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Remote Utilization Management Jobs in Oregon (NOW HIRING)

Centene

Utilization Review Clinician - Behavioral Health

OR · Remote

$27.02 - $48.55/hr

... Management/Health Services team. Centene is a diversified, national organization offering ... Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular ...

Centene

Psychologist Reviewer

OR · On-site +1

$87K - $157K/yr

... utilization management processes * Interact with the Medical Director, or designee, to discuss ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

phData

Program Manager, AI & Data

OR · Remote

... billable utilization and management of multiple customers concurrently. * Proficiency in Jira ... Experience leading remote, multi-geo teams. * Bachelor's degree in IT or a related technical field.

Abbott

Distribution Field Manager - West

Portland, OR · Remote

$86K - $173K/yr

... management of our Regional partners. This is a remote sales opportunity and will cover the West ... utilization, expand market share, and execute data-driven growth strategies. * Lead cross ...

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Showing results 21-40

All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Oregon

Remote Utilization Management information

See Oregon salary details

$22

$44

$72

How much do remote utilization management jobs pay per hour?

As of Jul 24, 2026, the average hourly pay for remote utilization management in Oregon is $44.70, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $51.35 per hour, depending on experience, location, and employer.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Oregon? The most popular types of Utilization Management jobs in Oregon are:
What are popular job titles related to Remote Utilization Management jobs in Oregon? For Remote Utilization Management jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Oregon look for? The top searched job categories for Remote Utilization Management jobs in Oregon are:
What cities in Oregon are hiring for Remote Utilization Management jobs? Cities in Oregon with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Oregon as of July 2026, with employment types broken down into 82% Full Time, 14% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $92,985 per year, or $44.7 per hour.
Utilization Review Clinician - Behavioral Health

Utilization Review Clinician - Behavioral Health

Centene

OR • Remote

$27.02 - $48.55/hr

Full-time

Medical, Retirement, PTO

Posted 21 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 398 frontline employees who took The Breakroom Quiz

16th of 890 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular holiday rotation required. Must be licensed in state of WA.

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

  • Evaluates member's treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
  • Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
  • Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
  • Analyzes BH member data to improve quality and appropriate utilization of services
  • Provides education to providers members and their families regrading BH utilization process
  • Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
  • Engages with medical directors and leadership to improve the quality and efficiency of care
  • Formulates and presents cases in staffing and integrated rounds
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience.
License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master's degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.
License/Certification:

  • LCSW- License Clinical Social Worker required or
  • LMHC-Licensed Mental Health Counselor required or
  • LPC-Licensed Professional Counselor required or
  • Licensed Marital and Family Therapist (LMFT) required or
  • Licensed Mental Health Professional (LMHP) required or
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular holiday rotation required. Must be licensed in state of WA.

Pay Range: $27.02 - $48.55 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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