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Remote Hca Utilization Review Jobs in Madison, WI

Senior IT Security Analyst

Madison, WI · On-site +1

$90K - $115K/yr

... utilization. * Have developed security awareness training programs to educate employees on ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...

Benefit & Compensation Analyst (on site)

Madison, WI · Remote

$70K - $87K/yr

Madison, WI Full Time | Day | Monday-Friday | 8am-5pm (option for 1 Day/Week remote) Make a lasting ... This role analyzes market trends, internal data, employee feedback, and program utilization to ...

Licensing Manager

Janesville, WI · On-site +1

$160K - $200K/yr

Hybrid or remote work arrangement will be considered. While our headquarters is located in ... Interface with regulatory agencies in the planning of regulatory engagements, regulatory reviews ...

Licensing Engineer

Janesville, WI · On-site +1

$73K - $121K/yr

... support of the review of licensing actions by the U.S. Nuclear Regulatory Commission; the ... Hybrid or remote work arrangement will be considered. While our headquarters is located in ...

Remote Hca Utilization Review information

See Madison, WI salary details

$21

$42

$69

How much do remote hca utilization review jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for remote hca utilization review in Madison, WI is $42.60, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $48.94 per hour, depending on experience, location, and employer.

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What cities near Madison, WI are hiring for Remote Hca Utilization Review jobs?

Cities near Madison, WI with the most Remote Hca Utilization Review job openings:

Infographic showing various Remote Hca Utilization Review job openings in Madison, WI as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $88,617 per year, or $42.6 per hour.

Senior IT Security Analyst

WPS

Madison, WI • On-site, Remote

$90K - $115K/yr

Full-time

Medical, Dental, Retirement, PTO

Posted 24 days ago


Job description

U.S. citizenship is required for this position due to Department of Defense restrictions.
Our Senior Security Policy Analyst is responsible for developing, implementing, and maintaining security policies, standards, and procedures while leveraging ServiceNow to streamline policy management, compliance tracking, and reporting. This Senior Analyst combines deep knowledge of cybersecurity frameworks with hands-on experience in governance, risk, and compliance (GRC) operations, and excels at clear communication and high-quality documentation, and actively supports security awareness and responsible AI initiatives.Salary Range$90,000 ~ $115,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.
Work LocationOur first consideration will be to have this employee be able to take advantage of Hybrid work and collaboration, living within the state of Wisconsin. Employees within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to be able to work in office 3 days a week on a regular basis.
**Secondary consideration will be given to remote candidates in Wisconsin, Illinois, Michigan, Minnesota, and Iowa.
***If not regionally local, frequent monthly travel to our WPS Headquarters will be likely.
How do I know this opportunity is right for me? If you:
  • Enjoy Developing, reviewing, and maintaining corporate security policies, standards, procedures, and guidelines in alignment with NIST CSF, regulatory requirements, and industry best practices.
  • Would like to be accountable for integration and management of security policies, controls, and risk assessments within ServiceNow IRM and Managed Documents.
  • Can conduct risk assessments, control evaluations, and gap analyses mapped to NIST CSF to support audit readiness and compliance initiatives.
  • Like to collaborate with IT, Risk, Compliance, and Business teams to ensure policy adoption and awareness across the organization.
  • Have created clear, concise, and actionable security documentation, including policies, procedures, guidance, and reports.
  • Wan to monitor compliance with internal policies and external regulatory requirements, identifying gaps and driving remediation efforts.
  • Like providing reports and analytics on policy adherence, exceptions, and trends using ServiceNow dashboards and workflows.
  • Can serve as a subject matter expert on security governance, NIST CSF implementation, and risk management best practices.
  • Would enjoy Mentor junior analysts and provide guidance on policy development, implementation, and ServiceNow utilization.
  • Have developed security awareness training programs to educate employees on corporate security policies, procedures, and best practices.
  • Can support AI governance awareness programs to inform employees about responsible AI use, ethical considerations, and regulatory requirements.
  • Like to maintain and update training materials to reflect changes in policies, regulations, or emerging AI and cybersecurity threats.
  • Have assessed and monitored third-party vendors to ensure compliance with company security policies and industry regulations.

Minimum Qualifications
  • U.S. citizenship is required for this position due to Department of Defense restrictions.
  • Bachelor's degree in Computer Science, Information Systems, Cybersecurity, Network Security or related field or equivalent combination of education and experience.
  • 5 or more years of experience in security policy, governance, risk, and compliance roles.
  • Strong working knowledge of NIST CSF and AI governance principles, as well as other cybersecurity frameworks such as ISO 27001, CIS, or SOC 2.
  • Strong knowledge and understanding of cloud security policies, configuration standards, and best practices for AWS, Azure, GCP, or SaaS applications in order to apply governance.
  • Demonstrated experience with ServiceNow IRM modules, including policy, risk, audit, and compliance workflows.
  • Ability to create clear, professional, and actionable security and risk governance documentation.
  • Experience developing and delivering security awareness training programs.
  • Excellent communication skills, capable of engaging both technical and non-technical stakeholders.
  • Demonstrated experience in developing and implementing security policies and standards in a highly regulated environment.
  • Strong analytical, organizational, and project management skills, with the ability to drive initiatives independently.

Preferred Qualifications
  • Familiarity with knowbe4 or other security awareness platform tools.
  • Familiarity using AI to facilitate automated workflows.

Remote Work Requirements
  • High speed cable or fiber
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
  • Please review Remote Worker FAQs for additional information.

Benefits
  • Remote and hybrid work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
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LinkedInFacebookWPS Health BlogThis position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.