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Remote Supervisor Utilization Management Jobs in Arizona

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location: This is a remote position ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Arizona Department of Administration

$71K/yr

REMOTE OPTIONS, PHOENIX Categories: Accounting/Auditing, Healthcare/Medical Support Level, Research ... Under the general direction of the Medical Management (MM) Manager and Supervisor, this position ...

Clarivate

Director & Product Management

Tempe, AZ · Remote

$156K - $195K/yr

... placement, utilization management, and lives data-into clear, actionable intelligence for our ... This is a remote role The expected base salary for this position is $156,000 - $195,000 USD per ...

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Remote Supervisor Utilization Management information

What is the highest paying job in healthcare management?

In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Medical Officer (CMO) tend to be the highest paying positions, often earning six-figure salaries. These roles require extensive experience, leadership skills, and often advanced degrees or certifications, and they oversee large healthcare organizations or systems.

How to make 2000 a week working from home?

A Remote Supervisor Utilization Management can earn $2,000 or more weekly by working full-time, managing multiple cases efficiently, and possessing relevant certifications such as CCM or ANCC. Increasing experience, demonstrating strong organizational skills, and working for organizations with higher pay scales can also help achieve this income level.

Is a utilization manager the same as a risk manager?

A utilization management supervisor focuses on evaluating healthcare services to ensure appropriate and efficient use of resources, often within insurance or healthcare organizations. A risk manager, on the other hand, identifies and mitigates potential risks to an organization, which can include financial, legal, or safety concerns. While both roles involve assessment and decision-making, they serve different functions and require distinct skill sets.

How to make $1000 a week remotely?

A Remote Supervisor Utilization Management role can pay around $1,000 or more per week depending on experience, certifications, and workload. Earning this amount typically involves managing a high volume of cases, utilizing strong organizational skills, and working full-time hours, often with overtime or bonuses for productivity. Building expertise in utilization review and maintaining relevant credentials can help increase earning potential in remote management positions.

What is the difference between Remote Supervisor Utilization Management vs Remote Utilization Review Nurse?

AspectRemote Supervisor Utilization ManagementRemote Utilization Review Nurse
CredentialsRN, often with management or supervisor certificationsRN, with clinical review certifications
Work EnvironmentSupervises teams, manages utilization processes remotelyPerforms clinical reviews, assesses patient necessity remotely
Employer & Industry UsageHealth insurance companies, managed care organizationsInsurance companies, third-party administrators
Primary FocusOverseeing utilization management operationsConducting clinical utilization reviews

Remote Supervisor Utilization Management roles focus on overseeing utilization management teams and processes, ensuring compliance and efficiency. In contrast, Remote Utilization Review Nurses primarily perform clinical assessments to determine the necessity of services. Both roles require RN credentials but differ in responsibilities and scope within the utilization management field.

What are the most commonly searched types of Supervisor Utilization Management jobs in Arizona? The most popular types of Supervisor Utilization Management jobs in Arizona are:
What are popular job titles related to Remote Supervisor Utilization Management jobs in Arizona? For Remote Supervisor Utilization Management jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Remote Supervisor Utilization Management jobs in Arizona look for? The top searched job categories for Remote Supervisor Utilization Management jobs in Arizona are:
What cities in Arizona are hiring for Remote Supervisor Utilization Management jobs? Cities in Arizona with the most Remote Supervisor Utilization Management job openings:
Remote Supervisor Utilization Management jobs near you
Utilization Review Nurse

Utilization Review Nurse

Oscar Health

Tempe, AZ • Remote

$35 - $45.94/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

239th of 281 rated insurance

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines)
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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