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Remote Supervisor Utilization Management Jobs in Kentucky

PharMerica

Claims Processing Supervisor

Louisville, KY · Remote

The Claims Supervisor manages associates' assignments and work queues on a daily and weekly basis ... This is a remote opportunity . Applicants can live anywhere within the Continental USA. Night Shift ...

Cayenta

(Remote) Application Consultant

Canada, KY · Remote

Work with colleagues and managers to implement and proactively manage superior utility CIS ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Harris

(Remote) Application Consultant

Canada, KY · Remote

Work with colleagues and managers to implement and proactively manage superior utility CIS ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

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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 Kentucky? The most popular types of Supervisor Utilization Management jobs in Kentucky are:
What are popular job titles related to Remote Supervisor Utilization Management jobs in Kentucky? For Remote Supervisor Utilization Management jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Remote Supervisor Utilization Management jobs in Kentucky look for? The top searched job categories for Remote Supervisor Utilization Management jobs in Kentucky are:
What cities in Kentucky are hiring for Remote Supervisor Utilization Management jobs? Cities in Kentucky with the most Remote Supervisor Utilization Management job openings:
Remote Supervisor Utilization Management jobs near you
Infographic showing various Remote Supervisor Utilization Management job openings in Kentucky as of July 2026, with employment types broken down into 82% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Claims Processing Supervisor

PharMerica

Louisville, KY • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 29 days ago

PharMerica rating

6.6

Company rating: 6.6 out of 10

Based on 103 frontline employees who took The Breakroom Quiz

65th of 110 rated pharmacies

Job description

Our Company

PharMerica

OverviewPharMerica, a part of Brightspring Health Services, is a longterm care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States. The Claims Supervisor manages associates' assignments and work queues on a daily and weekly basis, ensuring the timely resolution of claims, accurate billing, and the effective distribution of work to support operational efficiency. This is a remote opportunity. Applicants can live anywhere within the Continental USA.Night Shift Schedule: 10:00pm to 6:30am eastern. Must be able to work eastern time zone hours. The ideal candidate will have 3+ years direct supervisory experience along with 3rd party billing/collections experience. REQUIRED: Long-Term Care adjudication experience 

Benefits and perks for You! 

  • Medical, Dental, Vision insurance
  • Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
  • Tuition discounts & reimbursement
  • 401(k) 
  • Company Paid Time Off*
  • Shift Differential 
  • DailyPay
  • Pet Insurance
  • Employee wellness and discount programs 
Responsibilities

Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits. Establish and maintain professional and effective relationship with staff, peers, payers and other stakeholders. Provides associates assignments and work queues on a daily and/or weekly basis. Including resolution, billing, and appropriate distribution of work. Monitors quality of work performed by all associates, including interaction and compliance. Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals. Report to Manager any trends occurring with payers and/or processes Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance. Handles escalated calls from customers and payers to ensure proper resolution. Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager. Manages staff attendance and time sheets for payroll (Kronos) system. Assures staff is meeting attendance policies and reports any variations to Manager. In conjunction with feedback provided by Team Lead and/or Associate, monitor work performance including quality Ensure assignments are fair and balanced based on Team Lead/Associate level skills sets. Works to update, create and/or maintain Standard Operations Procedures for the department. Ensures Sarbanes Oxley (SOX) compliance on all variance, write-off and convert exception reports inclusive of adequate signatures are obtained. Proper storage of completed documents per Compliance policies. Performs other tasks as assigned. Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards. Works to update, create and/or maintain Standard Operations Procedures for the department.

Qualifications

Education/Learning Experience Required: Associates degree, 4 year college , technical degree or 4+ years equivalent experienceWork Experience Required: 3+ years direct supervisory experience Desired: 3rd Party Billing or collections/billing experience in the healthcare industry, AS400 computer systems experience or Pharmacy Technician.Skills/Knowledge Required: Proficiency in MS Office Products (Excel, Word) and Basic computer knowledge Required: Ability to maintain confidentiality Desired: AS400 Computer Systems ExperienceBehavior Competencies Required: Excellent communication skills, both written and oral Required: Problem solving and detail oriented Required: Strong time management, organizational skills and self-starter Required: Strong attendance and leadership

About our Line of BusinessPharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.Employment Type: FULL_TIME

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