The Utilization Management (UM) Coordinator provides MSO referral management services. The UM Coordinator serves as a liaison between members, physicians, providers, and MSO staff, processing initial ...
The Utilization Management (UM) Coordinator provides MSO referral management services. The UM Coordinator serves as a liaison between members, physicians, providers, and MSO staff, processing initial ...
Utilization Review Nurse
Plano, TX · Remote
Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ... Counties). POSITION: 6-month assignment
Utilization Review Nurse
Plano, TX · Remote
Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ... Counties). POSITION: 6-month assignment
Medical Director Utilization Management Oncology
Dallas, TX · Remote
$275K - $325K/yr
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
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Medical Director Utilization Management Oncology
Dallas, TX · Remote
$275K - $325K/yr
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
Behavioral Health Medical Director-Remote
Dallas, TX · Remote
$137 - $145/hr
Behavioral Health Medical Director (Psychiatrist) - Remote Remote | Temp-to-Perm | $137-$145/hr W2 ... Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ...
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Behavioral Health Medical Director-Remote
Dallas, TX · Remote
$137 - $145/hr
Behavioral Health Medical Director (Psychiatrist) - Remote Remote | Temp-to-Perm | $137-$145/hr W2 ... Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ...
Often has one or more regional directors, managers or supervisors reporting to the role. Essential ... Oversees a workforce that is primarily comprised of remote BSWH employees but also includes global ...
Often has one or more regional directors, managers or supervisors reporting to the role. Essential ... Oversees a workforce that is primarily comprised of remote BSWH employees but also includes global ...
Utilization Review Nurse
Dallas, TX · Remote
$35 - $45.94/hr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
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Utilization Review Nurse
Dallas, TX · Remote
$35 - $45.94/hr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Senior Director, Escalated Provider Issue Resolution
Dallas, TX · Remote
$196K - $258K/yr
... Utilization Management, Payment Integrity, Contact Center, Account Management, Technology ... You will report into the SVP, Network & Provider Management Work Location: This is a remote ...
New
Senior Director, Escalated Provider Issue Resolution
Dallas, TX · Remote
$196K - $258K/yr
... Utilization Management, Payment Integrity, Contact Center, Account Management, Technology ... You will report into the SVP, Network & Provider Management Work Location: This is a remote ...
New
Physician ED Claims Reviewer
Prosper, TX · Remote
$225K - $267K/yr
Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment. This is a remote position.
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Physician ED Claims Reviewer
Prosper, TX · Remote
$225K - $267K/yr
Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment. This is a remote position.
Epic Tapestry UM Analyst
Prosper, TX · Remote
$50/hr
^Remote Work **Must be authorized to work in USA. We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on ...
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Epic Tapestry UM Analyst
Prosper, TX · Remote
$50/hr
^Remote Work **Must be authorized to work in USA. We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on ...
Oral Surgery
Dallas, TX · On-site +1
$299K - $395K/yr
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
Oral Surgery
Dallas, TX · On-site +1
$299K - $395K/yr
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management). * Familiarity with agentic AI, rule engines, or decision orchestration frameworks. * Cloud experience (AWS preferred). This is a remote position.
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... utilization management). * Familiarity with agentic AI, rule engines, or decision orchestration frameworks. * Cloud experience (AWS preferred). This is a remote position.
Academic/Faculty/Research Physician
Dallas, TX · On-site +1
This need will be FULLY remote while the provider is working locums, but they will need to ... Provides clinical oversight for utilization management, disease management and quality management ...
Academic/Faculty/Research Physician
Dallas, TX · On-site +1
This need will be FULLY remote while the provider is working locums, but they will need to ... Provides clinical oversight for utilization management, disease management and quality management ...
Medical Case Manager
Dallas, TX · Remote
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote in Texas!
Medical Case Manager
Dallas, TX · Remote
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote in Texas!
Medical Case Manager
Dallas, TX · Remote
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote in Texas!
Medical Case Manager
Dallas, TX · Remote
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote in Texas!
Medical Case Manager
Dallas, TX · On-site +1
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote with a ...
Medical Case Manager
Dallas, TX · On-site +1
To provide comprehensive quality telephonic case management to proactively drive a medically ... utilization review, pharmacy oversight and care coordination. This position is remote with a ...
Solution Architect with AI and Healthcare
Plano, TX · Remote
$60.25 - $79.50/hr
... utilization management, claims operations, risk adjustment, Stars, quality, provider network optimization, and administrative automation. Location: Remote role to be located in the US If you are a ...
Solution Architect with AI and Healthcare
Plano, TX · Remote
$60.25 - $79.50/hr
... utilization management, claims operations, risk adjustment, Stars, quality, provider network optimization, and administrative automation. Location: Remote role to be located in the US If you are a ...
Solution Architect with AI and Healthcare
Plano, TX · Remote
$60.25 - $79.50/hr
... utilization management, claims operations, risk adjustment, Stars, quality, provider network optimization, and administrative automation. Location: Remote role to be located in the US If you are a ...
Solution Architect with AI and Healthcare
Plano, TX · Remote
$60.25 - $79.50/hr
... utilization management, claims operations, risk adjustment, Stars, quality, provider network optimization, and administrative automation. Location: Remote role to be located in the US If you are a ...
Remote Utilization Management information
See Dallas, TX salary details
$21.16 - $25.44
2% of jobs
$25.44 - $29.72
9% of jobs
$32.65 is the 25th percentile. Wages below this are outliers.
$29.72 - $34
21% of jobs
The median wage is $37.47 / hr.
$34 - $38.29
23% of jobs
$38.29 - $42.57
13% of jobs
$45.89 is the 75th percentile. Wages above this are outliers.
$42.57 - $46.85
10% of jobs
$46.85 - $51.13
8% of jobs
$51.13 - $55.41
5% of jobs
$55.41 - $59.69
5% of jobs
$59.69 - $63.97
2% of jobs
$63.97 - $68.25
2% of jobs
$21
$41
$68
How much do remote utilization management jobs pay per hour?
How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?
What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?
What is remote utilization management?
What is the difference between Remote Utilization Management vs Remote Case Management?
| Aspect | Remote Utilization Management | Remote Case Management |
|---|---|---|
| Credentials | RN, LPN, or licensed healthcare professionals | RN, LPN, or social workers |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Healthcare providers, insurance, community agencies |
| Industry Usage | Insurance, healthcare, telehealth | Healthcare, social services, insurance |
| Primary Focus | Reviewing medical necessity, authorizations | Coordinating 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.
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- Utilization Review No Experience

Full-time
Posted 5 days ago
Job description
The Utilization Management (UM) Coordinator provides MSO referral management services. The UM Coordinator serves as a liaison between members, physicians, providers, and MSO staff, processing initial intake of information, assisting with authorization functions, and gathering information. Position is responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities, and ancillary providers. The incumbent is responsible for tasks/functions related to the MSO’s prior authorization and referral process including applying the MSO’s criteria and policies/procedures to authorization requests from medical professionals, clinical facilities, and ancillary providers. The UM Coordinator will directly interact with providers, acting as a resource for their needs.
SPECIFIC SKILLS NEEDED- Excellent verbal and written communication skills
- Develop and maintain effective working relationships with all levels of staff, community agencies, providers, and members.
- Maintain an understanding of current CPT, ICD10 and HCPCS codes and continual updates to knowledge base regarding the codes.
- Utilize prior authorization protocols to determine when to refer matters to a licensed staff person.
- Familiar with EzCap
- Minimum typing speed of 40 wpm.
- Able to prioritize and delegate effectively.
- Attention to details.
- Excellent organizational skills.
- Must be familiar with Health Plan benefit verification
- Must have knowledge of medical terminology
- Proficient in Windows, Microsoft Word, and Excel. EDUCATION/EXPERIENCE/TRAININGRequired:
- High School Graduate or equivalent certification.
- Minimum of two (2) years’ experience in a managed care or health plan environment Preferred:
- Passed the Bilingual Fluency Assessment for Clinicians (BFAC Certified) by Language Line Solutions