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Remote Utilization Review Manager Jobs in Michigan

Lancesoft

Registered Nurse

Detroit, MI · On-site +1

$30 - $35/hr

Two to four years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population ...

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Remote Utilization Review Manager information

What are the key skills and qualifications needed to thrive as a Remote Utilization Review Manager, and why are they important?

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 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 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 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 are the most commonly searched types of Remote Utilization Review jobs in Michigan? The most popular types of Remote Utilization Review jobs in Michigan are:
What are popular job titles related to Remote Utilization Review Manager jobs in Michigan? For Remote Utilization Review Manager jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Manager jobs in Michigan look for? The top searched job categories for Remote Utilization Review Manager jobs in Michigan are:
Remote Utilization Review Manager jobs near you

French Document Review Attorney

CGS Federal (Contact Government Services)

Detroit, MI • Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

French Document Reviewer Location: Remote Start Date: Negotiable Experience & Qualifications Fluency in French Familiarity with document review workflows (Privilege/Responsiveness Review, Redactions, Conceptual Searching, First and Second Review, etc.) Experience with electronic document review technology (Relativity, Concordance, ViewPoint, etc.) Active bar admission in at least one U.S. jurisdiction and status in good standing Preferred Skills (Not Required) Experience as a member of a document review team Familiarity with Relativity 9.0 or higher version 2+ years of legal support experience Hours & Location Location and hours are established on a project‐by‐project basis, with opportunities for remote work and outside standard business hours. About Contact Contact Review prides itself on finding high‐quality, high‐accountability, barred attorneys specifically tailored to the needs of our project.

We seek attorneys to assist with document review, privilege review, expert testimony, legal research, and foreign language translation. Unlike other eDiscovery vendors, Contact fosters a culture where every project manager, programmer, engineer, reviewer, and analyst sees themselves as an extension of the projects' team. Here at Contact, we look for ways to improve efficiency, streamline workflows, and put our clients in the best possible position to weather the next storm.

For more information about Contact Review please visit: https://contactdiscoveryservices.com/managed-document-review/ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans.

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