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Remote Optum Health Utilization Review Jobs (NOW HIRING)

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 ...

Winston Medical Staffing

Be Seen First

Utilization Review Nurse

Newark, NJ · Remote

$38 - $40/hr

Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field ...

Cobalt Benefits Group

Utilization Review Nurse

As a Utilization Review Nurse (UR Nurse), you'll play an important role in helping us offer ... This role involves evaluating healthcare services and facilities under the provisions of applicable ...

The Meadows

Utilization Review Coordinator

Phoenix, AZ · On-site +1

Meadows Behavioral Healthcare offer a range of specialized programs including residential ... As the Utilization Review Coordinator, you will develop and implement systems for authorizations ...

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Remote Optum Health Utilization Review information

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

As of Jul 14, 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

Utilization Review Specialist

Charlie Health

Nashville, TN • Remote

Full-time

Posted 22 days ago

Charlie Health rating

8.5

Company rating: 8.5 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

Job description

Why Charlie Health?

Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection—between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home.

As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you.

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what's important, getting their loved ones the care they need.

We're a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you're inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today.

Responsibilities
  • Oversees all functions of a virtual IOP caseload
  • Collaborates at a high level to problem solve on complex cases with Manager
  • Completes pre-certs and authorizations for virtual IOP clients in a timely manner
  • Follows up on all outstanding authorizations and reports all barriers to Manager
  • Collaborates with Revenue Cycle Team and Admissions to improve patient experience from the front door through discharge
  • Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems
  • Delivers training to clinical teams for high quality documentation standardization
  • Participate in denial management, appeals, and peer-to-peer review processes
Requirements
  • High School Diploma
  • 2+ years of experience in a utilization role within the utilization review field required
  • Google proficiency
  • Strong interpersonal, relationship-building and listening skills, with a natural, consultative style
  • Ability to energize, communicate, and build rapport at all levels within an organization
  • Strong project management skills, with a demonstrable ability to corral and manage details in a fast-paced, fluid environment
  • Experience advising, presenting to, and persuading senior corporate personnel
  • Knowledge of utilization review processes, medical necessity criteria, and healthcare regulations
  • Familiarity with InterQual, MCG, or similar clinical guidelines
  • Strong analytical, communication, and documentation skills
  • Proficiency with electronic medical records (EMR) and utilization management systems
  • Understanding of HIPAA and patient confidentiality requirements
Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.
Please note that this role is not available to candidates in Alaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota.

#LI-REMOTE

Our Values
  • Connection: Care deeply & inspire hope.
  • Congruence: Stay curious & heed the evidence.
  • Commitment: Act with urgency & don't give up.

Please do not call our public clinical admissions line in regard to this or any other job posting.

Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page: https://www.charliehealth.com/careers/current-openings. Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent from @charliehealth.com email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services.

Recruiting agencies, please do not submit unsolicited referrals for this or any open role. We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals.

At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.

Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.

By clicking "Submit application" below, you agree to Charlie Health's Privacy Policy and Terms of Service.

By submitting your application, you agree to receive SMS messages from Charlie Health regarding your application. Message and data rates may apply. Message frequency varies. You can reply STOP to opt out at any time. For help, reply HELP.

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