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Remote Optum Health Utilization Review Jobs in Santa Rosa, CA

Madrona Hospice Care Inc.

Registered Nurse

Santa Rosa, CA · Remote

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

Madrona Hospice Care Inc.

Registered Nurse

Petaluma, CA · Remote

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

New

GCX Healthcare Solutions

Software Engineer

Petaluma, CA · Remote

$125K - $150K/hr

... retail, healthcare, hospitality, and events--to securely deploy tablets and self-service ... Collaborate on architecture, code reviews, and engineering best practices Required Qualifications ...

Direct Counsel

Senior Conflicts Analyst

Saint Helena, CA · On-site +1

$100K - $120K/yr

Review and analyze conflict check requests for new and existing clients and matters. * Collaborate ... Health, dental, vision, 401(k), profit sharing, and more. * Flexible Work Options: Hybrid and ...

ABB

Group Account Manager

CA · Remote

$163K - $261K/yr

Remote {#LI-Remote} Your role and responsibilities: * Drives strategic account planning, sales ... Health Advocate support resources for mental/behavioral health, general health navigation and ...

Doxel

Staff Software Engineer, Full Stack

Bodega Bay, CA · Remote

$200K - $250K/yr

Remote first culture (for most roles) * Comprehensive Health Insurance (Medical, Dental, Vision ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

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Showing results 41-60

All JobsOptum Health Utilization Review JobsRemote Optum Health Utilization Review JobsRemote Optum Health Utilization Review Jobs in Santa Rosa, CA

Remote Optum Health Utilization Review information

See Santa Rosa, CA salary details

$23

$46

$75

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

As of Aug 15, 2026, the average hourly pay for remote optum health utilization review in Santa Rosa, CA is $46.23, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.08 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 near Santa Rosa, CA are hiring for Remote Optum Health Utilization Review jobs?

Cities near Santa Rosa, CA with the most Remote Optum Health Utilization Review job openings:

Remote Optum Health Utilization Review jobs near you

Registered Nurse

Caring Hand Home Health Solutions, Inc.

Novato, CA • Remote

$110 - $130/hr

Full-time, Per diem

Posted 3 days ago

New

Job description

Caring Hand Home Health Solutions, Inc’s mission is to provide professional and paraprofessional services to clients in their homes assigning them to achieve the highest level of potential in their day-to-day self-care activities. We are committed to providing high quality, multidisciplinary care by professionals who recognize the need for comprehensive assessment of needs from both the client and professional’s point of view.

Our mission is to ensure a smooth transition for patients returning home from medical facilities by offering expert guidance throughout their recovery journey. As a Registered Nurse with Caring Hand Home Health Solutions, you will play a key part in ensuring the accuracy and quality of clinical documentation, helping our patients receive the right care at the right time. You’ll collaborate closely with clinical staff, contribute to quality improvement initiatives, and help uphold our commitment to regulatory compliance.

We value teamwork, empathy, and a commitment to high-quality service, all aimed at putting patients and their families at ease during their recovery. If you are passionate about making a positive impact in patients' lives and working in a supportive and family-oriented atmosphere, we encourage you to join us in providing exceptional home health care.

Please note that this role is per diem with a rate of $110 - $130 per visit.

Responsibilities
  • Review OASIS assessments for completeness, appropriateness, and compliance with federal and state regulations.
  • Ensure accurate ICD-10 coding and sequencing based on each patient’s medical condition and co-morbidities.
  • Partner with clinical staff to resolve documentation and data integrity issues.
  • Monitor visit utilization and flag potential financial risks or underutilization to clinical management.
  • Identify and communicate trends that impact agency outcomes and process measures.
  • Conduct OASIS inter-rater reliability visits with clinical team members.
  • Participate in Quality Improvement and Corporate Compliance activities.
  • Stay current with best practices through ongoing education and professional development.
  • Perform other duties as required for patient services.

Requirements

  • Active Californian RN license in good standing.
  • 1–2 years of clinical home health experience.
  • Working knowledge of OASIS assessments and ICD-10 coding.
  • Knowledge of federal regulations and state licensure requirements.
  • Strong communication skills and a keen eye for detail.
  • Ability to work independently and manage priorities with minimal supervision.
  • Proficiency with computer systems and electronic health records.
  • Current CPR certification with AHA.
  • Valid driver’s license, reliable insured vehicle.

Nice to Have

  • OASIS certification (COS-C).
  • OASIS Home Health ICD-10 coding certification.

Benefits

  • Flexible Schedule
  • Ability to Convert to Full-Time Based On Performance If Interested
  • Paid Sick Days
  • Paid Bereavement Leave
  • Skills Training & Development
  • Company Social Events
  • Mileage Reimbursement for Patient to Patient Visits
  • Referral Bonus