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Remote Utilization Management Jobs in Portage, IN

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

Provides consultation to attendings, nurses, and case management staff regarding complex clinical issues and advises on justification required for continued stay, medical necessity and utilization ...

Tailored Management

US_Strategic Consultant I

Chicago, IL · Remote

$63 - $70/hr

Marketing Operations Resource Manager Location: Remote ( EST Preferred) Duration: 6-month contract ... Analyze resource utilization, inventory levels, and related data to support prioritization and ...

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Remote Utilization Management information

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$38

$63

How much do remote utilization management jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for remote utilization management in Portage, IN is $38.79, according to ZipRecruiter salary data. Most workers in this role earn between $30.67 and $44.57 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive in remote utilization management?

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.

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 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 job categories do people searching Remote Utilization Management jobs in Portage, IN look for?

The top searched job categories for Remote Utilization Management jobs in Portage, IN are:

What cities near Portage, IN are hiring for Remote Utilization Management jobs?

Cities near Portage, IN with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Portage, IN as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $80,682 per year, or $38.8 per hour.

Medical Director Utilization Management Oncology

Chicago, IL • Remote

Starling Oncology
See more jobs at Starling Oncologyexternal

$275K - $325K/yr

Full-time

Re-posted 8 days ago

Job description

Starling Oncology (NASDAQ: STLN) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. Formerly known as The Oncology Institute, Starling Oncology offers cutting-edge, evidence-based cancer care to a population of approximately 2.1 million patients, including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With more than 400 employed and network clinicians and over 100 clinics and network locations of care across five states and growing, Starling Oncology is changing oncology for the better. For more information, visit www.starlingoncology.com.

Utilization Management Medical Director Oncology

Work Location: REMOTE (work from home)

California         Nevada               Arizona               Oregon                Florida

The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology care with a focus on direct utilization management for case review and clinical decision making.  

In this collaborative role, you will work with physicians, clinical teams and operational leaders to support evidence-based high quality and cost-effective care delivery across the network. You will also contribute to cross-functional initiatives, data-driven insights, and oversight of utilization management policies to optimize patient outcomes. 

  Key Responsibilities: 

  • Conduct medical reviews and make independent clinical decisions of hematology and oncology treatment plans to determine medical necessity, appropriateness, and alignment with value-based clinical guidelines and evidence-based practices. 
  • Review and assess the appropriateness of ongoing cancer treatment plans, ensuring that they align with evidence-based medicine and clinical best practices. 
  • Provide clinical guidance and recommendations that balance quality, outcomes, and cost-effectiveness.  
  • Liaise with providers, insurance companies, and patients to clarify and discuss treatment options and coverage. 
  • Evaluate clinical and utilization data to identify trends, variations in care, and opportunities for improvement 
  • Partner with clinical and operational teams to support value-based care. 
  • Ensure compliance with organizational policies, regulatory standards, and payer requirements in all clinical decisions. 
  • Participate in the development and continuous improvement of utilization management protocols and criteria specific to oncology. 

Qualifications: 

  • Medical degree (MD or DO) 
  • Board Certification in Oncology. 
  • Minimum of 5 years of clinical experience in oncology. 
  • 2+ years of Utilization Management experience 
  • Proven expertise in Utilization Management or experience with reviewing clinical appropriateness of treatment plans. 
  • Strong understanding of oncology-specific treatment protocols, guidelines, and reimbursement policies. 
  • Excellent analytical skills and the ability to evaluate complex clinical data. 
  • Ability to work independently and make evidence-based decisions in a collaborative, multidisciplinary setting. 
  • Excellent communication skills to engage effectively with healthcare providers, payers, and patients. 

If you're interested in learning more, but not ready to apply, please reach out to our team to set-up a call at your convenience. Physiciancareers@theoncologyinstitute.com

Ready to apply? Please complete the simple application and our team will reach out to you quickly.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. 

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$275,000—$325,000 USD

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