Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Columbia, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Columbia, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Florissant, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Florissant, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Quick apply
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Quick apply
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Kansas City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Kansas City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Quick apply
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as ...
Saint Louis, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Saint Louis, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Florissant, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Florissant, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
$29.10 - $62.32/hr
Fully Remote- WFH Schedule: Monday-Friday 10:30AM- 7:30PM Position Summary: UM Nurse Consultant ... The benefits for this position include medical, dental, and vision coverage, paid time off ...
$29.10 - $62.32/hr
Fully Remote- WFH Schedule: Monday-Friday 10:30AM- 7:30PM Position Summary: UM Nurse Consultant ... The benefits for this position include medical, dental, and vision coverage, paid time off ...
Kansas City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Kansas City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Jefferson City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Jefferson City, MO · On-site +1
$75K - $135K/yr
Collaborates with utilization management team to resolve complex care member issues * Maintains ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Draper, UT · On-site +1
$60K - $70K/yr
Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health ... Competitive salary & comprehensive benefits (health, dental, vision). * Paid time off, sick leave ...
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Draper, UT · On-site +1
$60K - $70K/yr
Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health ... Competitive salary & comprehensive benefits (health, dental, vision). * Paid time off, sick leave ...
As a Utilization Management Clinical Dental Processor, you will leverage your dental clinical ... success in this remote role. Preferred Qualifications: * X-Ray certification highly desired
As a Utilization Management Clinical Dental Processor, you will leverage your dental clinical ... success in this remote role. Preferred Qualifications: * X-Ray certification highly desired
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 ...
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 ...
$26.01 - $56.14/hr
Remote (Central Time) * Utilizes clinical experience and skills in a collaborative process to ... The benefits for this position include medical, dental, and vision coverage, paid time off ...
$26.01 - $56.14/hr
Remote (Central Time) * Utilizes clinical experience and skills in a collaborative process to ... The benefits for this position include medical, dental, and vision coverage, paid time off ...
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 ...
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 ...
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 ...
Quick apply
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 ...
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... Remote Qualifications: Education & Licensure (one of the following required): * Graduate of an ...
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... Remote Qualifications: Education & Licensure (one of the following required): * Graduate of an ...
$15.63 - $19.08
14% of jobs
$21.93 is the 25th percentile. Wages below this are outliers.
$19.08 - $22.53
14% of jobs
$22.53 - $25.98
17% of jobs
The median wage is $27.88 / hr.
$25.98 - $29.44
11% of jobs
$29.44 - $32.89
8% of jobs
$32.89 - $36.34
6% of jobs
$38.93 is the 75th percentile. Wages above this are outliers.
$36.34 - $39.79
7% of jobs
$39.79 - $43.25
7% of jobs
$43.25 - $46.70
5% of jobs
$46.70 - $50.15
5% of jobs
$50.15 - $53.61
5% of jobs
$15
$31
$53
| Aspect | Remote Dental Utilization Management | Remote Dental Claims Processing |
|---|---|---|
| Primary Role | Reviewing and authorizing dental treatments based on medical necessity | Processing and adjudicating dental insurance claims for reimbursement |
| Required Skills | Dental knowledge, review protocols, insurance policies | Claims coding, data entry, insurance guidelines |
| Work Environment | Remote, healthcare/insurance industry | Remote, insurance/healthcare industry |
| Certifications | Dental credentials often preferred; insurance knowledge | Claims 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.
Contractor
Medical, Dental, Vision, Life, Retirement
Re-posted 2 days ago
UTILIZATION MANAGEMENT COORDINATOR
Location: Remote — client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected extension possible) Schedule: 40 hours/week — must include a weekend day Pay (W2): USD 24.70/H
JOB OVERVIEW
In this role, you’ll support Utilization Management (UM) clinical teams by handling non-clinical administrative work tied to pre-service authorization, utilization review support, care coordination workflows, and quality-of-care processes. You’ll help manage authorization intake, documentation, and provider/member support—while working in a fast-paced environment where schedule flexibility (including weekends) is required.
WHAT YOU’LL DO
Provide member/provider administrative support such as benefit verification, authorization creation/management, claims inquiries, and case documentation.
Review incoming authorization requests for initial determination and/or triage items for clinical review and resolution.
Support day-to-day coordination for the department, including answering/responding to phone calls, taking messages, and responding to basic inquiries.
Research information and assist with issue resolution and operational problem-solving.
Assist with reporting, data tracking, and organizing/disseminating information (including Continuity of Care processes and tracking Peer-to-Peer reviews).
REQUIRED QUALIFICATIONS
High School Diploma (or equivalent)
3+ years of experience in healthcare claims/service areas and/or healthcare office/administrative support
Ability to work effectively within a multidisciplinary team (internal and external partners)
Strong communication, organization, and customer service skills
Strong attention to detail with sound judgment and decision-making
Comfortable with web-based tools and Microsoft Office (Word, Excel, PowerPoint)
NICE TO HAVE
Knowledge of CPT and ICD-10 coding / medical terminology used in managed care
Experience in a managed care environment (health plan / UM support)
Phone-heavy/customer support experience
Experience with Medicaid/Medicare (government programs)
Exposure to tools such as Facets, Guiding Care, and/or NICE CXone
System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
#M-M2 #LI-
Ref: #851-Rockville-S1