply