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Remote Optum Utilization Review Jobs in Hines, IL

AltaStaff, LLC

UM RN Care Review Clinician

Chicago, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

YO AI Labs

Hospitalist Physician - Remote

Chicago, IL · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

UnitedHealth Group

Software Engineer

Schaumburg, IL · Remote

$72K - $130K/yr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Review guidelines * Optimize infrastructure utilization and resource consumption by fine-tuning ...

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All JobsOptum Utilization Review JobsRemote Optum Utilization Review JobsRemote Optum Utilization Review Jobs in Hines, IL

Remote Optum Utilization Review information

See Hines, IL salary details

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$41

$68

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

As of Sep 2, 2026, the average hourly pay for remote optum utilization review in Hines, IL is $41.83, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.03 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 job categories do people searching Remote Optum Utilization Review jobs in Hines, IL look for?

The top searched job categories for Remote Optum Utilization Review jobs in Hines, IL are:

What cities near Hines, IL are hiring for Remote Optum Utilization Review jobs?

Cities near Hines, IL with the most Remote Optum Utilization Review job openings:

Remote Optum Utilization Review jobs near you

ABA Utilization Review (UR) Specialist

Spectrum Billing Solutions

Skokie, IL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 6 days ago

Job description

​
Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.
We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist external clients in understanding payer requirements for authorizations.
  • Participate in team meetings.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
  • Flexible work environment 
  • Competitive Salary
  • A close-knit team of talented and skilled individuals.
  • Growth opportunities 
  • Benefits – Medical, Dental, Vision
  • Flexible Paid Time Off
  • 401K with Company match
  • Supplemental Benefits
Qualifications:
  • 3-5 years of related ABA and/or Behavioral Health experience.
  • Bachelor’s or master’s degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services.
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​#UtilizationReviewSpecialist | #UtilizationManagementSpecialist | #URSpecialist | #RevenueCycleSpecialist | #InsuranceSpecialist | #URSpecialist | #RevenueCycleUtilizationReviewSpecialist | #ABAUtilizationReviewSpecialist | #ABAUtilizationManagementSpecialist | #ABAURSpecialist | #BehavioralHealthBillingSpecialist 
 

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