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Remote Utilization Review Manager Jobs in Puerto Rico

Veterans Health Administration

$89K - $116K/yr

... management, and direction of the Recreation Therapy Department with services offered to ... Observes the utilization of recreation therapy treatment modalities to ensure the most beneficial ...

Veterans Health Administration

$89K - $116K/yr

... management, and direction of the Recreation Therapy Department with services offered to ... Observes the utilization of recreation therapy treatment modalities to ensure the most beneficial ...

AbbVie

Senior Business Systems Analyst

PR · Remote

Conducts tests; develops preliminary findings for review by experienced analysts. * Assists in the ... Manages projects according to milestones and completes tasks assigned by more experienced analysts ...

RelateCare

$11/hr

We are a multidisciplinary team of nurses, contact management specialists and technologists who ... Remote

RelateCare

$11/hr

We are a multidisciplinary team of nurses, contact management specialists and technologists who ... Remote

Infotech Sourcing

Linguist III

PR · Remote

US - NY - Remote Duration:8 months Job Title: Linguist lII (FAIR) Main duties: Perform linguistic ... Conduct linguistic literature reviews on various NLP-adjacent topics, and summarize findings.

US Department of Commerce

Meteorologist

Carolina, PR · On-site +1

$40K/yr

For consideration during the current review cycle, applications must be received by 11:59 p.m ... Office of Personnel Management (OPM) Qualification Standards Handbook. BASIC REQUIREMENTS:

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

... member of DaVita's field management team. Location: This is a field-based/remote position ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

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Remote Utilization Review Manager information

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 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 are popular job titles related to Remote Utilization Review Manager jobs in Puerto Rico?

For Remote Utilization Review Manager jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Manager jobs in Puerto Rico look for?

The top searched job categories for Remote Utilization Review Manager jobs in Puerto Rico are:

Remote Utilization Review Manager jobs near you

Lead Substation Physical Engineer - Remote (Puerto Rico)

ICF

Mayaguez, PR • On-site, Remote

$102K - $134K/yr

Full-time

Posted 28 days ago

Job description

Title: Lead Substation PhysicalEngineer

This position is fully remote and can be performed from your home office in Puerto Rico.

Ready to make a difference?
ICF is seeking an experienced Substation Physical Engineer to lead the design and execution of high-voltage substation projects (typically 69kV to 500kV) with the goal of providing excellent quality work for our clients.

We are a relentlessly client-focused group who are re-imagining, re-designing, and re-engineering the way electric utilities tackle industry problems. We are seeking passionate and innovative people who are constantly looking for ways to provide better quality engineering services for our clients.

The Ideal Candidate

You are a highly motivated engineer who takes pride in the services you provide. You ensure the project is done right and all deadlines are met. You should be proactive, self-sufficient, and able to productively work out of your home without direct supervision.

This role requires a deep understanding of physical layout, bus design, equipment selection, grounding, and constructability. The ideal candidate will have extensive experience with utility clients, be self-motivated, and capable of mentoring junior staff.

**This position offers a clear growth path to becoming a Supervising Engineer, with increasing responsibility for project oversight, client engagement, and team leadership. **

What you will be doing:

  • Responsibilities include, but are not limited, leading and overseeing the design and preparation of substation physical design drawings and including:

    • Substation One Line and Three Line

    • Station General Arrangements & Sections

    • Electrical Details

    • Grounding Plan & Details

    • Conduit Plan & Details

    • Control Cubicle Layout, Sections, Cable Tray, Lighting, and Grounding

    • Low-Voltage AC Panels

    • Grounding Plan & Details

    • Lightning Protection

    • Illumination Plan & Details

  • Leading the design and preparation of engineering studies such as:

    • AC Load

    • Illumination

    • Grounding

    • Lightning Shielding

  • Develop Bill of Materials based on design criteria

  • Coordinate with protection & controls, civil/structural, and drafting disciplines to ensure quality deliverables

  • Support client meetings, technical discussions, and project planning efforts

  • Participate in site visits and constructability reviews

  • Interpret and incorporate vendor information into design deliverables

  • Apply client standards related to the work

  • Perform/ensure company's Quality Assurance/Quality Control (QA/QC) processes are being followed on all design packages

  • Ensure compliance with industry codes (e.g., IEEE, NESC, NEC) and utility standards

  • Continuous improvement of job-related engineering, technical and professional knowledge, skills, and performance

  • Mentor and guide junior engineers and designers

  • Demonstrate leadership potential to support transition into a Supervising Engineer

What we need you to have (minimum qualifications):

  • Bachelor's degree in Electrical Engineering (focus in power systems preferred)

  • 8+ years of experience in substation physical design for electric utilities

What we would like you to have (professional skills):

  • 12+ years of experience in substation physical design for electric utilities

  • Professional Engineer (PE) license or ability to obtain within 6 months

  • Proficiency in AutoCAD, MicroStation, or similar design tool

  • Familiarity with substation design standards and practices (IEEE, NESC, utility specs)

  • Excellent communication and interpersonal skills

  • Ability to manage multiple projects and mentor junior staff

  • Strong initiative and leadership qualities to support career advancement

  • Experience leading substation projects modelled in 3D using Autodesk Inventor

  • Familiarity with substation grounding studies and CDEGS

  • Familiarity with Agi32 illumination software

  • Advanced user of Microsoft products, specifically Word and Excel

To learn more about this team and how our grid engineering solutions help electric utilities balance cutting-edge technology with cost-efficiency and reliability> ICF Power Delivery Services

#GEA25

#POWERDELIVERY

#INDEED

#LI-CC1


Bot and Third-Party Applications

Please note that this application must be submitted directly by the applicant for consideration.Failure to do so may result in the application being excluded for consideration.Applicants needing an accommodation for disability or religious purposes in connection with the application process should contactCandidateaccommodation@icf.comfor assistance.

Working at ICF

ICF is a global advisory and technology services provider, but we're not your typical consultants. We combine unmatched expertise with cutting-edge technology to help clients solve their most complex challenges, navigate change, and shape the future.

We can only solve the world's toughest challenges by building a workplace that allows everyone to thrive. We are an equal opportunity employer.Together, our employees are empowered to share theirexpertiseand collaborate with others to achieve personal and professional goals. For more information, please read ourEEOpolicy.

We will consider for employment qualified applicants with arrest and conviction records.

Reasonable Accommodations are available, including, but not limited to, for disabled veterans, individuals with disabilities, and individuals withsincerely heldreligious beliefs, in all phases of the application and employment process. To requestan accommodation,please emailCandidateaccommodation@icf.comand we will be happy toassist. All information you provide will be kept confidential and will be used only to the extentrequiredto provide needed reasonable accommodations.

Read more aboutworkplacediscriminationrightsor our benefit offerings which are included in theTransparency in (Benefits) CoverageAct.

Candidate AI Usage Policy

At ICF, we are committed to ensuring a fair interview process for all candidates based on their own skills and knowledge. As part of this commitment, the use of artificial intelligence (AI) tools to generate orassistwith responses during interviews (whether in-person or virtual) is notpermitted. This policy is in place tomaintainthe integrity and authenticity of the interview process.

However, we understand that some candidates may require accommodationthat involves the use of AI. Ifsuch anaccommodation is needed, candidates are instructed to contact us in advance atcandidateaccommodation@icf.com. Weare dedicated to providingthe necessary support to ensure that all candidates have an equal opportunity to succeed.


Pay Range - There are multiple factors that are considered in determining final pay for a position, including, but not limited to, relevant work experience, skills, certifications and competencies that align to the specified role, geographic location, education and certifications as well as contract provisions regarding labor categories that are specific to the position.

The pay range for this position based on full-time employment is:

$107,959.00 - $183,531.00Puerto Rico Remote Office (PR99)

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