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Remote Insurance Utilization Review Jobs in Mobile, AL

Pharmacy Careers

Appeals Pharmacist (Remote)

Mobile, AL · On-site +1

$48.75 - $59.50/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Nexera

Entry Level Remote Sales Role

Mobile, AL · Remote

$1.5K - $5.3K/wk

No prior experience in finance or insurance is required. We provide full training and licensing ... Answer the screener questions below honestly -- we review every application and respond within 2 ...

Apply Early

Nexera

Remote Sales Consultant - Financial Services

Mobile, AL · Remote

$4.0K - $6.3K/wk

Access to products from 60-plus insurance carriers so you can match every client with the right fit ... In the screener questions below, answer honestly -- we review every application and respond within ...

Apply Early

Outokumpu

Legal Counsel - USA & Canada

Calvert, AL · On-site +1

If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...

Ecolab

Sr Project Sales Accelerator

Mobile, AL · Remote

$107K - $161K/yr

This is a remote role, with someone ideally being located in the Southern part of the US near a ... Review and/or propose service plan / program management * Assign internal responsibilities for ...

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All JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Mobile, AL

Remote Insurance Utilization Review information

See Mobile, AL salary details

$21

$41

$68

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

As of Jul 2, 2026, the average hourly pay for remote insurance utilization review in Mobile, AL is $41.96, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.17 per hour, depending on experience, location, and employer.

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.

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 Mobile, AL? For Remote Insurance Utilization Review jobs in Mobile, AL, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Mobile, AL look for? The top searched job categories for Remote Insurance Utilization Review jobs in Mobile, AL are:
What cities near Mobile, AL are hiring for Remote Insurance Utilization Review jobs? Cities near Mobile, AL with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you

Remote Prior Authorization Pharmacist

Pharmacy Careers

Mobile, AL • Remote

Other

Posted 9 days ago

Job description

Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities

  • Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
  • Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
  • Communicate approval/denial decisions clearly to providers and patients.
  • Collaborate with physicians, nurses, and medical directors on complex cases.
  • Document outcomes in compliance with health plan policies and CMS/state regulations.
  • Support process improvements to streamline workflow and turnaround times.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
  • Skills: Excellent clinical review, documentation, and communication skills.

Why This Role?

  • Flexibility: 100% remote work from home with flexible scheduling options.
  • Impact: Directly influence patient access to safe and cost-effective medications.
  • Growth: Build specialized skills in utilization management and managed care.
  • Rewards: Competitive compensation, benefits, and career advancement opportunities.


About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.

Apply