Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Appeals Pharmacist (Remote)
Mobile, AL · On-site +1
$48.75 - $59.50/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 ...
Appeals Pharmacist (Remote)
Mobile, AL · On-site +1
$48.75 - $59.50/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 ...
FINANCIAL MANAGEMENT ANALYST
Pascagoula, MS · On-site +1
$61K - $97K/yr
... remote or isolated sites. You must be able to travel on military and commercial aircraft for ... utilization, and ensure regulatory compliance within an organization. FOR GS-09 GRADE LEVEL: Your ...
FINANCIAL MANAGEMENT ANALYST
Pascagoula, MS · On-site +1
$61K - $97K/yr
... remote or isolated sites. You must be able to travel on military and commercial aircraft for ... utilization, and ensure regulatory compliance within an organization. FOR GS-09 GRADE LEVEL: Your ...
Legal Counsel - USA & Canada
Calvert, AL · On-site +1
If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... This role is responsible for managing all day-to-day legal matters for Business Area Americas ...
Legal Counsel - USA & Canada
Calvert, AL · On-site +1
If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... This role is responsible for managing all day-to-day legal matters for Business Area Americas ...
This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ... Managing pricing appeals, coordinating with Maxor Specialty, and compiling data for automated ...
This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ... Managing pricing appeals, coordinating with Maxor Specialty, and compiling data for automated ...
Conduct structured reviews of clinical records to assess service utilization, client engagement ... Referral and Linkage Management * Create, follow up, and close referrals in the Care Manager System.
Conduct structured reviews of clinical records to assess service utilization, client engagement ... Referral and Linkage Management * Create, follow up, and close referrals in the Care Manager System.
Remote Utilization Management information
See Mobile, AL salary details
$21.23 - $25.52
2% of jobs
$25.52 - $29.82
9% of jobs
$32.76 is the 25th percentile. Wages below this are outliers.
$29.82 - $34.11
21% of jobs
The median wage is $37.59 / hr.
$34.11 - $38.41
23% of jobs
$38.41 - $42.70
13% of jobs
$46.04 is the 75th percentile. Wages above this are outliers.
$42.70 - $46.99
10% of jobs
$46.99 - $51.29
8% of jobs
$51.29 - $55.58
5% of jobs
$55.58 - $59.87
5% of jobs
$59.87 - $64.17
2% of jobs
$64.17 - $68.46
2% of jobs
$21
$41
$68
How much do remote utilization management jobs pay per hour?
As of Jul 3, 2026, the average hourly pay for remote utilization management in Mobile, AL is $41.96, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.17 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?
| 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.
What are popular job titles related to Remote Utilization Management jobs in Mobile, AL? For Remote Utilization Management jobs in Mobile, AL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Mobile, AL look for? The top searched job categories for Remote Utilization Management jobs in Mobile, AL are:
- Remote Utilization Review
- Remote Lpn Utilization Review
- Freelance International Utilization Review Nurse
- Volunteer Navihealth Utilization Review
- Chart Utilization Review
- Remote Occupational Therapy Utilization Review
- Remote Aetna Utilization Review Nurse
- Contract Utilization Review
- Flex Schedule Remote Utilization Review
- Fulltime Cigna Utilization Review Nurse
What cities near Mobile, AL are hiring for Remote Utilization Management jobs? Cities near Mobile, AL with the most Remote Utilization Management job openings:
Other
Posted 10 days ago
Job description
Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities
- Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
- Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
- Communicate approval/denial decisions clearly to providers and patients.
- Collaborate with physicians, nurses, and medical directors on complex cases.
- Document outcomes in compliance with health plan policies and CMS/state regulations.
- Support process improvements to streamline workflow and turnaround times.
What You'll Bring
- Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
- Licensure: Active and unrestricted pharmacist license in the U.S.
- Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
- Skills: Excellent clinical review, documentation, and communication skills.
Why This Role?
- Flexibility: 100% remote work from home with flexible scheduling options.
- Impact: Directly influence patient access to safe and cost-effective medications.
- Growth: Build specialized skills in utilization management and managed care.
- Rewards: Competitive compensation, benefits, and career advancement opportunities.
About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.