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Remote Optum Health Utilization Review Jobs (NOW HIRING)

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks ...

Dane Street, LLC

Utilization Review Physician

Overview We are seeking a high-performing Physician Reviewer to join our Group Health division. The ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Health Care Insurance Company. * Knowledge of medical terminology and procedures. * Verbal and ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

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

ERC Pathlight

Utilization Review Manager

Denver, CO · On-site +1

$93K - $117K/yr

And as the need for world-class mental health care continues to rise, our commitment is stronger ... This position is posted as remote; however, per company policy, candidates residing within a ...

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All JobsRemote Optum Health Utilization Review Jobs

Remote Optum Health Utilization Review information

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How much do remote optum health utilization review jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for remote optum health utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Remote Optum Health Utilization Review vs Remote UnitedHealth Group Utilization Review?

AspectRemote Optum Health Utilization ReviewRemote UnitedHealth Group Utilization Review
CertificationsTypically requires RN, LPN, or medical reviewer credentialsSimilar certifications, often RN or licensed healthcare professionals
Work EnvironmentRemote, healthcare insurance settingRemote, healthcare insurance setting
Employer & IndustryOptum, part of UnitedHealth Group, healthcare and insuranceUnitedHealth Group, healthcare and insurance
Job ResponsibilitiesReview medical necessity, authorizations, and claimsReview medical necessity, authorizations, and claims

Both roles involve remote medical review within the healthcare insurance industry, focusing on medical necessity and claims. The main difference lies in the specific employer, with Optum being a subsidiary of UnitedHealth Group. The certifications, work environment, and job responsibilities are very similar, making them comparable roles for healthcare professionals seeking remote utilization review positions.

What cities are hiring for Remote Optum Health Utilization Review jobs? Cities with the most Remote Optum Health Utilization Review job openings:
What are the most commonly searched types of Optum Health Utilization Review jobs? The most popular types of Optum Health Utilization Review jobs are:
What states have the most Remote Optum Health Utilization Review jobs? States with the most job openings for Remote Optum Health Utilization Review jobs include:
Remote Optum Health Utilization Review jobs near you

Utilization Review Specialist

Mindful Health

Remote

$25 - $30/hr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 12 days ago

Job description

Utilization Review Specialist
Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks and mortar locations and virtual service offerings across the state of Texas to create a high-end client experience.
Mindful Health creates an atmosphere that supports and values our clients and team members. Our commitment is to cultivate a place that provides intentional and exceptional care for our clients and a warm and nurturing environment for our team so we can make a lasting impact in our communities. We believe that health encompasses the whole person, mind, and body, and our clinical programming is built around this belief. We work to empower clients to live fuller and healthier lives. We maintain these same beliefs in developing and supporting our Mindful Health team. We seek enthusiastic individuals passionate about helping clients and value working in a team environment. Please visit our website for more information about our services, locations and team at www.mindful.health.
Job Summary:
Utilization Review Specialist: Responsible for ensuring adherence to Mindful Health’s utilization review plan by evaluating the efficiency, effectiveness, and medical necessity of outpatient services, including admissions and extended treatment. *Must reside in Texas*
Duties/Responsibilities:
  • Establish processes to verify the medical necessity and appropriateness of outpatient admissions
  • Conduct concurrent reviews to ensure extended stays are justified and properly documented
  • Track patient lengths of stay and continued-stay days
  • Refer non-compliant cases to the Physician Advisor for further evaluation
  • Collaborate with the Utilization Review Committee to identify and resolve review-related issues
  • Flag quality-of-care concerns and escalating them to the Quality Assurance Committee
  • Coordinate with Social Services to support timely discharge planning
  • Prepare and present monthly utilization reports and key metrics
Required Skills:
  • Strong verbal and written communication abilities
  • Exceptional organizational skills and keen attention to detail
  • Proven time management skills with the ability to meet deadlines consistently
  • Proficiency in Microsoft Office Suite and related software applications
Education and Experience:
  • Associate's or Bachelor’s degree in a healthcare related field preferred
  • 1–2 years of experience in utilization review
  • Active CPR certification
Physical Requirements:
  • Ability to sit at a desk and work on a computer for extended periods
  • Capable of lifting, holding, pushing, and pulling up to 15 pounds
  • Proficient in typing, navigating, and viewing monitors for prolonged durations
  • Visual acuity to view monitors with close vision, color perception, depth perception, and focus adjustment
  • Effective verbal and written communication skills to engage with patients, team members, and customers
  • Ability to read, write, and comprehend information through active listening
  • Consistent performance of essential job functions in accordance with ADA, FMLA, and applicable federal, state, and local regulations, including meeting productivity standards
  • Reliable and punctual attendance aligned with workplace standards
  • Flexibility to work at multiple locations during a scheduled work week
  • Mobility to move throughout the office or client sites to assist patients as needed
Mindful Health offers:
  • A healthy amp; positive atmosphere where everyone is valued.
  • Schedule: Monday-Friday, 8AM-5PM CST
  • Salary: $25.00 - $30.00 / hr

Benefits:
  • 120 hours (15 days) of paid time off annually
  • 9 paid holidays
  • 40 hours (5 days) of sick leave
  • 24 hours (3 days) of bereavement leave per occurrence
  • Comprehensive medical and supplemental health insurance, including vision, dental, life insurance, amp; both short- and long-term disability
  • Opportunities for professional development and continued education

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. Employee signature below indicates the employee’s understanding of the requirements, essential functions, and duties of the position.

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