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Remote Optum Utilization Review Jobs in Colorado

Solution Architect - Remote

Denver, CO · Remote

$112K - $193K/yr

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

Solution Architect - Remote

Denver, CO · On-site +1

$64.75 - $85.50/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

Solution Architect - Remote

Denver, CO · Remote

$64.75 - $85.50/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

Solution Architect - Remote

Denver, CO · On-site +1

$112K - $193K/yr

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

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Remote Optum Utilization Review information

What is a Remote Optum Utilization Review?

A Remote Optum Utilization Review position involves working for Optum, a healthcare services company, to evaluate medical records and determine the necessity and appropriateness of healthcare services. Employees in this role review clinical documentation to ensure that treatments meet established guidelines and help to manage healthcare costs while ensuring patient care is not compromised. The position is remote, meaning you can work from home or another location outside of a traditional office. Utilization review professionals often interact with healthcare providers, insurance companies, and patients, using their clinical expertise to make informed decisions.

What are the key skills and qualifications needed to thrive as a Remote Optum Utilization Review nurse?

To thrive as a Remote Optum Utilization Review Nurse, you need a current RN license, strong clinical judgment, knowledge of utilization management, and experience in case review or discharge planning. Proficiency with medical review software, electronic health records, and familiarity with UM guidelines such as InterQual or Milliman is typically required. Exceptional communication, attention to detail, and critical thinking are vital soft skills for effective collaboration and decision-making in a remote environment. These skills ensure accurate assessments, regulatory compliance, and optimal patient outcomes while maintaining efficiency in a virtual workflow.

How does a Remote Optum Utilization Review nurse typically collaborate with multidisciplinary teams while working from home?

As a Remote Optum Utilization Review nurse, collaboration with multidisciplinary teams is primarily conducted through secure digital platforms, including video calls, emails, and electronic health record systems. You’ll regularly communicate with physicians, social workers, case managers, and other healthcare providers to review patient cases, coordinate care plans, and ensure compliance with clinical guidelines. Despite working remotely, maintaining clear and timely communication is essential for effective patient advocacy and decision-making. Team meetings and case discussions are scheduled virtually, fostering a supportive environment and ensuring you stay connected to the broader healthcare team.

What is the difference between Remote Optum Utilization Review vs Remote UnitedHealthcare Utilization Review?

AspectRemote Optum Utilization ReviewRemote UnitedHealthcare Utilization Review
CredentialsLicenses in relevant states, certifications like CCM or CRC often preferredLicenses in relevant states, certifications like CCM or CRC often preferred
Work EnvironmentRemote, home-based with flexible hoursRemote, home-based with flexible hours
Employer & IndustryOptum, healthcare services and utilization managementUnitedHealthcare, health insurance and utilization review

Both roles involve reviewing healthcare claims and authorizations remotely, requiring similar credentials and work environments. The main difference lies in the employer and specific healthcare focus: Optum specializes in healthcare services and utilization management, while UnitedHealthcare focuses on health insurance and claims review. Candidates often compare these roles to determine the best fit based on employer and industry specialization.

What are the most commonly searched types of Optum Utilization Review jobs in Colorado?

The most popular types of Optum Utilization Review jobs in Colorado are:

What cities in Colorado are hiring for Remote Optum Utilization Review jobs?

Cities in Colorado with the most Remote Optum Utilization Review job openings:

Infographic showing various Remote Optum Utilization Review job openings in Colorado as of August 2026, with employment types broken down into 100% Full Time. Highlights an 3% Hybrid, and 97% Remote job distribution.

Utilization Review Coordinator

UCHealth Colorado Career

Fort Collins, CO • On-site, Remote

$29.54 - $44.31/hr

Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


UCHealth (Colorado) rating

7.4

Company rating: 7.4 out of 10

Based on 453 frontline employees who took The Breakroom Quiz

269th of 889 rated healthcare providers


Job description

Description

Location: UCHealth Poudre Valley Hospital, CO, Fort Collins

Department: IP Behavioral Unit

Work Schedule: PRN, 0.00 hours per pay period (2 weeks)  

Shift: Days 

Pay: 29.54 - 44.31 / hour. Pay is dependent on applicant's relevant experience

This position is an onsite role and does not offer a hybrid or remote option

Summary:
Facilitates coordination of reimbursement processes for all levels of care to include authorizations, data collection and tracking, internal and external communications.

Responsibilities:

  • Manages and tracks reimbursement for treatment via certification and authorization processes. Completes data tracking to monitor authorization status, complete reports, denials and notes.
  • Completes initial authorization for Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP). Completes concurrent reviews and assists with admission authorizations.
  • Ensures appropriate Release of Information (ROI) are in place for all patients for insurance coordination.
  • Facilitates communication related to authorization information and challenges/items needed between payors and clinical team members.
  • Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements:

  • Bachelor's degree.

Employees are our number one asset.

UCHealth promotes a culture that invests in professional success and personal well-being through a comprehensive total rewards program. *

Recognition

  • Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure. The bonus accumulates annually each October and is paid out in October during the third year of employment.
  • Performance-based pay increase: The Annual Merit Pay Increase recognizes work performance that meets or consistently exceeds performance standards documented through UCHealth's established evaluation process and accounts for increased experience, skills and cost of living. 
  • Market reviews: All UCHealth positions are reviewed annually to ensure UCHealth base pay aligns with market standards. Base pay rates are adjusted as needed to stay market competitive. 

Health and well-being

  • Medical, dental and vision coverage.
  • Access to 24/7 mental health and well-being support for employees and dependents.
  • Discounted gym memberships and fitness resources.
  • Free Care.com membership.
  • Voluntary benefits such as accident insurance, critical illness insurance, group legal plan, identity theft protection, pet insurance, auto and home insurance, and employee discount programs.
  • Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence.
  • Employer-provided basic life and accidental death and dismemberment coverage with buy-up coverage options.
  • Employer-provided short-term disability and long-term disability with a buy-up coverage option.

Retirement and savings

  • 403(b) plan with employer matching contribution.
  • Additional 457(b) plan may be available.
  • Flexible spending accounts for health care and dependent day care; health savings account available when enrolled in high-deductible (HD) medical plan.

Education and career growth

  • UCHealth provides access to academic degrees and certificate programs to promote professional and personal growth.
    • Up to 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. 
    • Other programs may qualify for up to 10,000/year pre-paid by UCHealth or up to 5,250/year in the form of tuition reimbursement. 
  • Access to LinkedIn Learning, which offers thousands of virtual courses and seminars, and internal professional development opportunities. 
  • Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness.

*Eligibility for some programs is based on an employee's scheduled work hours. 

We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives. 

UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when the do not impose an undue hardship on the organization.

Who We Are (uchealth.org)

Employment Type:

What UCHealth (Colorado) employees say

Pay

Benefits

Hours and flexibility

Workplace

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