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Remote Supervisor Utilization Management Jobs in Florida

LIBERTY DENTAL

Senior Staff Dentist

Tampa, FL · On-site +1

$175K - $185K/yr

What You'll Do Clinical Review & Utilization Management * Perform clinical reviews of dental claims ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...

Serve Robotics

Remote Supervision Coordinator

Miami, FL · On-site +1

$55K - $64K/yr

Support special trials and pilot programs to test features ahead of broader Remote Supervisor ... Strong attention to detail with the ability to monitor and manage multiple robots and tasks ...

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Remote Supervisor Utilization Management information

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 Florida? The most popular types of Supervisor Utilization Management jobs in Florida are:
What are popular job titles related to Remote Supervisor Utilization Management jobs in Florida? For Remote Supervisor Utilization Management jobs in Florida, the most frequently searched job titles are:
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Remote Supervisor Utilization Management jobs near you

Utilization Review Specialist (Remote) - Behavioral Health

Adolescent Wellness Academy

Davie, FL • Remote

Full-time

Posted 3 days ago

New

Job description

Remote Authorization Specialist

Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour

About the Role
This role manages insurance authorization for clients across our PHP and IOP programs - completing pre-certifications, concurrent reviews, verifying benefits, obtaining Single Case Agreements, and managing appeals so that client access to treatment is never disrupted by a payer issue.

Backgrounds that translate well: Utilization Review Insurance Authorization/Precertification Behavioral Health Case Management

What You'll Do

  • Verify benefits and eligibility prior to admission and throughout treatment
  • Complete pre-certifications, concurrent reviews, and re-certifications for PHP/IOP levels of care
  • Obtain Single Case Agreements with out-of-network payers
  • Build the medical necessity case using ASAM, LOCUS, and CALOCUS criteria
  • Prepare and submit appeals on denied authorizations
  • Maintain accurate, audit-ready authorization, denial, and SCA records

What We're Looking For

Required

  • 2+ years of experience as a UR/authorization specialist at the PHP and IOP levels of care for a mental health or substance use facility
  • Working knowledge of ASAM, LOCUS, and CALOCUS criteria and medical necessity standards
  • Strong organizational skills with the ability to manage multiple authorizations and deadlines concurrently
  • Strong familiarity with EMR platforms and authorization software
  • Strong written and verbal communication skills, with the ability to advocate effectively with payers
  • Eligible for DCF and AHCA Level 2 Background Check

Preferred

  • CPT/ICD-10 and DSM-5 familiarity
  • Multi-payer SCA experience
  • Bilingual (English/Spanish)
  • Kipu or similar EMR experience

AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. We exist to serve clients and families at their most critical moments - and this role sits at the front door of that mission.


Learn More: Adolescent Wellness Academy Principles Recovery Center

Employment Type: FULL_TIME

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