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Remote Optum Utilization Review Jobs in Edmond, OK

ABB

Utility Sales Support

OK · Remote

$17.75 - $23.25/hr

While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred

Lochner

Airport Civil Project Manager

Oklahoma City, OK · On-site +1

$69K - $93K/yr

Ensure efficient and productive utilization of staff in providing high-quality service ... remote opportunities where business needs allow • Life insurance and disability coverage ...

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Remote Optum Utilization Review information

See Edmond, OK salary details

$19

$38

$62

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

As of Sep 3, 2026, the average hourly pay for remote optum utilization review in Edmond, OK is $38.20, according to ZipRecruiter salary data. Most workers in this role earn between $30.19 and $43.89 per hour, depending on experience, location, and employer.

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 popular job titles related to Remote Optum Utilization Review jobs in Edmond, OK?

For Remote Optum Utilization Review jobs in Edmond, OK, the most frequently searched job titles are:

What job categories do people searching Remote Optum Utilization Review jobs in Edmond, OK look for?

The top searched job categories for Remote Optum Utilization Review jobs in Edmond, OK are:

What cities near Edmond, OK are hiring for Remote Optum Utilization Review jobs?

Cities near Edmond, OK with the most Remote Optum Utilization Review job openings:

Remote Optum Utilization Review jobs near you

Orthopedic Spine Reviewer (Remote)

Managed Medical Review Organization

Oklahoma City, OK • Remote

Contractor

Posted 9 days ago

Job description

About MMRO
Managed Medical Review Organization (MMRO) is a nationally recognized, URAC-accredited Independent Review Organization (IRO) specializing in objective, evidence-based medical peer reviews and disability evaluations. For more than 30 years, MMRO has partnered with government agencies, health plans, employers, and disability systems across the United States to deliver high-quality, clinically sound, and impartial medical reviews.
Our mission is to support fair and accurate healthcare and disability-related decisions by leveraging the expertise of experienced practicing physicians. MMRO is committed to integrity, clinical excellence, quality assurance, and timely service, providing an environment where physician expertise directly impacts important healthcare determinations.
We are currently seeking Board-Certified Orthopedic Surgeons, with a preference for physicians who have completed an Orthopedic Spine Fellowship, to join our nationwide network of independent Physician Reviewers.
Position Overview
As an Independent Physician Reviewer, you will perform objective medical record reviews and provide evidence-based opinions regarding diagnosis, treatment, disability, impairment, and medical necessity questions. Reviews are conducted remotely and do not require direct patient interaction.
This role is ideal for physicians seeking flexible consulting opportunities that allow them to apply their clinical expertise while maintaining control over their schedule and workload.
Responsibilities
  • Conduct thorough, unbiased medical chart reviews in accordance with accepted clinical standards and evidence-based guidelines.
  • Analyze medical records and supporting documentation to formulate clear, well-reasoned clinical opinions.
  • Prepare concise, accurate, and defensible written reports that clearly support review determinations.
  • Complete reviews in accordance with MMRO's quality standards and established turnaround times.
  • Utilize MMRO review templates and ensure all required elements are addressed completely and accurately.
  • Maintain professionalism, objectivity, and confidentiality throughout the review process.
  • Respond promptly to communications from MMRO clinical and operations staff.
  • Participate in required reviewer orientation and ongoing training activities.
  • Incorporate quality feedback provided by MMRO's Medical Director, Associate Medical Director, and clinical team.
  • Support continuous quality improvement initiatives through constructive suggestions and collaboration.
Qualifications
Required
  • Current, unrestricted M.D. or D.O. license to practice medicine in the United States.
  • Active Oklahoma state medical license.
  • Board Certification through an American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) recognized specialty board.
  • Minimum of five (5) years of full-time equivalent clinical practice providing direct patient care.
  • Active clinical experience within the past three (3) years.
  • Strong written communication skills and attention to detail.
  • Ability to meet established review deadlines consistently.
Preferred
  • Fellowship training in Orthopedic Spine Surgery.
  • Prior experience performing peer reviews, independent medical reviews, disability evaluations, utilization review, or expert medical opinions.
Why Partner with MMRO?
  • 100% remote independent contractor opportunity
  • Flexible scheduling with the ability to accept cases based on your availability
  • No patient appointments, call coverage, or administrative practice responsibilities
  • Competitive per-case compensation
  • Opportunities to review cases aligned with your specialty expertise
  • Dedicated clinical and operational support team
  • Work with a respected, URAC-accredited organization committed to quality and clinical integrity
  • Make a meaningful impact on healthcare and disability-related decision-making nationwide

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