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Remote Optum Utilization Review Jobs in Orem, UT

UnitedHealth Group

Senior Fraud Analyst - Remote

Draper, UT · On-site +1

$72K - $130K/yr

Optum is a global organization that delivers care, aided by technology to help millions of people ... The Senior Fraud Analyst will be responsible for reviewing and investigating potential cases of ...

401GO

Regional Relationship Manager - HCM

Sandy, UT · On-site +1

Flexible (In Office, Hybrid, or Remote) Job Type: Full-time Reports to: Director of Sales Travel ... Conduct regular business reviews with partners to evaluate performance, identify opportunities, and ...

Canals

Customer Success Manager

Lehi, UT · Remote

Facilitate regular business reviews to demonstrate ROI and align on future goals. * Contribute to ... Demonstrated success driving product adoption, utilization and training end users. * Proven ...

All JobsOptum Utilization Review JobsRemote Optum Utilization Review JobsRemote Optum Utilization Review Jobs in Orem, UT

Remote Optum Utilization Review information

See Orem, UT salary details

$18

$36

$59

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

As of Sep 1, 2026, the average hourly pay for remote optum utilization review in Orem, UT is $36.76, according to ZipRecruiter salary data. Most workers in this role earn between $29.04 and $42.21 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 Orem, UT?

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

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

The top searched job categories for Remote Optum Utilization Review jobs in Orem, UT are:

What cities near Orem, UT are hiring for Remote Optum Utilization Review jobs?

Cities near Orem, UT with the most Remote Optum Utilization Review job openings:

Remote Optum Utilization Review jobs near you
Infographic showing various Remote Optum Utilization Review job openings in Orem, UT as of August 2026, with employment types broken down into 2% As Needed, 79% Full Time, 13% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $76,458 per year, or $36.8 per hour.

Behavioral Health Utilization Management Specialist

Row Partners

Draper, UT • On-site, Remote

Full-time

Medical, Dental, Vision, PTO

Re-posted 19 days ago

Job description

Behavioral Health Utilization Management Specialist 

Location: Utah (Hybrid & Remote Options Available) 

Job Type: Full-time 

Department: Behavioral Health / Utilization Management 

Who We Are 

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team. 

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day. 

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you. 

The Role 

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes. 

What You’ll Do 

  • Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services. 
  • Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
  • Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
  • Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
  • Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care. 
  • Stay ahead of industry standards, insurance requirements, and treatment protocols. 
  • Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers. 
  • Document with precision for utilization reviews, audits, and compliance needs. 

What You Bring 

Proven Success 

  • A history of professional growth, creative problem-solving, and a commitment to excellence. 
  • Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike. 

Preferred Experience 

  • 2+ years in utilization management, case management, or behavioral health services 
  • Familiarity with mental health and substance use disorder diagnoses. 
  • Understanding of insurance coding, billing, and behavioral health authorization procedures. 

Preferred Skills 

  • Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
  • Comfort with utilization management tools (ASAM, MCG, InterQual). 
  • Excellent communication and relationship-building skills.
  • Ability to multitask in a fast-paced environment. 
  • EHR system proficiency. 

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.) 

Work Location 

  • Based in Sandy, Utah — remote work available for those living more than 50 miles from the office. 

Why You’ll Love Working With Us 

  • Competitive salary & comprehensive benefits (health, dental, vision).
  • Paid time off, sick leave, and paid holidays.
  • Opportunities for growth, training, and continuing education. 
  • Supportive, team-first culture where your contributions matter. 
  • The chance to impact lives and improve care outcomes every single day. 

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.