2

Remote Utilization Review Manager Jobs in Ohio (NOW HIRING)

Clinical Data Coder

Cincinnati, OH ยท On-site +1

$18 - $22.75/hr

Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet needs of the study; and * Produce coding reports for team review and utilization *Stable schedule with ...

Remote Is this position eligible for bonus or commission - Bonus eligible based on company ... Ensure quality and adherence to methodology via engagement reviews and documentation. Team ...

Manages delinquencies, collateral exceptions, borrowing base, portfolio reviews, specialized ... Effective utilization of IT systems that support the Commercial Segment. Systems include; CLOS ...

New

Manages delinquencies, collateral exceptions, borrowing base, portfolio reviews, specialized ... Effective utilization of IT systems that support the Commercial Segment. Systems include; CLOS ...

New

Virtual Therapist

Toledo, OH ยท On-site +1

$401K/yr

Collaborate with psychiatry, medical providers, case management, peer recovery support, admissions, utilization review, and leadership staff to ensure continuity and coordination of care.

Showing results 41-60

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 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:

Credit Review Team Leader - Consumer

Huntington

Cleveland, OH โ€ข On-site, Remote

$93K - $189K/yr

Full-time

Medical, Life, Retirement, PTO

Re-posted 29 days ago


Job description

Description

Summary:

The Credit Review Team Leader will report directly to the Credit Review Group Manager. The ideal candidate is a proven credit risk manager with an exceptional delivery track record within a demanding environment. They possess a detailed working knowledge of the methodologies and techniques for performing credit risk review engagements and continuous monitoring activities associated with a strong independent credit review and/or segment risk function.

Duties & Responsibilities:

  • Serve as the departmental subject matter expert in Consumer/Scored Commercial Credit Risk, including originations, portfolio-level monitoring, risk management, credit data analysis and general knowledge of lending support area practices impact on credit risk within the financial services industry. 
  • Develop and maintain working relationships with bank management, regulators, as well as with the broader Credit Review team to execute review responsibilities effectively and efficiently. 
  • Contribute to the development and execution of Credit Reviewโ€™s annual and strategic plans, including the monitoring of annual plan progress, identification of required changes, adherence to engagement budget/staffing and post-exam follow-up on status of identified recommendations
  • Participate in the monitoring of credit-related risk throughout the Bank and the Holding Company including subsidiaries.  
  • Provide technical guidance for integrated CR engagements.  
  • As part of the respective credit risk focus area, develop and manage a credit review program which assesses the management framework in selecting, underwriting, and administering the direct and indirect credit risk inherent in products/services and related activities administered by business segments, assess adherence to policies and procedures and compliance with legal and regulatory requirements, and evaluate results to determine if issues exist and improvement recommendation are necessary. 
  • Coordinate with the management team on the development of credit review objectives and related procedures to address relevant credit risks. 
  • Contribute to the continuous improvement of Credit Review tools and methods.   
  • Identify and communicate emerging risk issues to enhance credit risk management practices across the enterprise.  
  • Through contribution to Credit Review leadership presentations, provide senior management and the Board of Directors with information regarding the identification, measurement, and management of credit risk for designated credit risk focus areas in the Consumer Lending segments.  
  • Represent Credit Review in risk meetings with business segments and affiliates, executive leadership, and the Board when necessary.  
  • Strong verbal and written communication skills, the ability to engage in difficult conversations, as well as ability to manage multiple engagements/projects simultaneously are essential to providing a strong, independent role when evaluating areas of the Bank and Holdco

Basic Qualifications:

  • Bachelorโ€™s degree in Accounting, Finance, Economics, Business or related field.
  • 7+ or more years of progressively responsible experience in credit review, risk and/or credit risk management, portfolio monitoring, underwriting and/or analysis, including a management role.

Preferred Qualifications:

  • Strong working knowledge of risk and/or credit risk management and control frameworks.
  • Project management skills, ability to deliver high quality results while meet deadlines, department and personal goals
  • Prior Credit Review and/or risk officer experience in Consumer or Scored Commercial Lending areas.  
  • Technical accounting (GAAP) or financial statement analysis knowledge
  • Understanding of application of credit and behavioral models within a scored originations environment
  • Working knowledge of MS Access, Excel, Word and credit/statistical analysis tools
  • Conflict management experience

#LI-RP1


Exempt Status: (Yes = not eligible for overtime pay) (No = eligible for overtime pay)

Yes

Workplace Type:

Office

Our Approach to Office Workplace Type

Certain positions outside our branch network may be eligible for a flexible work arrangement. Weโ€™re combining the best of both worlds:  in-office and work from home. Our approach enables our teams to deepen connections, maintain a strong community, and do their best work. Remote roles will also have the opportunity to come together in our offices for moments that matter. Specific work arrangements will be provided by the hiring team.

Compensation Range:

$93,000 - $189,000 USD Annual

The compensation range represents the anticipated low and high end of the base compensation range for this position. Actual compensation will vary based on various factors including but not limited to location, experience, and education. โ€ฏColleagues in this position are also eligible to participate in an applicable incentive compensation plan. โ€ฏIn addition, Huntington provides a variety of benefits to colleagues, including health insurance coverage, wellness program, life and disability insurance, retirement savings plan, paid leave programs, paid holidays and paid time off (PTO). 

Huntington is an Equal Opportunity Employer.

Tobacco-Free Hiring Practice: Visit Huntington's Career Web Site for more details.

Note to Agency Recruiters:  Huntington will not pay a fee for any placement resulting from the receipt of an unsolicited resume.  All unsolicited resumes sent to any Huntington colleagues, directly or indirectly, will be considered Huntington property. Recruiting agencies must have a valid, written and fully executed Master Service Agreement and Statement of Work for consideration.