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Remote Utilization Review Manager Jobs in Franklin, IN

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · On-site +1

$48 - $65/hr

Modify existing databases and database management systems. * Write and code logical and physical ... Review project requests describing database user needs to estimate time and cost required to ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Franklin, IN

Remote Utilization Review Manager information

See Franklin, IN salary details

$36.5K

$85.2K

$156.9K

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

As of Sep 4, 2026, the average yearly pay for remote utilization review manager in Franklin, IN is $85,235.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,700.00 and $102,600.00 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 Franklin, IN?

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

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

The top searched job categories for Remote Utilization Review Manager jobs in Franklin, IN are:

What cities near Franklin, IN are hiring for Remote Utilization Review Manager jobs?

Cities near Franklin, IN with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Cobol/IDMS Developer (Remote)

A.C.Coy Company

Indianapolis, IN • Remote

$48 - $65/hr

Contractor

This job post has expired today. Applications are no longer accepted.

Job description

COBOL/IDMS DeveloperTier One Technologies is looking for a COBOL/IDMS Developer to maintain and support a large payroll application as well as helping in the database environment. This will be a 100% remote Contract-to-Hire position. Must be a US Citizen. SELECTED CANDIDATES WITHOUT REQUIRED CLEARANCE WILL BE SUBJECT TO A FEDERAL GOVERNMENT BACKGROUND INVESTIGATION TO RECEIVE IT.ResponsibilitiesDesign, develop and modify software systems, using scientific analysis and mathematical models to predict and measure outcomes and consequences of design.

Coordinate software system installations and monitor equipment functioning to ensure specifications are met.

Modify existing databases and database management systems. Write and code logical and physical database descriptions and specify identifiers of database to management system or direct others in coding descriptions.

Work as part of a project team to coordinate database development and determine project scope and limitations.

Conduct multidisciplinary research and collaborate with equipment designers and/or hardware engineers in the planning, design, development, and utilization of electronic data processing systems for product and commercial software.

Determine computer user needs; analyze system capabilities to resolve problems on program intent, output requirements, input data acquisition, programming techniques and controls; prepare operating instructions; design and develop compilers and assemblers, utility programs, and operating systems. Ensure software standards are met. Analyze user needs and software requirements to determine feasibility of design within time and cost constraints.

Confer with systems analysts, engineers, programmers and others to design systems and to obtain information on project limitations and capabilities, performance requirements and interfaces.

Review project requests describing database user needs to estimate time and cost required to accomplish project.

QualificationsBachelor's degree in Computer Science, Software Engineering, or a related field required.8+ years of IBM z/OS-based mainframe experience using COBOL, JCL, TSO, ISPF, Endevor, and REXX.Expertise working with the CA IDMS system, with the ability to perform the following: CA IDMS database installation & maintenanceCA IDMS buffer tuningCA IDMS index tuningCA IDMS system generationCA IDMS security administrationMust have active CompTIA Security+ certification.

Ability of designing, coding and testing software requirements.

Familiarity with computer development software as it relates to systems, such as SQL, Visual Basic, etc. Basic knowledge of the full software development lifecycle: from business/systems analysis, through requirements gathering and functional specification authoring, to development, testing and delivery.

Familiarity and knowledge of the Agile methodology is a plus.

Strong verbal and written communication skills, problem solving skills, customer service and interpersonal skills. Must be a US Citizen and be able to obtain a DoD Public Trust clearance.

Must not have traveled outside the US for a combined total of 6 months or more in the last 5 years.

Must have resided in the US for the last 5 years.

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