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Remote Insurance Utilization Review Jobs in Orem, UT

Embedded Insurance

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 ...

firsthand Health

Remote Triage Nurse

Provo, UT · On-site +1

$80K/yr

... are utilization. Together with our health plan partners, we are changing the way our society ... Such requests will be subject to review and approval by the Company, and exemptions will be granted ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Orem, UT

Remote Insurance Utilization Review information

See Orem, UT salary details

$18

$36

$59

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

As of Jul 26, 2026, the average hourly pay for remote insurance utilization review in Orem, UT is $36.76, according to ZipRecruiter salary data. Most workers in this role earn between $29.04 and $42.21 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 Orem, UT? For Remote Insurance Utilization Review jobs in Orem, UT, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Orem, UT look for? The top searched job categories for Remote Insurance Utilization Review jobs in Orem, UT are:
Remote Insurance Utilization Review jobs near you

Behavioral Health Utilization Management Specialist

Row Partners

Draper, UT • On-site, Remote

$60K - $70K/yr

Full-time

Medical, Dental, Vision, PTO

Posted 12 days ago

Job description

Behavioral Health Utilization Management Specialist

Location: Utah (Hybrid & Remote Options Available)

Job Type: Full-time

Department: Behavioral Health / Utilization Management

Who We Are

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team.

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day.

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you.

The Role

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes.

What You’ll Do

  • Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services.
  • Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
  • Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
  • Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
  • Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
  • Stay ahead of industry standards, insurance requirements, and treatment protocols.
  • Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers.
  • Document with precision for utilization reviews, audits, and compliance needs.

What You Bring

Proven Success

  • A history of professional growth, creative problem-solving, and a commitment to excellence.
  • Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike.

Preferred Experience

  • 2+ years in utilization management, case management, or behavioral health services
  • Familiarity with mental health and substance use disorder diagnoses.
  • Understanding of insurance coding, billing, and behavioral health authorization procedures.

Preferred Skills

  • Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
  • Comfort with utilization management tools (ASAM, MCG, InterQual).
  • Excellent communication and relationship-building skills.
  • Ability to multitask in a fast-paced environment.
  • EHR system proficiency.

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.)

Work Location

  • Based in Sandy, Utah — remote work available for those living more than 50 miles from the office.

Why You’ll Love Working With Us

  • Competitive salary & comprehensive benefits (health, dental, vision).
  • Paid time off, sick leave, and paid holidays.
  • Opportunities for growth, training, and continuing education.
  • Supportive, team-first culture where your contributions matter.
  • The chance to impact lives and improve care outcomes every single day.

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.