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Remote Occupational Therapy Utilization Review Jobs in Oregon

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97470, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

Umpqua Health

Utilization Review Clinician

Roseburg, OR · On-site +1

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR ... Licensed Marriage and Family Therapist (LMFT) * Registered Nurse (RN) with Behavioral Health ...

Centene

Clinical Appeals Coordinator

OR · On-site +1

$33.71 - $60.67/hr

  • Medical

  • Retirement

  • PTO

... therapy services in healthcare or home health settings. Managed care or utilization review ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Appeals

OR · On-site +1

$236K - $449K/yr

  • Medical

  • Retirement

  • PTO

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Inpatient Medicare

OR · On-site +1

$236K - $449K/yr

  • Medical

  • Retirement

  • PTO

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Psychologist Reviewer

OR · On-site +1

$87K - $157K/yr

  • Medical

  • Retirement

  • PTO

We are seeking a Remote Psychologist Reviewer with experience in outpatient behavioral health ... Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified ...

BetterHelp

Psychiatrist - Remote

OR · On-site +1

$119 - $242/hr

At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... utilization of add-on codes (such as 90833) when clinically appropriate and properly documented

Beacon Talent

Remote Psychiatrist

Portland, OR · Remote

$150 - $200/hr

Coordinate with therapists, care navigators, and primary care where indicated * Document within our ... review * Escalate acute safety concerns per protocol, with 24/7 crisis-team backup Practice ...

Bcbsa

Director, Trade Client Relations

OR · On-site +1

$155K - $175K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

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All JobsOccupational Therapy Utilization Review JobsRemote Occupational Therapy Utilization Review JobsRemote Occupational Therapy Utilization Review Jobs in Oregon

Remote Occupational Therapy Utilization Review information

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$47

$70

How much do remote occupational therapy utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote occupational therapy utilization review in Oregon is $47.97, according to ZipRecruiter salary data. Most workers in this role earn between $40.91 and $53.89 per hour, depending on experience, location, and employer.

What is a remote occupational therapy utilization review?

A Remote Occupational Therapy Utilization Review job involves evaluating occupational therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review documentation, provide recommendations, and collaborate with healthcare providers and insurance companies. Their main goal is to ensure appropriate care while preventing unnecessary costs. Strong analytical skills and knowledge of occupational therapy practices and insurance regulations are essential for this role.

What does a remote occupational therapy utilization review do?

Professionals in Remote Occupational Therapy Utilization Review primarily review clinical documentation to determine the medical necessity and appropriateness of occupational therapy services. Typical daily tasks include analyzing therapy notes, applying payer criteria to case reviews, communicating with providers for clarifications, and documenting decisions within electronic systems. You may also participate in team meetings, provide feedback to therapy staff, and stay updated on changing regulations or insurance policies. This role requires a balance of independent work and frequent collaboration with other utilization reviewers, case managers, and healthcare providers to ensure the highest quality of care and compliance.

What are the key skills and qualifications needed to thrive in remote occupational therapy utilization review?

To thrive as a Remote Occupational Therapy Utilization Review professional, you need a background in occupational therapy, solid clinical assessment skills, and familiarity with medical necessity criteria such as Medicare or insurance guidelines. Experience using electronic medical record (EMR) systems, utilization review software, and knowledge of relevant certifications like OTR/L or CHT are typically required. Attention to detail, critical thinking, and strong written communication skills are highly valued in this role. These abilities are crucial to making accurate determinations, maintaining compliance, and effectively collaborating with healthcare teams and insurers from a remote setting.

What are popular job titles related to Remote Occupational Therapy Utilization Review jobs in Oregon?

For Remote Occupational Therapy Utilization Review jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Remote Occupational Therapy Utilization Review jobs in Oregon look for?

The top searched job categories for Remote Occupational Therapy Utilization Review jobs in Oregon are:

What cities in Oregon are hiring for Remote Occupational Therapy Utilization Review jobs?

Cities in Oregon with the most Remote Occupational Therapy Utilization Review job openings:

Remote Occupational Therapy Utilization Review jobs near you
Infographic showing various Remote Occupational Therapy Utilization Review job openings in Oregon as of August 2026, with employment types broken down into 83% Full Time, 11% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $99,781 per year, or $48 per hour.

Utilization Review Nurse

Umpqua Health

Roseburg, OR • On-site, Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago

Job description

UTILIZATION REVIEW NURSE
REMOTE
Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97470, as needed for business operations.
EMPLOYMENT TYPE: Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization-we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare, and applicable regulations. The UM Nurse collaborates with interdisciplinary teams and community providers to promote integrated, high-quality care.
ESSENTIAL JOB RESPONSIBILITIES
  • Perform clinical assessments and prior authorizations to determine medical necessity
  • Escalate complex cases to Medical Directors and request additional documentation as needed
  • Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions
  • Liaise with internal departments to resolve eligibility, benefits, or service issues
  • Participate in discharge planning for members transitioning from acute, long-term, or residential care
  • Conduct audits and support quality improvement initiatives
  • Provide training and mentorship on UM protocols and workflows
  • Maintain relationships with community providers and service organizations
  • Ensure compliance with organizational policies, clinical standards, and federal/state regulations
  • Perform other nursing-related duties as assigned

CHALLENGES
  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS
  • Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state
  • Graduation from an accredited nursing program
  • Minimum 5 years of direct patient care experience
  • Proficiency with Microsoft Office, EHR systems, and UM software
  • Strong clinical knowledge, communication, and organizational skills
  • No suspension, exclusion, or debarment from federal healthcare programs

PREFERRED QUALIFICATIONS
  • 2+ years of utilization review or case management experience in managed care
  • Oregon residency and license
  • Bilingual or translation skills a plus
  • Experience with quality improvement audits and diverse team collaboration
  • Ability to work independently in fast-paced environments
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $85,000- $105,340
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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