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Remote Utilization Management Jobs in Toronto, ON

Cayenta

(Remote) Application Consultant

Guelph, ON · Remote

Work with colleagues and managers to proactively manage a superior technology solution for our ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Toronto, ON · Remote

Work with colleagues and managers to proactively manage a superior technology solution for our ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Oakville, ON · Remote

Work with colleagues and managers to proactively manage a superior technology solution for our ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Markham, ON · Remote

Work with colleagues and managers to proactively manage a superior technology solution for our ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Minute Media

Senior Manager, Ad Operations

Toronto, ON · Remote

CA$100K - CA$120K/yr

Monitor inventory utilization and identify opportunities to maximize yield and revenue performance ... Experience with Agile project management methodologies. * Background in sports, media, publishing ...

Lone Wolf Technologies

Implementation Specialist

Toronto, ON · Remote

CA$55K - CA$60K/yr

Implement a coordinated project plan to manage successful client implementations, conversions and ... Proven track record in providing in-house and remote training * Proven ability to meet and exceed ...

Lifeworks

Sr Disability Claims Manager

Toronto, ON · On-site +1

CA$70K - CA$90K/yr

... management. We offer: Remote / work-from-home arrangements and flexible hours A competitive ... interventions, utilization of specialized resources or consultations etc. * Determine an ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Toronto, ON

Remote Utilization Management information

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 popular job titles related to Remote Utilization Management jobs in Toronto, ON? For Remote Utilization Management jobs in Toronto, ON, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Toronto, ON look for? The top searched job categories for Remote Utilization Management jobs in Toronto, ON are:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Toronto, ON as of July 2026, with employment types broken down into 83% Full Time, 13% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.
Principal Consultant of Business Operations - 1099 Toronto, Canada

Principal Consultant of Business Operations - 1099 Toronto, Canada

Information Services Group

Toronto, ON • Remote

Full-time

Posted 5 days ago

Job description

Principal Consultant of Business Operations (1099/Contractor) 
Position Overview 
 
ISG is looking for a Business Operations delivery lead. The Principal Consultant’s responsibility includes leading large/complex engagements to help assess/design/execute strategy for primarily business process sourcing transactions support and operational improvement projects related to Business Operations sourcing agreements.  The Principal Consultant will be responsible for overall delivery and client satisfaction, project status management and reporting, recommendation and implementation approach development, implementation management, identifying and selling additional value-add work for clients, and supporting sales opportunities.
 
This is a contractor position with opportunities for full time hires in the future. 
 
Role & Responsibilities 
 
  • Participates in some business development and sales activities
  • Provides consultation services to clients and suppliers in areas of service delivery models (GBS/GCC, sourcing, and hybrid), project management, financial modeling, leadership, and contract negotiation
  • Knowledge of how AI and Agentic AI solutions are applied to business processes
  • Interacts directly with senior client and service provider executives
  • Independently develops project work plans and customizes to meet client specifications as well as estimates staffing, task duration, and client staffing requirements
  • Develops medium to large complex financial models and possesses a thorough knowledge of budgets, the budgeting process, and corporate finance for large or geographically global dispersed clients
  • Oversees or develops the financial, statement of work, service level and contract terms portions of the RFP, for outsourcing related clients
  • Assisting with the evaluation of service provider proposals and identifies potential strengths/weaknesses
  • Develops strategy or tactics to move service providers to the client-desired outcome
  • Supports both project work as well as within ISG. Supporting the development Intellectual Property and supporting sales initiatives/pursuits
  • Assisting with the planning and the development of all project deliverables and assumes overall responsibility for staffing, budget, work plans, scope, project milestones, issues management and risk management utilizing ISG’s project management methods, tools and templates
Required Skillsets 
 
  • This is a remote position based in the Toronto, Canada area.
  • Travel may be necessary and can be up to 50%
  • 5 to 15 years of recent experiences in several roles including shared services/global business services/offshore captives, outsourcing agreements, finance and accounting consulting and/or operations, revenue cycle management, as well as supply chain management and related business process technologies, sales support and service delivery management
  • Significant process knowledge across all F&A and or Procurement process areas is required. 
  • Knowledge of revenue cycle management, Supply Chain Management or any other industry BPO is a plus.   
  • Experience in call center management, print management, facilities management, service delivery models, operating models, and service provider management would be considered a plus
  • Experience working for an outsourcing service provider or advisory services firm is a plus
  • Prior experience with consulting engagements or with large consulting firm is a plus
  • Prior experience of “hands on” sourcing consulting experience developing complex operation solutions with executive teams and coaching and advising executive
  • Significant delivery management experience, including managing teams at all project phases, exemplary track record in successful client relationship management and multi-project oversight is a plus
  • Knowledge of sourcing contract terms and conditions
  • Thorough understanding of global corporate financial practices and goals - including drivers of process costs, ability to work with internal business owners and/or service providers to ensure effective cost solutions and agreed upon service level agreements
  • Experience in proposal writing and sales support
  • Strong understanding of capabilities for Tier 1 and Tier 2 outsourcing service providers
  • Team development and management experience, relationship management, mentoring and utilization management
  • Expert presentation, verbal and written communication skills with the ability to articulate complex ideas in easy-to-understand business terms to all levels of management
  • Demonstrates working knowledge with MS-Office suite of software applications and tools, including: Microsoft Word, Excel, PowerPoint, and Project, MS-Outlook, MS TEAMS
  • Expert project management skills are required and PMP certification is a plus
 Education
  • Bachelor of Arts or Science degree
  • MBA/MS or other advanced degree(s) desirable
 
At ISG, we don’t just accept difference — we celebrate it, we support it, and we thrive on it for the benefit of our employees, our clients, and our communities. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. ISG is proud to be an equal opportunity workplace, and we are committed to creating an inclusive environment for all employees. The more diverse and inclusive we are, the better our work will be.
 
The duties and responsibilities described in this job description may not be a comprehensive list. Additional tasks may be assigned to the employee from time to time and/or the scope of the job may change as necessitated by business demands.
 
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