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Remote Utilization Review Manager Jobs in Calgary, AB

Maintain a clean and up to date pipeline forecast to be reviewed weekly with your manager ... REMOTE WORKSPACE REQUIREMENTS: * You have a safe, comfortable, and ergonomic workspace and working ...

Event Success Manager - Canada Remote

Calgary, AB ยท Remote

CA$65K - CA$80K/yr

** EventMobi is a remote-first company and this is a fully remote position. You may reside anywhere in ... Conduct regular customer touchpoints including strategy sessions and quarterly reviews to align on ...

Criminal Lawyer - Remote

Calgary, AB ยท Remote

$140 - $400/hr

Review and analyze legal documents, court filings, and case materials to support AI system ... Collaborate remotely with project managers and technical teams to clarify requirements and ...

Estimate Reviewer

Calgary, AB ยท On-site +1

CA$54K - CA$67K/yr

Canada (Remote, Hybrid, or In-Office) Salary: $54,000 - $67,000 annually Join a Team That Values ... Manage multiple assignments and priorities within XactAnalysis Estimate Review queues. * Maintain a ...

Family Law Attorney - Remote

Calgary, AB ยท Remote

$150 - $400/hr

Document Review * Legal Summarization * Critical Thinking * Attention to Detail * Written & Verbal Communication * Collaboration * Remote Work Skills * Digital Project Management Tools * Technology ...

Backend Engineer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

Frontend Developer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

Backend Developer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

AI Trainer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

AI Technical Trainer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

AI Software Engineer - Remote

Calgary, AB ยท Remote

$80 - $120/hr

Remote Job Summary We are seeking experienced Senior Software Engineers to support an AI training ... Hiring Manager review. Compensation Compensation is output-based , with payment provided per task ...

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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 Calgary, AB?

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

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

The top searched job categories for Remote Utilization Review Manager jobs in Calgary, AB are:

Account Manager - Canada Remote

EventMobi

Calgary, AB โ€ข Remote

CA$105K/yr

Other

Medical, Dental, Life

Re-posted 29 days ago


Job description

** EventMobi is a remote-first company and this is a fully remote position. You may reside anywhere in Canada provided you are able to accommodate EST working hours. 


WHY YOU SHOULD JOIN US?


Are you ready to take your Sales career to the next level? Do bigger deals, negotiate more strategic contracts? As an integral part of an all-star Sales team in North America, the AM is the primary owner of our existing client business. 


Working closely with the Event Success team (“Customer Success”), you will be responsible for proactively engaging with each of your assigned customers every month - regularly providing product demos, educating them on new services, gathering feedback & ensuring their overall event success in order to drive account growth and retention YoY.


Your mission? Land & expand. Find ways to grow our footprint by being the trusted advisor to hundreds of our top customers.


WHAT YOUR WORK WILL FOCUS ON:


  • Manage a pipeline of existing customer business to drive customer retention & growth and achieve Net Revenue Retention & Account Retention Targets
  • Build long-term relationships with 150+ accounts by conducting regular account-level debriefs, product demos & check-in calls
  • Prospect for growth opportunities within your existing client base through referral and other networking initiatives
  • Follow the AM Daily Dashboard workflow provided in the CRM to ensure prioritized regularly scheduled touchpoints with your accounts
  • Maintain a clean and up to date pipeline forecast to be reviewed weekly with your manager
  • Effectively communicate and collaborate with the Customer Success & Support teams to ensure client satisfaction
  • Actively participate and contribute to team meetings, Slack discussions & 1:1s
  • Leverage a mix of communication methods (phone, meeting, in mails, emails) to proactively engage and grow your accounts


YOUR QUALIFICATIONS:


  • 3-4 years experience in B2B Sales
  • Prior outbound or prospecting experience is a plus!
  • A track record of achieving and/or exceeding targets through upsell and growth
  • Unbeatable listening skills. It’s one thing to talk, it’s another to listen. You will need to hone in on what the customer is truly asking for, and be able to reflect back.
  • Extensively worked within CRM such as HubSpot or Salesforce
  • Obtained a Bachelor's degree or equivalent


YOU ARE: 


  • An outstanding communicator. You will be connecting with customers and EM team members constantly. You will need to be well-spoken and meticulous in all communications.
  • Adaptable to change - you see ambiguity as an opportunity to grow, ask questions or innovate
  • Organized & proactive - you follow through on time and with a high degree of professionalism
  • Solution-oriented - you see challenges as opportunities to delight your customer & to rise above


WHAT WILL YOU GET FROM EVENTMOBI? 


  • Compensation: OTE up to $105K CAD + Stock Options + Benefits  
  • Time-Off: 3-weeks vacation + 1 week Sick Days + 3-summer days + your birthday is a  holiday (seriously! log-off and hang out with the fam or go do something fun) + opportunities to meet your co-workers in person throughout the year
  • Benefits: Dental, Health, Life, Mental Health Consultations (GreenShields+)
  • Tools: Top of the line hardware and the best collaboration software for remote work so you can be as productive as possible while working from home
  • The Best Coworkers Ever: If you ask anyone that has worked at EventMobi, they will tell you that their fellow Mobiers are the best part of their experience! Don't underestimate the positive impact of caring co-workers have on your everyday happiness. 


REMOTE WORKSPACE REQUIREMENTS: 


  • You have a safe, comfortable, and ergonomic workspace and working environment - a private and quiet workspace is a vital requirement for doing your best work!
  • You have a reliable internet connection capable of participating in video calls, with at least 30Mbps download speed


ABOUT EVENTMOBI  


We're focused on building the most comprehensive event management platform to help conference organizers create engaging event experiences. We believe live events bring people together and enable positive change. Over 30,000+ events in 70+ countries from major brands such as Shoppers Drug Mart, amazing non-profits such as American Psychiatric Nurses Association and Canadian Real Estate Association have trusted EventMobi’s suite of software technology to manage their events and engage their attendees.  


If you are interested in seeing EventMobi in action, check out some of the videos below: 


  • The Experience Manager Platform
  • The EventMobi Mobile Event App
  • The Product Tour
  • Top brands and organizations from around the world have used EventMobi’s event app technology to create incredible event experiences - hear directly from our customers. 



EventMobi is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment. Accommodations are available upon request for candidates taking part in all aspects of the selection process.