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Remote Optum Utilization Review Jobs in Seattle, WA

Centene

Remote Medical Director, Appeals

Auburn, WA · On-site +1

$236K - $449K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

YO AI Labs

Hospitalist Physician - Remote

Seattle, WA · 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 ...

YO AI Labs

Hospitalist Physician - Remote

Seattle, WA · 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 ...

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing and reimbursement Remote in Washington State only Posted wage ranges represent the ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing and reimbursement Remote in Washington State only Posted wage ranges represent the ...

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All JobsOptum Utilization Review JobsRemote Optum Utilization Review JobsRemote Optum Utilization Review Jobs in Seattle, WA

Remote Optum Utilization Review information

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$48

$78

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

As of Sep 12, 2026, the average hourly pay for remote optum utilization review in Seattle, WA is $48.12, according to ZipRecruiter salary data. Most workers in this role earn between $38.03 and $55.24 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 the most commonly searched types of Optum Utilization Review jobs in Seattle, WA?

The most popular types of Optum Utilization Review jobs in Seattle, WA are:

What are popular job titles related to Remote Optum Utilization Review jobs in Seattle, WA?

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

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

The top searched job categories for Remote Optum Utilization Review jobs in Seattle, WA are:

What cities near Seattle, WA are hiring for Remote Optum Utilization Review jobs?

Cities near Seattle, WA 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 Seattle, WA as of September 2026, with employment types broken down into 2% As Needed, 82% Full Time, 8% Part Time, and 8% Contract. Highlights an 100% Remote job distribution, with an average salary of $100,085 per year, or $48.1 per hour.

Sr Hospitalist Clinical Reviewer - Remote

Seattle, WA • Remote

YO AI Labs
See more jobs at YO AI Labsexternal

$70 - $100/hr

Full-time

Posted 21 days ago

Job description

Senior Hospitalist Clinical Reviewer

Job Type: Contractor
Location: Remote

Job Overview

We are seeking experienced Senior Hospitalist Clinical Reviewers to support a high-impact project focused on inpatient clinical quality, documentation accuracy, and medical review. In this role, you will apply your hospitalist expertise and clinical judgment to evaluate inpatient cases, identify complex or ambiguous clinical scenarios, and provide clear, well-reasoned feedback.

This opportunity is ideal for experienced physicians with a strong background in hospital medicine, inpatient quality, medical auditing, clinical documentation, and quality assurance.

Key Responsibilities
  • Review inpatient cases for clinical quality, appropriate care, and documentation accuracy.
  • Evaluate clinical decisions and identify potential quality, documentation, or care concerns.
  • Apply advanced clinical judgment to complex, unusual, or ambiguous inpatient cases.
  • Provide clear and concise explanations supporting clinical review decisions.
  • Assess medical records, clinical documentation, and relevant supporting information.
  • Identify inconsistencies, gaps, or areas requiring clarification within clinical documentation.
  • Apply established clinical standards, guidelines, and quality frameworks when appropriate.
  • Contribute to the development and improvement of clinical review guidelines and quality standards.
  • Collaborate with project teams to resolve challenging clinical cases and review questions.
  • Maintain consistent, accurate, and high-quality review standards across assigned cases.
  • Work independently while meeting project timelines and quality expectations.
Required Qualifications
  • MD or DO degree.
  • 10+ years of attending-level hospitalist experience.
  • Strong experience in inpatient medicine and hospital-based clinical care.
  • Demonstrated experience with inpatient quality, clinical documentation review, medical auditing, or quality assurance.
  • Excellent clinical judgment and ability to evaluate complex or ambiguous cases.
  • Strong written and verbal communication skills.
  • Ability to clearly articulate clinical reasoning and support review decisions.
  • Strong attention to detail and ability to analyze medical records comprehensively.
  • Ability to work independently in a remote environment.
Preferred Qualifications
  • Experience leading or contributing to hospital quality improvement programs.
  • Experience with clinical documentation improvement (CDI).
  • Experience with medical coding, utilization review, or physician audit processes.
  • Experience developing or reviewing clinical quality standards.
  • Familiarity with hospital quality metrics and inpatient quality initiatives.
  • Previous experience mentoring physicians or participating in physician peer review.
Core Skills
  • Inpatient Quality
  • Quality Assurance
  • Medical Auditing
  • Hospital Medicine / Hospitalist Practice
  • Clinical Judgment
  • Clinical Documentation Review
  • Medical Record Review
  • Quality Improvement
  • Critical Thinking
  • Written and Verbal Communication
  • Attention to Detail