We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
Utilization and Care Management Nurse
Salt Lake City, UT · Remote
$36.80 - $49.80/hr
... review, post-discharge care coordination) to best meet the member's specific healthcare needs and ... Knowledge of health insurance industry trends, technology and contractual arrangements. * General ...
Utilization and Care Management Nurse
Salt Lake City, UT · Remote
$36.80 - $49.80/hr
... review, post-discharge care coordination) to best meet the member's specific healthcare needs and ... Knowledge of health insurance industry trends, technology and contractual arrangements. * General ...
Utilization and Care Management Nurse
Bluffdale, UT · Remote
$36.80 - $49.80/hr
... review, post-discharge care coordination) to best meet the member's specific healthcare needs and ... Knowledge of health insurance industry trends, technology and contractual arrangements. * General ...
Utilization and Care Management Nurse
Bluffdale, UT · Remote
$36.80 - $49.80/hr
... review, post-discharge care coordination) to best meet the member's specific healthcare needs and ... Knowledge of health insurance industry trends, technology and contractual arrangements. * General ...
Utilization Management Inpatient Clinical Specialist
Salt Lake City, UT · Remote
$25.90 - $37.30/hr
... insurance industry. * You'll perform job duties and responsibilities for an UM IP Clinical ... You'll utilize clinical knowledge and critical thinking to research and review IP UM requests ...
Utilization Management Inpatient Clinical Specialist
Salt Lake City, UT · Remote
$25.90 - $37.30/hr
... insurance industry. * You'll perform job duties and responsibilities for an UM IP Clinical ... You'll utilize clinical knowledge and critical thinking to research and review IP UM requests ...
Utilization Management Inpatient Clinical Specialist
Bluffdale, UT · Remote
$25.90 - $37.30/hr
... insurance industry. * You'll perform job duties and responsibilities for an UM IP Clinical ... You'll utilize clinical knowledge and critical thinking to research and review IP UM requests ...
Utilization Management Inpatient Clinical Specialist
Bluffdale, UT · Remote
$25.90 - $37.30/hr
... insurance industry. * You'll perform job duties and responsibilities for an UM IP Clinical ... You'll utilize clinical knowledge and critical thinking to research and review IP UM requests ...
Remote Insurance Broker
Layton, UT · On-site +1
$10K - $20K/wk
... review their needs. Prepare Personalized Solutions (4-5 hrs/week) Analyze client information to ... Manage Follow-Up (2 hrs/week) Coordinate with insurance carriers and support clients through the ...
Remote Insurance Broker
Layton, UT · On-site +1
$10K - $20K/wk
... review their needs. Prepare Personalized Solutions (4-5 hrs/week) Analyze client information to ... Manage Follow-Up (2 hrs/week) Coordinate with insurance carriers and support clients through the ...
Medical Director - Utilization Management (Remote)
Salt Lake City, UT · On-site +1
$240K/yr
An award-winning remote work environment Position Summary Our Medical Director, also known as a ... Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers ...
Medical Director - Utilization Management (Remote)
Salt Lake City, UT · On-site +1
$240K/yr
An award-winning remote work environment Position Summary Our Medical Director, also known as a ... Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
When reviewing, please consider those tasks applicable to your specialty. In general, paralegals ... The practice currently manages approximately 140 active insurance claims, and the attorney is ...
When reviewing, please consider those tasks applicable to your specialty. In general, paralegals ... The practice currently manages approximately 140 active insurance claims, and the attorney is ...
When reviewing, please consider those tasks applicable to your specialty. In general, paralegals ... The practice currently manages approximately 140 active insurance claims, and the attorney is ...
When reviewing, please consider those tasks applicable to your specialty. In general, paralegals ... The practice currently manages approximately 140 active insurance claims, and the attorney is ...
Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation ... Clinical experience in utilization review, clinical quality auditing, or related healthcare review ...
Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation ... Clinical experience in utilization review, clinical quality auditing, or related healthcare review ...
Licensed Insurance Agent
Park City, UT · Remote
$125K/yr
Remote Employment Type: Full-time Advertised Compensation: $60K - 125K About Embedded Insurance ... Detailed utilization of CRM to manage leads, track pipeline activity. * Adherence to all compliance ...
Licensed Insurance Agent
Park City, UT · Remote
$125K/yr
Remote Employment Type: Full-time Advertised Compensation: $60K - 125K About Embedded Insurance ... Detailed utilization of CRM to manage leads, track pipeline activity. * Adherence to all compliance ...
Remote Prior Authorization Pharmacist
South Jordan, UT · Remote
$55.25 - $66.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
South Jordan, UT · Remote
$55.25 - $66.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Lehi, UT · Remote
$54.75 - $65.75/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Lehi, UT · Remote
$54.75 - $65.75/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Licensed Insurance Professional
Salt Lake City, UT · Remote
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Quick apply
Remote Licensed Insurance Professional
Salt Lake City, UT · Remote
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Remote Licensed Insurance Professional
Salt Lake City, UT · On-site +1
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Remote Licensed Insurance Professional
Salt Lake City, UT · On-site +1
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Remote Licensed Insurance Professional
Salt Lake City, UT · Remote
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Quick apply
Remote Licensed Insurance Professional
Salt Lake City, UT · Remote
$35K - $42K/yr
This remote position is only available to candidates who meet the following criteria: * Must have ... Use a customer-focused, needs-based review process to educate clients about insurance options
Appeals Pharmacist (Remote)
Lehi, UT · On-site +1
$53.75 - $65.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Lehi, UT · On-site +1
$53.75 - $65.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
South Jordan, UT · On-site +1
$54.25 - $66.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
South Jordan, UT · On-site +1
$54.25 - $66.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Remote Insurance Utilization Review information
What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?
| Aspect | Remote Insurance Utilization Review | Remote Claims Reviewer |
|---|---|---|
| Credentials | Typically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professional | Usually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H |
| Work Environment | Remote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of services | Remote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance |
| Industry Usage | Commonly used in healthcare insurance to evaluate medical necessity | Used across insurance sectors to process and validate claims |
Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.
How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?
Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.
What are remote insurance utilization review jobs?
Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.
What are the key skills and qualifications needed to thrive as a Remote Insurance Utilization Review Specialist, and why are they important?
To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.
What are popular job titles related to Remote Insurance Utilization Review jobs in Utah? For Remote Insurance Utilization Review jobs in Utah, the most frequently searched job titles are:
- Flex Schedule Remote Utilization Review Nurse
- Per Diem Utilization Review Nurse
- Utilization Review Physician
- Remote Utilization Review Physical Therapist
- Seasonal Remote Hedis Review Nurse
- Physician Advisor
- Remote Utilization Management Pharmacist
- Behavioral Health Utilization Review
- Remote Utilization Management
- Part Time Utilization Review Nurse
What job categories do people searching Remote Insurance Utilization Review jobs in Utah look for? The top searched job categories for Remote Insurance Utilization Review jobs in Utah are:
- Therapy Utilization Review
- Utilization Review No Experience
- Remote Aetna Utilization Review
- Remote Physical Therapy Utilization Review
- Remote Lpn Utilization Review
- Psychiatric Utilization Review
- Full Time Navihealth Utilization Review
- Remote Optum Utilization Review
- Remote Occupational Therapy Utilization Review
- Remote Aetna Utilization Review Nurse
What cities in Utah are hiring for Remote Insurance Utilization Review jobs? Cities in Utah with the most Remote Insurance Utilization Review job openings:
Contractor
Posted 17 days ago
Job description
Description
Flexible Independent Contractor (1099)
Require a DC or Maryland State Medical License
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews. This is a flexible remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
Requirements
California Consumer Privacy Act (CCPA) Information (California Residents Only):
Flexible Independent Contractor (1099)
Require a DC or Maryland State Medical License
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews. This is a flexible remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
- Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US).
- Covered under MRIoA's Errors and Omissions policy.
- Independent Contractor (1099) opportunity.
- Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.
Requirements
- Must have a Medical Degree MD or DO
- Must have a current state medical license in DC or Maryland
- Current Board Certification in Radiology
- Must have 5 years of clinical experience residency to be included
- Daytime availability is required for peer-to-peer conversations
California Consumer Privacy Act (CCPA) Information (California Residents Only):
- Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
- Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.