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Remote Dental Utilization Management Jobs (NOW HIRING)

Intus Care

Utilization Management Nurse

$80K - $95K/yr

... dental, and vision insurance, a collaborative, inclusive, and dynamic work environment, and ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Comprehensive benefits including health, dental, and vision insurance. * A collaborative, inclusive ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

INTUS INC

Utilization Management Nurse

$80K - $95K/yr

Comprehensive benefits including health, dental, and vision insurance. * A collaborative, inclusive ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Centene

Supervisor, Utilization Management

$75K - $135K/yr

Supervises day-to-day activities of utilization management team. Key Details: Must be authorized to ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Director, Utilization Management

$133K - $247K/yr

Leads utilization management team on performance, improvement, and career growth path ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Appworks

Utilization Management Registered Nurse

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented ... This is a fully remote opportunity requiring discipline, accuracy, and effective collaboration ...

Intus Care

Contract Utilization Management Nurse

$42/hr

Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Minnesota Jobs

Utilization Management Nurse

This is a remote position. * This role is responsible for overseeing weekend workflow, monitoring ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

Humana

Manager, Utilization Management Nursing

Remote work at Home Location: Reside in a state participating in a compact license, (eNLC) Schedule ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

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Remote Dental Utilization Management information

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How much do remote dental utilization management jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for remote dental utilization management in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

What is a remote dental utilization management?

A Remote Dental Utilization Management job involves reviewing dental treatment plans and claims to ensure they meet established clinical guidelines and policies, all while working from a remote location. Professionals in this role assess the necessity and appropriateness of dental services, help control costs, and may interact with dentists, patients, and insurance companies. They often use their dental expertise to make recommendations or decisions about coverage and authorizations. This position typically requires a background in dentistry or dental hygiene, strong analytical skills, and familiarity with insurance processes.

What are the key skills and qualifications needed to thrive as a remote dental utilization management professional?

To thrive as a Remote Dental Utilization Management professional, you need a background in dental hygiene or dentistry, strong analytical abilities, and knowledge of insurance guidelines, usually supported by credentials such as RDH, DDS, or DMD. Familiarity with dental claims processing software, electronic health record (EHR) systems, and utilization review platforms is typically required. Exceptional communication, attention to detail, and critical thinking skills help professionals effectively assess claims and collaborate with providers. These competencies are essential to ensure accurate adjudication, cost control, and high levels of service in remote dental benefits management.

What are some common challenges faced by professionals in remote dental utilization management roles?

Professionals in Remote Dental Utilization Management often encounter challenges such as staying updated on evolving dental policies and coverage criteria, as well as interpreting complex clinical documentation without direct patient interaction. Communicating effectively with providers and patients via phone or email, rather than in-person, can also be demanding. Additionally, balancing productivity expectations with the need for careful, accurate reviews requires strong time management and attention to detail. Collaborating virtually with team members and adapting to new technologies are also important aspects of the role.

What is the difference between Remote Dental Utilization Management vs Remote Dental Claims Processing?

AspectRemote Dental Utilization ManagementRemote Dental Claims Processing
Primary RoleReviewing and authorizing dental treatments based on medical necessityProcessing and adjudicating dental insurance claims for reimbursement
Required SkillsDental knowledge, review protocols, insurance policiesClaims coding, data entry, insurance guidelines
Work EnvironmentRemote, healthcare/insurance industryRemote, insurance/healthcare industry
CertificationsDental credentials often preferred; insurance knowledgeClaims processing certifications, insurance knowledge

Remote Dental Utilization Management focuses on evaluating dental treatments for necessity, while Remote Dental Claims Processing handles the financial reimbursement process. Both roles are essential in dental insurance workflows but differ in responsibilities and skill sets.

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What are the most commonly searched types of Dental Utilization Management jobs?

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For Remote Dental Utilization Management jobs, the most frequently searched job titles are:

Remote Dental Utilization Management jobs near you

Utilization Management Nurse

Remote

Intus Care
Health Care and Social Assistance • 1 - 10 employees
Learn more about Intus Careexternal

$80K - $95K/yr

Other

Medical, Dental, Vision

Posted 27 days ago

Job description

Utilization Management Nurse

IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors – some of the most socially vulnerable and clinically complex individuals in the US healthcare system.

The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual partners closely with PACE Interdisciplinary Teams, Medical Directors, and provider networks to review service utilization, guide care decisions and support timely, appropriate transitions across care settings. Blending clinical expertise with analytical thinking, the Utilization Management Nurse ensures services are medically necessary, aligned with care plans and consistent with PACE regulations and best practices. This role is essential to maintaining program integrity, improving participant outcomes and supporting the delivery of coordinated, value-based care.

Responsibilities include rigorous adherence to PACE program service authorization policies, ensuring that participant care and related claims are reasonable and necessary for diagnosis or treatment and consistent with PCP coordination decisions. Active involvement in various aspects of the utilization management process, including concurrent review of all hospital admissions, retrospective review of inpatient admissions under 48 hours, and coordination and review of all other services delivered by contracted providers. Employ effective use of knowledge, critical thinking, and skills to advocate quality care and enhanced quality of life, maintain accurate records of all patient related interactions, and appeal management in cases of claim rejection.

Qualifications include 3 to 5 years of utilization management experience, current RN license, proven experience working in risk based integrated models of care, ability to use data to drive decisions and collaboration with internal and external stakeholders, strong strategic thinking, problem solving, and decision making skills, and excellent communication and leadership abilities.

What We Offer includes a chance to be a part of a trailblazing team in healthcare technology, competitive salary and equity package, comprehensive benefits including health, dental, and vision insurance, a collaborative, inclusive, and dynamic work environment, and opportunities for professional growth and development.

Compensation: The salary range for this role is $80K-$95K. Work location: This is a fully remote role based in the United States. Sponsorship: This position is not eligible for sponsorship.

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