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Remote Optum Utilization Review Jobs in Wisconsin

Benefit & Compensation Analyst (on site)

Madison, WI · Remote

$70K - $87K/yr

Madison, WI Full Time | Day | Monday-Friday | 8am-5pm (option for 1 Day/Week remote) Make a lasting ... This role analyzes market trends, internal data, employee feedback, and program utilization to ...

Licensing Manager

Janesville, WI · On-site +1

$160K - $200K/yr

Hybrid or remote work arrangement will be considered. While our headquarters is located in ... Interface with regulatory agencies in the planning of regulatory engagements, regulatory reviews ...

Licensing Engineer

Janesville, WI · On-site +1

$73K - $121K/yr

... support of the review of licensing actions by the U.S. Nuclear Regulatory Commission; the ... Hybrid or remote work arrangement will be considered. While our headquarters is located in ...

US Remote Dallas and Scottsdale preferred Overview: The Senior Director, Finance IT is a senior ... Conduct regular license and entitlement reviews across all Finance platforms to ensure the ...

Showing results 21-38

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 Wisconsin?

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

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

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

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

Director, Total Rewards (Remote, USA)

Optiv Security, Inc.

Milwaukee, WI • Remote

$123K - $168K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 5 days ago


Job description

The Director, Total Rewards serves as a strategic leader responsible for the strategy, design, and development of total rewards. This includes leading the annual compensation review, managing effective base pay, developing variable and bonus compensation targets, health and welfare programs, a variety of rewards and recognition programs, and retirement plan for our expanding global workforce. This role will lead the total rewards strategy for Optiv by building a cohesive set of programs that align employees' needs to business strategy and enhance attraction and retention of our workforce. This role reports directly to the Senior Vice President of Human Resources (SVP, HR) and serves as a member of the Optiv HR Leadership Team (HRLT). The details below refer to compensation and benefits in multiple countries (USA, India, and Canada) with employees spread throughout.
How you'll make an impact

  • Partner with business leaders and HR leadership to develop global, strategic, total rewards strategy

  • Provide executive leadership with strategic total rewards program enhancements that will enable the attraction, development, and retention of talent

  • Design and recommend global compensation and benefits programs by assessing Optiv's future needs, reviewing competitor and general industry practices, and analyzing cost impact/effectiveness

  • Develop and coordinate communication strategies and activities designed to educate and inform Optiv about total rewards

  • Review benefit premium rate contribution, claims and utilization data on an annual basis; analyze and interpret data for trends, improvements, and efficiencies

  • Coordinate and lead the 401(k) administration and investment committee

  • Collaborate with Talent Partners, HR Business Partners and business leaders to understand their issues related to compensation and benefits. Provide counsel and build solutions appropriately (e.g. training for Managers on how to have a compensation conversation)

  • Own and evolve our Total Rewards programs and scalable strategy targeted at retaining Optiv's competitive position, engagement, and retention

  • Provide subject matter expertise and accurately interpret, counsel, communicate, and educate HR Business Partners, managers, and executives on pay decisions, policy and guideline interpretations, and job evaluations

  • Manage payroll and benefits for the India entity of 650+ employees

  • Direct the benchmarking efforts associated with the rewards mechanics and elevate our understanding of competitiveness

  • Collaborate with Finance and executive leadership to build and manage cyclical and non-cyclical compensation budgets. Ensuring we generally have what we need

  • Responsible for analysis, design, compliance, communication, implementation, administration, monitoring and reporting of health, life, disability, and other benefit programs

  • Oversee all vendors, consultants and outsourced relationships for the department

  • Provide oversight and guidance of internal procedures to ensure compliance and consistency. Ensures that all welfare and retirement plans (health, dental, vision, life, disability, FSA, 401(k), etc.) meet legal, regulatory and audit compliance (ERISA, 5500 Filings, SPD's, SBC's, COBRA, FMLA, HIPAA, ADA, ACA, GINA, etc.)

  • Evolve current salary pay band structures that integrate job bands, grade levels, and promotion guidelines into the total rewards programs

  • Lead all global compensation processes (base and variable pay, merit, promotions, bonuses) including plan design, market competitiveness, distribution and sign off

  • Focus on health and welfare plan management that includes strategic and tactical planning as well as ongoing administration of the plans and open enrollment cycles

  • Supervise renewals, census, maintenance of enrollment, application, and claims records for all benefits plans

  • Maintain expert knowledge of benefit laws/regulations, provide oversight and guidance of internal procedures to ensure compliance and consistency.

  • Partner with brokers and insurance carriers to create and implement annual wellness initiatives; analyze ROI regarding the programs

  • Propose policies and procedures to ensure that the company's total reward programs support business objectives, are fair and competitive, and are legally compliant

  • Participate in M&A due diligence; manages the M&A comp and benefit integration process including job profile integration, compensation integration, and FLSA review/determinations

  • Complies with all policies and standards

  • Perform other duties as assigned

What we're looking for

  • Bachelor's degree in Human Resources, Business, Finance or other related areas, Master's Degree preferred

  • Demonstrated experience in total rewards design and implementation

  • Demonstrated compensation experience in the following areas: executive compensation, compensation committee management, base salary, market pricing, variable pay and performance management, job evaluation, data analysis, research, and cost modeling

  • Demonstrated benefit experience including knowledge of health and welfare plans, Leaves and time off practices, and retirement plans. Global exposure preferred

  • 10+ years of relevant experience: Compensation, HR and Benefits with half of those years managing people, processes and technology

  • Understanding of HR principles, laws, and practices

  • Technical understanding of HR Systems, how they work together and the downstream impact of data quality. Workday experience preferred

  • Ability to understand, balance, and articulate both tactical and strategic planning issues

  • Strong project management skills with proven track record, including ability to manage diverse cross-functional teams and multiple projects

  • Must possess excellent written/verbal communication, presentation, and facilitation skills

  • Effectively translates quantitative and qualitative data into actionable insights, strategies and plans and can articulate data visually and in an understandable manner

  • Effective at leading, and communicating with leadership, but with a willingness to play a 'hands-on' role with key projects and workstreams

Salary Range Description

$148,100.00 - $197,300.00 Annual

The Hiring Range provided for this role is informed by (but not limited to) various factors including responsibilities of the position, work experience, education/training, internal peer equity, geography, as well as other market influences when extending an offer. The disclosed range has not been adjusted for these factors. This role may also be eligible to participate in a variable incentive-based bonus plan. Optiv offers a comprehensive compensation and benefits package, of which salary is a component.

Job Application Window

This position accepts applicants for a minimum of 4 business days after the job posting date and will remain available until an applicant has been selected for the position.


What you can expect from Optiv

  • A company committed to our inclusive value through our Employee Resource Groups
  • Work/life balance
  • Professional training resources
  • Creative problem-solving and the ability to tackle unique, complex projects
  • Volunteer Opportunities. "Optiv Chips In" encourages employees to volunteer and engage with their teams and communities.
  • The ability and technology necessary to productively work remotely/from home (where applicable)

EEO Statement

Optiv is an equal opportunity employer. All qualified applicants for employment will be considered without regard to race, color, religion, sex, gender identity or expression, sexual orientation, pregnancy, age 40 and over, marital status, genetic information, national origin, status as an individual with a disability, military or veteran status, or any other basis protected by federal, state, or local law.

Optiv respects your privacy.By providing your information through this page or applying for a job at Optiv, you acknowledge that Optiv will collect, use, and process your information, which may include personal information and sensitive personal information, in connection with Optiv's selection and recruitment activities. For additional details on how Optiv uses and protects your personal information in the application process, click here to view ourApplicant Privacy Notice. If you sign up to receive notifications of job postings, you may unsubscribe at any time.