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Remote Utilization Review Manager Jobs in Bolingbrook, IL

Corvel

Bilingual Medical Case Manager II

Downers Grove, IL · On-site +1

$65K - $98K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

A cost containment background, such as utilization review or managed care is helpful. * Strong ... Remote Equal Opportunity Employer This employer is required to notify all applicants of their ...

Danaher

Pricing Manager - Remote

Chicago, IL · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pricing and Contracts Manager is responsible for leading commercial deal support across pricing ... Lead pricing review and oversee approval processes for customer quotes, bids and contracts.

Danaher

Pricing Manager - Remote

Chicago, IL · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pricing and Contracts Manager is responsible for leading commercial deal support across pricing ... Lead pricing review and oversee approval processes for customer quotes, bids and contracts.

Rise25

Product Manager (Remote)

Chicago, IL · Remote

As a remote Product Manager, you will play a pivotal role in driving our product vision, defining ... Lead and facilitate agile ceremonies, such as sprint planning, reviews, and retrospectives. This ...

Epiq

Sr. Consultant - Invoice Review

Chicago, IL · Remote

As the market leader in spend management solutions, Epiq Global is a trusted partner to 75% of ... JA1 #LI-REMOTE "In compliance with federal law, all persons hired will be required to verify ...

Epiq

Sr. Consultant - Invoice Review

Chicago, IL · On-site +1

As the market leader in spend management solutions, Epiq Global is a trusted partner to 75% of ... JA1 #LI-REMOTE "In compliance with federal law, all persons hired will be required to verify ...

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

Remote Utilization Review Manager information

See Bolingbrook, IL salary details

$38.6K

$90K

$165.6K

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

As of Aug 16, 2026, the average yearly pay for remote utilization review manager in Bolingbrook, IL is $89,996.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,800.00 and $108,300.00 per year, depending on experience, location, and employer.

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 popular job titles related to Remote Utilization Review Manager jobs in Bolingbrook, IL?

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

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

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

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

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

Remote Utilization Review Manager jobs near you

Quality Review Specialist (RN or LPN/LVN)

VIVA USA INC

Downers Grove, IL • On-site, Remote

Contractor

Posted 20 days ago

Job description

Work closely with Utilization Management (UM), Case Management (CM) and Customer Service (CS) to ensure appeal process meets established guidelines.
Adhere to accreditation and regulatory requirements to improve customer service and achieve organizational goals related to complaint and appeal resolution.
Manage individual inventory through appropriate workflow.
Facilitate final resolution of member and provider appeals.
Participate in department initiatives related to NCQA and URAC audits, DOI audits, revision project, audits, and correspondence revision projects.
Serve on workgroups.
Adhere to compliance with external regulatory and accreditation standards.
Facilitate access to appeal files by members or member designee under federal guidelines.
Provide data for required reporting. 10.Work directly with members and providers to resolve appeals.
Support other team members in appeal resolution and in fulfilling other department responsibilities.
Assist in maintaining working relationships across organizational lines.
Ensure our member/providers requirements are met at all times.
Communicate and interact effectively and professionally with co-workers, management, customers, etc.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business.
Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
JOB REQUIREMENTS:
Applicants must hold an active RN or LPN/LVN license in good standing.
Bachelor's Degree OR 4 years in health care experience.
5 years utilization management, appeals, claims and mainframe system experience.
Experience in health operations.
Experience with internal/external customer relations.
Knowledge of managed care processes.
Knowledge and familiarity of national accreditation standards, specifically NCQA and URAC standards.
Knowledge of state and federal health care and health operations regulations.
Organizational skills and ability to meet deadlines and manage multiple priorities.
Verbal and written communication skills to include interfacing with staff across organizational lines plus interfacing with members and providers.
PC proficiency to include Microsoft Word, Access, and Excel.
PREFERRED JOB REQUIREMENTS:
Appeals or Utilization management experience.
Notes:
Fully remote
This is a M-F shift 40 hours per week, with MANDATORY holiday and weekend rotations.
Holidays rotation scheduled 3-4 holidays per year and one weekend every 3rd weekend.
This is a contract role with the possibility of conversion to full-time based on business needs and performance
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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