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Remote Behavioral Health Utilization Review Jobs in Remote, OR

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Lancesoft INC

Remote - Director of Behavioral Health

OR · Remote

$88K - $138K/yr

The Remote Director of Behavioral Health leads the Behavioral Health Transfer Center, ensuring exceptional operational performance, timely service, and sound clinical judgment. This role requires a ...

Progressive Option Support Services

Be Seen First

Board Certified Behavior Analyst

OR · Remote

$75 - $80/hr

Board Certified Behavior Analyst (BCBA) | BILINGUAL| REMOTE Locations: multiple states At ... behavioral health challenges. We strive to provide the best services with the highest regard to ...

Progressive Option Support Services

Be Seen First

Board Certified Behavior Analyst

OR · Remote

$75 - $80/hr

Board Certified Behavior Analyst (BCBA) | BILINGUAL| REMOTE Locations: multiple states At ... behavioral health challenges. We strive to provide the best services with the highest regard to ...

1st Choice, LLC

Be Seen First

Remote Sr Inpatient Coder - Trauma Experience Required

OR · Remote

$38 - $42/hr

Review and validate complex inpatient cases including trauma, rehab, neurology, and critical care ... Registered Health Information Technician RHIT * Registered Health Information Administrator RHIA

Umpqua Health

Care Coordinator

Roseburg, OR · On-site +1

$80K - $92K/yr

CARE COORDINATOR REMOTE, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Care Coordinator

Roseburg, OR · Remote

$80K - $92K/yr

CARE COORDINATOR REMOTE EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, w ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Care Coordinator

Roseburg, OR · On-site +1

$80K - $92K/yr

CARE COORDINATOR REMOTE, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

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Remote Behavioral Health Utilization Review information

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How much do remote behavioral health utilization review jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for remote behavioral health utilization review in Remote, OR is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $48.51 per hour, depending on experience, location, and employer.

What is a Remote Behavioral Health Utilization Review job?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Remote Behavioral Health Utilization Review position, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

What are the typical daily responsibilities for someone working in Remote Behavioral Health Utilization Review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Remote, OR? For Remote Behavioral Health Utilization Review jobs in Remote, OR, the most frequently searched job titles are:
What cities near Remote, OR are hiring for Remote Behavioral Health Utilization Review jobs? Cities near Remote, OR with the most Remote Behavioral Health Utilization Review job openings:
Remote Behavioral Health Utilization Review jobs near you
Utilization Review Nurse

Utilization Review Nurse

Umpqua Health

Roseburg, OR • Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description


UTILIZATION REVIEW NURSE 
REMOTE
Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. 
EMPLOYMENT TYPE: Full-Time, Exempt

About Umpqua Health

At Umpqua Health, we’re more than a healthcare organization—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare, and applicable regulations. The UM Nurse collaborates with interdisciplinary teams and community providers to promote integrated, high-quality care.
ESSENTIAL JOB RESPONSIBILITIES

  • Perform clinical assessments and prior authorizations to determine medical necessity
  • Escalate complex cases to Medical Directors and request additional documentation as needed
  • Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions
  • Liaise with internal departments to resolve eligibility, benefits, or service issues
  • Participate in discharge planning for members transitioning from acute, long-term, or residential care
  • Conduct audits and support quality improvement initiatives
  • Provide training and mentorship on UM protocols and workflows
  • Maintain relationships with community providers and service organizations
  • Ensure compliance with organizational policies, clinical standards, and federal/state regulations
  • Perform other nursing-related duties as assigned

CHALLENGES

  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS

  • Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state
  • Graduation from an accredited nursing program
  • Minimum 5 years of direct patient care experience
  • Proficiency with Microsoft Office, EHR systems, and UM software
  • Strong clinical knowledge, communication, and organizational skills
  • No suspension, exclusion, or debarment from federal healthcare programs

PREFERRED QUALIFICATIONS

  • 2+ years of utilization review or case management experience in managed care
  • Oregon residency and license
  • Bilingual or translation skills a plus
  • Experience with quality improvement audits and diverse team collaboration
  • Ability to work independently in fast-paced environments
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $85,000- $105,340
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more
 
Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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