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Remote Utilization Review Manager Jobs in Colorado

Standish Management

Engagement Manager

Denver, CO · On-site +1

$95K - $120K/yr

Manage engagement keeping in mind client needs, staff utilization and overall engagement efficiency ... Review all communications to the client and its investors on an ongoing basis * Assist with ...

Solid Rock Recruiting LLC

Remote Tax Manager

Denver, CO · On-site +1

$135K - $195K/yr

Prepare and review: * Individual (1040), business (1120S, 1065), and basic corporate returns ... managing client relationships * Ability to work independently in a remote environment * Strong ...

Agile Space Industries, Inc.

Contracts Manager

Denver, CO · On-site +1

$99K - $150K/yr

... utilization to national defense, human exploration, and commercial space transport. We are seeking ... All stock grants are subject to executive review and approval in accordance with the Company ...

Huntington

Credit Review Team Leader - Consumer

Denver, CO · On-site +1

$93K - $189K/yr

The ideal candidate is a proven credit risk manager with an exceptional delivery track record ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

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Remote Utilization Review Manager information

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.
What are the most commonly searched types of Remote Utilization Review jobs in Colorado? The most popular types of Remote Utilization Review jobs in Colorado are:
What are popular job titles related to Remote Utilization Review Manager jobs in Colorado? For Remote Utilization Review Manager jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Manager jobs in Colorado look for? The top searched job categories for Remote Utilization Review Manager jobs in Colorado are:
Remote Utilization Review Manager jobs near you

Remote Utilization Manager - Inpatient

AllHealth Network

Watkins, CO • Remote

$75K - $83K/yr

Full-time

Posted 2 days ago

New

Job description

Join Our Team as a Utilization Review Manager (RN or Social Worker)

Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment.

Why AllHealth Network?

  • Work in a supportive, interdisciplinary environment that values your professional judgment
  • Enjoy opportunities for ongoing learning, growth, and advancement
  • Make a tangible impact on client outcomes and community well-being
  • Be part of a mission-driven organization dedicated to high-quality, client-centered care

What You'll Do:

  • Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations
  • Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units
  • Collaborate with nurses, social workers, case managers, and other healthcare professionals
  • Ensure quality care by coordinating with payers, treatment teams, and billing staff
  • Maintain accurate records and use your problem-solving skills to navigate challenging cases

What We’re Looking For:

  • Registered Nurse (BSN/RN) or Master’s in a human services field
  • Clinical license (LPC, LCSW) required 
  • Minimum 2 years’ experience in behavioral health utilization management, care coordination, or case management
  • Strong communication, organization, and advocacy skills
  • Experience with insurance processes, electronic records, and multidisciplinary teamwork

Ready to take your career to the next level with a team that cares as much as you do? Apply today and help us transform lives—one client at a time.

$75,000 - $83,000 annually 

AllHealth Network also provides a 10% compensation differential for individuals who are bilingual in English and Spanish (language proficiency testing required). 

The base salary range represents the low and high end of the AllHealth Network hiring range for this position. Actual salaries will vary and may be above or below the range based on various factors including but not limited to experience, education, training, merit, and the ability to embody the AllHealth Network mission and values.  The range listed is just one component of AllHealth Networks’ total compensation package for employees. Other rewards may include short-term and long-term incentives as well as a generous benefits package detailed below.

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