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Remote Utilization Management Jobs in Utah (NOW HIRING)

Optimize the sales process, pipeline management, and CRM utilization to improve efficiency and ... Flexible working arrangements and remote work options * Professional development budget and career ...

New

The role is a remote position; location base will be reviewed as this position covers all regions ... Develop communication and territory management skills throughout the field sales team * Identify ...

Remote- (UT, WY, ID preferred) | Travel Required Who We Are At Accelerate Dental, we partner with ... Support implementation and utilization of: * Accelerate University * Practice Management Software ...

NetDocuments is the world's #1 trusted cloud-based content management and productivity platform ... Two-time winner (2024, 2023) Top Workplace Innovation * 2025 Remote Work * 2024 Technology Industry ...

Senior Data Analyst - Remote

Draper, UT · On-site +1

$80K - $101K/yr

Create and maintain SSRS reports to support operational, regulatory, and management reporting needs ... utilization, and portfolio performance * Advanced Python proficiency, with hands-on experience ...

Senior Data Analyst - Remote

Draper, UT · On-site +1

$80K - $101K/yr

Create and maintain SSRS reports to support operational, regulatory, and management reporting needs ... utilization, and portfolio performance * Advanced Python proficiency, with hands-on experience ...

Our Practice Management Suite is purpose-built for firms that want to work smarter, grow faster ... Tool Utilization and Integration: Leverage tools and technologies like Python, Pytest, PyCharm ...

Our Practice Management Suite is purpose-built for firms that want to work smarter, grow faster ... Tool Utilization and Integration: Leverage tools and technologies like Python, Pytest, PyCharm ...

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Remote Utilization Management information

See Utah salary details

$19

$38

$62

How much do remote utilization management jobs pay per hour?

As of Jun 11, 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 cities in Utah are hiring for Remote Utilization Management jobs? Cities in Utah with the most Remote Utilization Management job openings:
Infographic showing various Remote Utilization Management job openings in Utah as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $80,064 per year, or $38.5 per hour.
Business Analyst, Pricing and Underwriting

Business Analyst, Pricing and Underwriting

Maxor National Pharmacy Services

Orem, UT • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago


Maxor National Pharmacy Services rating

8.8

Company rating: 8.8 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

3rd of 99 rated pharmacies


Job description

The Business Analyst, Pricing and Underwriting, is responsible for the compilation, analysis, and reporting of data to support pricing contracts for Specialty services within a Pharmacy Benefit Manager (PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account Management teams to develop custom reports, assess the impact of client-driven changes, and perform data-driven analyses. Utilize SQL, Excel, and data visualization tools to maintain and monitor Specialty pricing models, support financial forecasting, and contribute to strategic economic modeling. Design and generate reports to inform daily operations and executive decision-making. Collaborate within the Pricing & Underwriting department to develop queries across multiple systems, offering robust analytical support to key business units.

Position Location:

This is a remote-based position within the Continental US.

Our Company Founded in 1926, Maxor is a leading, independent pharmacy solutions platform that improves prescription drug affordability and outcomes. Over time, Maxor has built a unique and complementary suite of clinically integrated services and technology offerings that deliver clinical, financial and strategic value to patients, payors and providers across the pharmacy supply chain. Maxor has a proud heritage of growth and innovation earned over the decades. Amarillo, Texas is the legacy headquarters for Maxor, but our talent base is national. We operate pharmacies and other business operation sites across the United States with employees working from 44 states.

Why Join Maxor?

At Maxor, we recognize that our employees are our most valuable assets. We actively seek and retain talented professionals who are mission-driven to improve healthcare outcomes for patients. Likewise, our employees are essential to their own well-being, finding fulfillment in meaningful work, competitive compensation, diverse and inclusive teams, and limitless career possibilities. With a growing workforce of 1,500+ and almost a century of pharmacy experience, we offer the stability of a Fortune 500 company and the energy and innovation of a startup. Our expertise and technology support the entire pharmacy ecosystem, but our impact goes beyond pharmacy services. We enable pharmacy care.

Responsibilities
  • Create and maintain custom data-mining queries to produce actionable insights for pricing and business strategy.
  • Analyze pharmacy claims, drug pricing, rebate models, and utilization trends for internal teams and client reporting.
  • Interpret complex pharmacy benefit structures and clearly communicate findings to varied audiences.
  • Provide forecasting, reporting, and analytical support to senior management for strategic planning.
  • Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations.
  • Contribute to Specialty Pricing operations by:
    • Managing pricing appeals, coordinating with Maxor Specialty, and compiling data for automated processing.
    • Executing weekly pricing tasks to ensure accuracy and implementation consistency.
    • Gathering and preparing input data from pricing resources to support core processes.
    • Documenting procedures to meet audit and compliance requirements.
  • Execute dynamic pricing strategies in response to market changes to ensure competitive positioning and profitability.
  • Collaborate with Pricing, Underwriting, Sales, and Account Management teams to evaluate and support new/existing client opportunities.
  • Enhance financial models and streamline operational processes for greater accuracy and efficiency.
  • Create and distribute ad hoc reports and financial models tailored to business needs.
  • Develop tools for performance monitoring and key metric tracking across business units.
  • Maintain current knowledge of financial tools, market conditions, and PBM industry trends.
  • Author and manage Standard Operating Procedures (SOPs) for custom and standardized tasks.
  • Communicate complex analytical findings effectively across technical and non-technical audiences.
  • Foster continuous improvement with a strong focus on operational excellence and process optimization.
Qualifications

Education:  Bachelor’s Degree in Finance, Business Analytics, Computer Information Systems, Data Science, or Economics. Or similarly related degree preferred.

Experience: Minimum of 2 years’ experience completing complex analytical, financial analysis for PBM services. Minimum of 1 year experience using SQL or other applicable programming language (Python/VBA/C++/etc).

Knowledge, Skills, and Abilities:

  • Knowledge of pricing components and service mix, including plan design, prescription utilization, retail networks, rebates, Specialty/Mail pharmacy services, and brand/generic dynamics.
  • Advanced Excel and Word expertise, with experience in building complex financial models and reports.
  • Proficient in SQL, using SELECT, CASE, JOIN, and conditional logic to extract and analyze large datasets.
  • Strong analytical skills to assess client-specific data within the broader context of business strategy, delivering actionable pricing recommendations.
  • Experience working with complex, unstructured datasets to drive insights and decisions.
  • Proven ability to manage multiple priorities, coordinate deliverables, and meet critical deadlines.
  • Effective cross-functional collaborator in fast-paced environments involving Operations, Sales, Account Management, and Finance.
  • Skilled communicator with experience presenting findings to senior leadership. Self-motivated project manager with excellent follow-through and organizational discipline.
  • Detail-oriented with exceptional time management and process documentation skills.

WE OFFER

At Maxor, we foster a diverse and progressive culture that promotes a work-from-home model and a "dress-for-your-day" approach to work attire. Our team-oriented environment encourages collaboration and innovation.

We offer highly competitive compensation and comprehensive health benefits including:

  • Comprehensive mental health and wellbeing resources
  • Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
  • Company-paid basic life/AD&D, short-term and long-term disability insurance
  • Rx, dental, vision, other voluntary benefits, and FSA
  • Employer-matched 401k Plan
  • Industry-leading PTO plan
  • And more!

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