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Remote Optum Utilization Review Jobs in Wisconsin

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 ...

Showing results 41-46

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.

Senior Licensing Engineer

SHINE Technologies LLC

Janesville, WI • On-site, Remote

$100K - $161K/yr

Full-time

Re-posted 22 days ago


Job description

Description

SHINE Technologies is seeking a Senior Licensing Engineer who will assist the company in the support of the review of licensing actions by the U.S. Nuclear Regulatory Commission (NRC); the preparation for, and coordination of, construction inspections and operational readiness reviews by the NRC; the preparation and submittal of permit applications to other applicable regulatory agencies; and to ensure ongoing compliance with all licenses and permits.


The Senior Licensing Engineer will work as part of an innovative, collaborative, cross-discipline team to license SHINE's commercial and research and development activities, including the SHINE medical isotope production facility.

Hybrid or remote work arrangement will be considered. While our headquarters is located in Janesville, Wisconsin, we welcome applicants from across the U.S. who can effectively collaborate in a virtual environment. Candidates may be asked to travel occasionally for team meetings or onsite engagements, depending on business needs.  

The base salary range for this position is $100,000 - $161,000 per year plus a comprehensive compensation package. Our salary ranges are determined by role, level, and location.


Duties and Responsibilities:

Specific duties and responsibilities of the Senior Licensing Engineer include, but are not limited to:

  • Maintain the licensing basis of SHINE's licensed activities, including Safety Analysis Reports and the programs and plans described therein.
  • Coordinate with technical personnel to ensure design changes meet the applicable licensing basis or are adequately incorporated into the licensing basis.
  • Lead interactions with regulatory agencies, including public meetings, regulatory audits, and clarification discussions.
  • Support the development of licensing strategies.
  • Prepare and deliver licensing presentations to internal and external organizations.
  • Coordinate NRC construction inspections, including pre-inspection assessments and responses to inspector requests.
  • Oversight of vendor deliverables to ensure regulatory, quality, and schedule objectives are met.
  • Preparation and review of licensing correspondence to regulatory agencies (e.g., regulatory engagement plans, application supplements, amendment requests, responses to requests for additional information, exemption requests).
  • Ensure compliance with local, state, and federal regulations for construction and operation of licensed facilities.
  • Participate in regulator-led and industry-led activities related to nuclear licensing.
  • Perform other duties as assigned.


Requirements

  • Bachelor's degree in engineering, scientific discipline, or related field, or equivalent experience such as a Senior Reactor Operator License or the Naval Nuclear Propulsion Program.
  • A minimum of 5 years of experience in nuclear licensing or comparable field.
  • Familiarity with Title 10 of the Code of Federal Regulations (CFR) and other applicable regulations.
  • Familiarity with regulatory guidance applicable to non-power production and utilization facilities and radioactive material licenses.
  • Proficient in Microsoft Office Suite and Adobe Acrobat.
  • Ability to communicate effectively with all levels within the organization, as well as interface with regulators, contractors, and suppliers.

Working Conditions and Physical Effort: 

  • Requires frequent leaning, bending, stooping, crouching, grasping, and reaching above the shoulders and below the knees.
  • Moderate physical activity. Requires handling of average-weight objects up to 40 pounds or standing and/or walking for more than four (4) hours per day. 
  • Fine motor coordination and strong depth perception is beneficial.
  • Work involves moderate exposure to unusual elements, such as extreme temperatures, dirt, dust, fumes, smoke, unpleasant odors, and/or loud noises. 
  • Work environment involves some exposure to hazards or physical risks, which require following basic safety precautions. 

Employees must be able to perform the essential functions of the position satisfactorily. If requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of this job, absent undue hardship.


Eligibility for employment is conditioned on the applicant's ability to qualify for access to information subject to U.S. Export Controls. Additionally, applicant's eligibility may be conditioned based upon meeting the Nuclear Regulatory Commission requirements for access to Safeguards Information, which typically requires a pre-employment drug screen, fingerprinting and criminal background check.


SHINE values diversity in all its forms as a critical component of innovation, which is fundamental to our success. Every member of the SHINE community benefits from the talents and experiences of our peers, from the mutual respect we exercise, and from the responsibility we take for our actions.


SHINE Technologies is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Pay Transparency Policy 

Employee Rights Under the NLRA 

Equal Opportunity Employment

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