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Remote Insurance Utilization Review Jobs in Des Moines, IA

HealthCheck360

Bilingual RN Case Manager

Des Moines, IA · Remote

$21 - $26.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote. We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our ... Provide telephonic case management and utilization review for assigned consumers. * Develop ...

HealthCheck360

Bilingual RN Case Manager

Des Moines, IA · Remote

$21 - $26.50/hr

Remote. We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our ... Provide telephonic case management and utilization review for assigned consumers. * Develop ...

Dwolla

Business Intelligence Developer

Des Moines, IA · On-site +1

$110K - $116K/yr

The position duties include the utilization of SQL programming and ETL to analyze data; promote ... Remote work from any location in the US is an option for this position. Minimum requirements are a ...

Dwolla

Business Intelligence Developer

Des Moines, IA · On-site +1

$110K - $116K/yr

The position duties include the utilization of SQL programming and ETL to analyze data; promote ... Remote work from any location in the US is an option for this position. Minimum requirements are a ...

QuickVisit Urgent Care

Remote Receptionist (PRN)

Alleman, IA · On-site +1

$15 - $19.75/hr

Ensure patient demographic and insurance information is accurate and updated. Collect patient copay ... Reviews details and expectation of referral with the potential patient * Ensures that referrals are ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Des Moines, IA

Remote Insurance Utilization Review information

See Des Moines, IA salary details

$20

$41

$67

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

As of Aug 17, 2026, the average hourly pay for remote insurance utilization review in Des Moines, IA is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.40 per hour, depending on experience, location, and employer.

What is a remote insurance utilization review?

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 skills and qualifications are needed for a remote insurance utilization review specialist?

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.

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 is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed 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.

What are popular job titles related to Remote Insurance Utilization Review jobs in Des Moines, IA?

For Remote Insurance Utilization Review jobs in Des Moines, IA, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Utilization Review jobs in Des Moines, IA look for?

The top searched job categories for Remote Insurance Utilization Review jobs in Des Moines, IA are:

Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Des Moines, IA as of July 2026, with employment types broken down into 83% Full Time, and 17% Temporary. Highlights an 100% Remote job distribution, with an average salary of $85,829 per year, or $41.3 per hour.

Bilingual RN Case Manager

HealthCheck360

Des Moines, IA • Remote

$21 - $26.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

Job description

Bilingual RN Case Manager

Location: Remote. 

We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our team. This role is responsible for delivering comprehensive case management services across the continuum of care. The RN Case Manager will assess, plan, implement, coordinate, monitor, and evaluate care for assigned consumers, ensuring quality outcomes and cost-effective treatment. 

Key Responsibilities:

  • Provide telephonic case management and utilization review for assigned consumers.
  • Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
  • Collaborate with healthcare providers, payors, and internal teams to coordinate care.
  • Serve as a liaison between consumers and benefit administrators, ensuring clear communication and support.
  • Track and report case outcomes, including cost savings and quality improvements.

Qualifications:

  • Bilingual: the ability to speak Spanish
  • Education: RN licensure in the State of Iowa required. BSN or higher preferred.
  • Experience: Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred.
  • Skills: Strong communication, problem-solving, and computer skills. Ability to work independently.

Full-Time Benefits - Most benefits start day 1

  • Medical, Dental, Vision Insurance
  • Flex Spending or HSA
  • 401(k) with company match
  • Profit-Sharing/Defined Contribution (1-year waiting period)
  • PTO/Paid Holidays
  • Company-paid ST and LT Disability
  • Maternity Leave/Parental Leave
  • Subsidized Parking
  • Company-paid Term Life/Accidental Death Insurance

About HealthCheck360

HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.

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