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Remote Dental Utilization Management Jobs (NOW HIRING)

CVS Health

Utilization Management Nurse Consultant

$29.10 - $62.32/hr

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

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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 Aug 21, 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.

More about Remote Dental Utilization Management jobs

What cities are hiring for Remote Dental Utilization Management jobs?

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

The most popular types of Dental Utilization Management jobs are:

What states have the most Remote Dental Utilization Management jobs?

States with the most job openings for Remote Dental Utilization Management jobs include:

What job categories do people searching Remote Dental Utilization Management jobs look for?

The top searched job categories for Remote Dental Utilization Management jobs are:

Remote Dental Utilization Management jobs near you

Utilization Management Rep

Allmed Staffing Inc

Pearland, TX • Remote

Full-time

Medical, Dental, Vision, Retirement

Re-posted 23 days ago

Job description

Job Title: Utilization Management Representative (UMR)

Work Location: 11511 Shadow Creek Parkway
Schedule: Monday – Friday | 8:00 AM – 5:00 PM | 24–40 hours per week
Interview Process: Virtual interview via camera
Dress Code: Business Casual
Pay Rate: 13/hr (Paid Weekly)
Allmed Benefits: Vision, Health, Dental Insurance & 401(k)

Position Overview

The Utilization Management Representative (UMR) plays a critical role in supporting Utilization Management operations by ensuring the timely and accurate processing of authorization requests and communicating authorization determinations to providers and members. This role directly supports regulatory compliance, operational efficiency, and quality patient care by facilitating appropriate utilization of healthcare services.

The UMR serves as a key point of contact between providers, members, and the clinical review team while supporting overall care management strategies through efficient workflow management and effective communication.

Team Environment

The selected candidate will join a collaborative Utilization Management team consisting of approximately 20 Utilization Management Representatives (UMRs) working alongside clinical reviewers, including Registered Nurses (RNs), LVNs, and Medical Directors.

The team operates in a fast-paced, production-driven environment where accuracy, efficiency, and teamwork are critical to success. Team culture emphasizes:

  • Collaboration and strong communication
  • Accountability for productivity and quality metrics
  • Continuous learning and process improvement
  • Supportive teamwork across clinical and operational departments
  • Commitment to regulatory compliance and quality member care

Team members regularly collaborate with internal departments including clinical review teams, provider relations, claims, and appeals teams.

Key Responsibilities

  • Answer inbound calls from providers, members, and healthcare facilities regarding authorization requests, status updates, and coverage questions
  • Create authorization cases by reviewing and processing clinical requests received through fax, electronic submissions, or phone communication
  • Accurately document authorization requests within utilization management systems and/or electronic medical record systems
  • Coordinate with clinical review staff, including RNs, LVNs, and Medical Directors, to appropriately route cases requiring medical necessity review
  • Communicate authorization determinations verbally to providers and members in compliance with regulatory guidelines and organizational requirements
  • Maintain accurate records and ensure documentation standards are consistently met
  • Support workflow efficiency while managing multiple priorities in a high-volume environment
  • Provide exceptional customer service while maintaining confidentiality and professionalism

Required Qualifications

  • 1–3 years of healthcare experience, preferably within:
    • Utilization Management
    • Insurance operations
    • Medical office environments
    • Managed care settings
  • Experience handling high-volume calls in a professional and efficient manner
  • Strong data entry and documentation skills with high attention to detail
  • Ability to effectively manage multiple tasks simultaneously in a fast-paced environment
  • Strong verbal and written communication skills when interacting with providers, members, and internal teams
  • Basic understanding of healthcare authorization processes and insurance workflows
  • Experience using EMR/EHR platforms, case management systems, or related healthcare systems
  • Strong organizational and time-management skills

Preferred Qualifications

  • Experience supporting authorization processes within healthcare operations or managed care settings
  • Previous experience in health plans, hospitals, medical offices, or healthcare call center environments
  • Experience working with provider communication and care coordination activities
    #ZR

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