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Remote Supervisor Utilization Management Jobs in Texas

Oscar Health

Utilization Review Nurse

Dallas, TX · 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 ...

Ascension

Registered Nurse Utilization Review

Austin, TX · Remote

$84K - $118K/yr

Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l Full Time Salary range: $84,060.91 - $118,668.99 per year (Texas) | Pay ranges vary based on candidate ...

CareVitality Inc

Care Manager - Remote

Houston, TX · Remote

$60K - $77K/yr

Title: Care Manager - Remote- Texas /Arkansas preferred Reports to: CEO/President Status ... health or utilization management, is preferred. Language Skills: * Must have excellent ...

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

Utilization Management Nurse (84124)

Regency Integrated Health Services

Austin, TX • Remote

Full-time

Re-posted 14 days ago

Job description

Primary Responsibilities

The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations.

Essential Functions

Perform concurrent, retroactive and pre-service authorization reviews for inpatient and outpatient services.

Follow and maintain compliance with CMS requirements, may include after-hours, holiday and weekend coverage.

Collaborate with staff, physicians, care/service coordinators, and medical directors to coordinate and provide the level of care necessary to meet member's health need.

Location Requirements

This position is remote but requires the employee to live within our service area, which can include any of the following areas within Texas: Rio Grande Valley, DFW, greater Austin, greater Houston, greater San Antonio, Coastal Bend, or Laredo.

Educational/Training Requirements

  • Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience.
  • Payor Utilization Management: 3 years recommended experience
  • Proficiency with Microsoft Office applications, specifically Word, Excel, and Outlook
  • Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria.

Licensing Requirements

  • Current unencumbered LVN or RN license in Texas or compact license.

Experience Requirements

  • 2+ years Utilization management experience with a health insurance company (managed care/payer experience required).
  • UM for Medicare Advantage, Managed Medicaid, Dual SNP Lines of Business, on the payer side. 
  • 5+ years of acute clinical experience.
  • The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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About Regency Integrated Health Services

Sourced by ZipRecruiter

Regency Integrated Health Services, located in Victoria, Texas, U.S., is a healthcare provider operating within post-acute healthcare and rehabilitation industry sector. As a well-known name in the industry with an official website at regencyhealthcare.com, the company specializes in offering a wide range of health services which primarily include skilled nursing, rehabilitation, long-term care, and assisted living services. Since its inception, Regency Integrated Health Services has been committed to providing the highest possible standards in healthcare.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Victoria, TX, US

Year founded

2015

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