WHAT YOU'LL DO Complete, review, and audit MDS assessments for accuracy and compliance with CMS and ... managing Quality Measures Excellent communication, organization, and critical thinking skills ...
WHAT YOU'LL DO Complete, review, and audit MDS assessments for accuracy and compliance with CMS and ... managing Quality Measures Excellent communication, organization, and critical thinking skills ...
Client Manager, Employee Benefits - Position Summary The Client Manager is responsible for managing ... analysis, claims utilization review, underwriting analysis, and cost projections. · Market ...
Client Manager, Employee Benefits - Position Summary The Client Manager is responsible for managing ... analysis, claims utilization review, underwriting analysis, and cost projections. · Market ...
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
RN Care Manager PRN
Cleveland, OH · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
RN Care Manager PRN
Cleveland, OH · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Management will be conducting interviews with those candidates who are the most qualified, with ...
Remote Tax Manager
Columbus, OH · 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 ...
Quick apply
Remote Tax Manager
Columbus, OH · 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 ...
Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Our program offers a customized model of remote care services that blends Chronic Care Management ...
Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Our program offers a customized model of remote care services that blends Chronic Care Management ...
Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Our program offers a customized model of remote care services that blends Chronic Care Management ...
Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Our program offers a customized model of remote care services that blends Chronic Care Management ...
Tax Manager / Senior Manager (Remote - Ohio)
OH · Remote
$150K - $220K/yr
Review and prepare complex individual, partnership, S Corporation, C Corporation, fiduciary and ... Fully remote opportunity for Ohio-based professionals * Competitive compensation plus annual bonus
Quick apply
Tax Manager / Senior Manager (Remote - Ohio)
OH · Remote
$150K - $220K/yr
Review and prepare complex individual, partnership, S Corporation, C Corporation, fiduciary and ... Fully remote opportunity for Ohio-based professionals * Competitive compensation plus annual bonus
Optometrist - Remote
Columbus, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Columbus, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Cleveland, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Cleveland, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
New Carlisle, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
New Carlisle, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Toledo, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Toledo, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Toledo, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Toledo, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
New Carlisle, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
New Carlisle, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Columbus, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
Optometrist - Remote
Columbus, OH · On-site +1
In addition, the Optometrist will also diagnose and treat visual problems and manage diseases ... Staying abreast of changing healthcare landscape and opportunities for utilization of technologies ...
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?
| Aspect | Remote Utilization Review Manager | Remote Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certifications like URAC or AAPC, and management experience | Licensed Registered Nurse (RN) with utilization review certification often preferred |
| Work Environment | Oversees review teams, manages processes, and ensures compliance remotely | Performs case reviews, assesses medical necessity, and documents findings remotely |
| Employer & Industry Usage | Health 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 Ohio? The most popular types of Remote Utilization Review jobs in Ohio are:
What are popular job titles related to Remote Utilization Review Manager jobs in Ohio? For Remote Utilization Review Manager jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Manager jobs in Ohio look for? The top searched job categories for Remote Utilization Review Manager jobs in Ohio are:
What cities in Ohio are hiring for Remote Utilization Review Manager jobs? Cities in Ohio with the most Remote Utilization Review Manager job openings:
Other
Posted 12 days ago
Job description
Description
REMOTE MDS NURSE (RN) - WISCONSIN
Full-Time | Work From Home
Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, PDPM, Medicare, Medicaid, and Quality Measure experience to join our growing team.
This is a full-time remote opportunity for an RN who enjoys working independently while partnering with skilled nursing facilities to improve reimbursement, maintain regulatory compliance, and support quality resident care.
WHAT YOU'LL DO
Complete, review, and audit MDS assessments for accuracy and compliance with CMS and state regulations
Ensure timely completion of MDS assessments and supporting documentation
Analyze Case Mix and PDPM opportunities to maximize reimbursement
Review and improve Quality Measures through accurate assessments and clinical documentation
Partner with interdisciplinary teams to strengthen documentation and reimbursement outcomes
Provide education and support related to MDS processes, reimbursement, and regulatory requirements
Maintain accurate records while meeting deadlines in a remote work environment
Assist with compliance initiatives and reimbursement optimization
WHAT WE'RE LOOKING FOR
Active Wisconsin Registered Nurse (RN) license or active Nurse Licensure Compact (NLC) license
Recent MDS experience in a Skilled Nursing Facility (SNF)
Strong knowledge of PDPM, Medicare, Medicaid, and Case Mix reimbursement
Experience managing Quality Measures
Excellent communication, organization, and critical thinking skills
Ability to work independently in a remote setting
Experience with electronic medical records and MDS software
PREFERRED
RAC-CT Certification
Multi-facility MDS experience
WHY JOIN ENGAGE CONSULTING?
100% Remote Position
Full-Time Opportunity
Competitive Compensation
Flexible Work Environment
Supportive and Collaborative Team
Opportunity to work with skilled nursing facilities throughout Wisconsin
Make a meaningful impact on reimbursement, compliance, and resident outcomes
If you're an experienced MDS RN looking for a rewarding remote opportunity where your expertise makes a difference every day, we'd love to hear from you.
Apply today and join the Engage Consulting team!