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Remote Utilization Review Manager Jobs in Algonquin, IL

Epiq

Senior Review Manager

Chicago, IL · On-site +1

$120K - $140K/yr

Lead and manage teams conducting compliance reviews of eDiscovery processes and documents ... TP1 #remote Your specific salary will be determined based on several factors: * Location-based ...

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

... and utilization management to recommend methods to optimize use of hospital services for all ... Responds to requests for assistance on clinical reviews for medical necessity or any other reason ...

YO AI Labs

Hospitalist Physician - Remote

Chicago, IL · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Algonquin, IL

Remote Utilization Review Manager information

See Algonquin, IL salary details

$38.2K

$89K

$163.9K

How much do remote utilization review manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for remote utilization review manager in Algonquin, IL is $89,037.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,200.00 and $107,100.00 per year, depending on experience, location, and employer.

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 Algonquin, IL?

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

What job categories do people searching Remote Utilization Review Manager jobs in Algonquin, IL look for?

The top searched job categories for Remote Utilization Review Manager jobs in Algonquin, IL are:

What cities near Algonquin, IL are hiring for Remote Utilization Review Manager jobs?

Cities near Algonquin, IL with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Utilization Review Nurse - Remote - Contract

HireOps Staffing, LLC

Chicago, IL • Remote

$41/hr

Full-time

Re-posted 2 days ago

Job description

Remote position, however, candidates must reside in the State of TX or State of IL

This position is a contract for about 9 months.

Pay:  $41/hour

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible For Performing Accurate And Timely Medical Review Of Claims Suspended For Medical Necessity, Contract Interpretation, Pricing; And To Initiate And/Or Respond To Correspondence From Providers Or Members Concerning Medical Determinations.
Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. :Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience.

Needs to be able to navigate MCG and Medical policies with the reviews.