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Remote Optum Utilization Review Jobs in Appleton, WI

Remote Optum Utilization Review information

See Appleton, WI salary details

$20

$41

$67

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

As of Jul 6, 2026, the average hourly pay for remote optum utilization review in Appleton, WI is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.36 per hour, depending on experience, location, and employer.

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.

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 a Remote Optum Utilization Review position?

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, and why are they important?

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.
What are popular job titles related to Remote Optum Utilization Review jobs in Appleton, WI? For Remote Optum Utilization Review jobs in Appleton, WI, the most frequently searched job titles are:
What cities near Appleton, WI are hiring for Remote Optum Utilization Review jobs? Cities near Appleton, WI with the most Remote Optum Utilization Review job openings:
Territory Business Manager, Green Bay Wisconsin

Territory Business Manager, Green Bay Wisconsin

Argenx

Green Bay, WI • Remote

$140K - $192K/yr

Full-time

Medical, Retirement

Posted 23 days ago


Job description

Join us as we transform immunology and deliver medicines that help autoimmune patients get their lives back. argenx is preparing for multi-dimensional expansion to reach more patients through a rich pipeline of differentiated assets, led by VYVGART, our first-in-class neonatal Fc receptor blocker approved for the treatment of gMG, and with the potential to treat patients across dozens of severe autoimmune diseases.

We are building a new kind of biotech company, one that maintains its roots as a science-based start-up and pushes our commitment to innovate across all corners of our business. We strive to inspire and grow our company, our partnerships, our science, and our people, because when we do, we deliver more for patients.

At argenx, we build our culture from the collective power of the team and the knowledge that together, we are better. We are one team, one culture, with one purpose. As part of that team, the Territory Business Manager (TBM) for the Neurology Franchise will drive demand generation through a focused approach on healthcare professionals, academic institutions, and specialty pharmacy/infusion providers. Through exemplary collaboration with internal and field-based partners and a patient-first mindset, the TBM will help deliver on quarterly sales objectives within their assigned geography. TBM's will report into the Strategic Business Leader.

Roles and Responsibilities:

  • Travel within assigned geography and occasionally beyond
  • Territory planning and development of local market strategy
  • Collaborate with regional colleagues and cross-functional team members
  • Communicate and engage with assigned HCP's and affiliated staff
  • Consistently meet and exceed sales objectives
  • Effective utilization of market tools and resources
  • Timely submission of account plans and activity including CRM
  • Adhere to all argenx compliance policies, guidelines and approved sales messages

Skills and Competencies:

  • Ability to sell collaboratively
  • High level of clinical, product, and business acumen
  • Problem solving
  • Working effectively together
  • Results Oriented
  • Capable in a virtual sales environment
  • Demonstrates ownership and accountability
  • Passionate about serving patients
  • Understanding of market access dynamics, emphasis on specialty pharmacy and buy & bill accounts

Education, Experience and Qualifications:

  • 5+ years of specialty/rare disease/biologics sales experience, neurology strongly preferred
  • Proven track record of consistent high sales performance
  • Adept at planning, organizing, and executing sales strategy
  • Demonstrate ability to collaborate with internal stakeholders
  • Ability to adapt to an ever-changing environment
  • Experienced in product launches
  • Align with core values of the organization - co-creation, humility, excellence, empowerment and innovation
  • Education: B.S. or B.A. degree required

#LI-Remote

For applicants in the United States: The annual base salary hiring range for this position is $140,000.00 - $192,500.00 USD. This range reflects our good faith estimate at the time of posting. Individual compensation is determined using objective, inclusive, and job-related criteria such as relevant experience, skills, demonstrated competencies and internal equity. This means actual pay may differ from the posted range when justified by these factors. Because market conditions evolve, pay ranges are reviewed regularly and may be adjusted to remain aligned with external benchmarks.

This job is eligible to participate in our short-term and long-term incentive programs, subject to the terms and conditions of those plans and applicable policies. It also includes a comprehensive benefits package, including but not limited to retirement savings plans, health benefits and other benefits subject to the terms of the applicable plans and program guidelines.

At argenx, all applicants are welcomed in an inclusive environment. They will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.

Before you submit your application, CV or any other personal details to us, please review our argenx Privacy Notice for Job Applicants to learn more about how argenx B.V. and its affiliates ("argenx") will handle and protect your personal data. If you have any questions or you wish to exercise your privacy rights, please contact our Global Privacy Office by email at privacy@argenx.com.

If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at hr.us@argenx.com. Only inquiries related to an accommodation request will receive a response.