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Remote Utilization Management Jobs in Utah (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Lehi, UT · On-site +1

$53.75 - $65.50/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

South Jordan, UT · On-site +1

$54.25 - $66.25/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Imh

Social Worker

Murray, UT · Remote

$39.16 - $60.42/hr

... Utilization Management, discharge planning, managed care, health promotion, health coaching ... Experience working successfully g in a remote environment or using Advanced Microsoft Suite ...

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Remote Utilization Management information

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$19

$38

$62

How much do remote utilization management jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for remote utilization management in Utah is $38.49, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $44.18 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 Utah? The most popular types of Utilization Management jobs in Utah are:
What are popular job titles related to Remote Utilization Management jobs in Utah? For Remote Utilization Management jobs in Utah, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Utah look for? The top searched job categories for Remote Utilization Management jobs in Utah are:
What cities in Utah are hiring for Remote Utilization Management jobs? Cities in Utah with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you

Medical Director - Utilization Management (Remote)

MRIoA

Salt Lake City, UT • On-site, Remote

$240K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

Job description

Description
Who We Are - Motivated by Purpose. Powered by Clinical Expertise.
Founded in 1983, we're a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.
Excellence starts with our people.
WE OFFER
  • A competitive compensation package
  • Benefits include healthcare, vision, and dental insurance
  • A generous 401(k) match
  • Paid vacation, PTO, and holidays
  • Growth and training opportunities
  • An award-winning remote work environment

Position Summary
Our Medical Director, also known as a Physician Advisor, is responsible for performing clinical utilization management, peer review activities, and clinical quality management activities.
Key Responsibilities
  • Perform utilization management case reviews.
  • Maintain productivity score per company standard.
  • Maintain annual quality score per company standard.
  • Complete annual inter-rater reliability testing.
  • Train across all queues as requested by MRIoA leadership.
  • Complete all client specific training as requested by MRIoA leadership.
  • Maintain up-to-date records of case completion if required
  • Consistently show willingness to take cases as requested.
  • Demonstrate respect in interactions across the company.
  • Consistently submit scheduling requests at least three months in advance. Consistently work scheduled hours.
  • Provide ideas for promotion and growth of the company as requested (i.e. contribute to the vision of the company).
  • Respond appropriately and in a timely manner to licensing/CME requests from the Senior Medical Directors, Vice President of Medical Affairs, or Chief Medical Officer and/or administrative team.
  • Actively participate in the MRIoA evaluation process (both company and individual).
  • Participate in all company meetings and committees as requested.
  • Complete other duties as requested or approved by the CEO and/or chief medical officer.
  • Thorough understanding of the Company's clients, products, departments, workflows, and applicable regulatory requirements and accreditation standards

Work Schedule
  • 40 hours per week
  • Five 8-hour shifts or four 10-hour shifts (available after training)
  • Shifts scheduled between 6:00 AM - 7:00 PM MST
  • Includes 2-3 weekend rotating shifts per month
  • Schedules are fixed and released 60 days in advance

Compensation & Expanded Benefits
  • Base salary: $240,000 per year
  • 20 days of Paid Time Off per year
  • 6 company Holidays (New Year's, Memorial Day, Independence Day, Labor Day, Thanksgiving, Christmas) and 1 Floating Holiday
  • 8 days of Paid Sick Leave
  • Medical and Prescription Benefits administered by Aetna
  • Dental and Vision benefits
  • Basic Life and Accidental Death and Dismemberment (AD&D) Insurance
  • Short-Term & Long-term Disability insurance

Requirements
Skills and Experience
  • Minimum of five years' full-time equivalent experience providing direct clinical care to patients
  • Minimum of five years' experience administering utilization management and peer review programs preferred
  • Credentialed and privileged by the Company's Credentialing Committee
  • Obtain additional state licensure as required for the position

Education:
  • MD/DO degree
  • Current, unrestricted medical license as required for clinical practice in a state of the United States
  • Board certification by a medical specialty board approved by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) or other board recognized by URAC preferred

Additionally:
  • Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers are covered under MRIoA's Errors and Omissions policy.

Work Environment:
Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).
Diversity Statement:
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Drug-Free Workplace:
This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. Employees are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.
California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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