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Remote Utilization Review Manager Jobs in Portage, WI

The Hometown Pharmacy

Remote Managing Pharmacist

De Forest, WI · On-site +1

$58.50 - $70.50/hr

Review medication safety, dispensing processes, controlled-substance procedures, medication storage ... The Remote Managing Pharmacist will conduct monthly on-site inspections of assigned pharmacy ...

MD Group LLC

Hybrid-Remote Managing Pharmacist

De Forest, WI · Remote

$58.50 - $70.50/hr

Review medication safety, dispensing processes, controlled-substance procedures, medication storage ... The Remote Managing Pharmacist will conduct monthly on-site inspections of assigned pharmacy ...

New

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

System One

ServiceNow IRM Developer (remote)

Arlington, WI · Remote

$55.25 - $76/hr

Ensure compliance by participating in code reviews, maintaining version control, ensuring security ... Build and maintain custom capabilities utilizing the Audit Management component of IRM. * Use ...

Presence

Wisconsin (remote) - School psychologist

Ripon, WI · On-site +1

$46 - $49/hr

Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ... An extensive virtual library of peer-reviewed studies and online assessments, including online ...

FLAMBEAU, Inc.

Business Development Manager

Baraboo, WI · On-site +1

... Review and approve the repricing of existing parts and programs as needed, while maintaining ... Experience & Skill Requirements : • This is a Remote or Hybrid position. • 3+ years Sales ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Portage, WI

Remote Utilization Review Manager information

See Portage, WI salary details

$41.4K

$96.7K

$178K

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

As of Sep 7, 2026, the average yearly pay for remote utilization review manager in Portage, WI is $96,697.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,200.00 and $116,300.00 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 Portage, WI?

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

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

The top searched job categories for Remote Utilization Review Manager jobs in Portage, WI are:

What cities near Portage, WI are hiring for Remote Utilization Review Manager jobs?

Cities near Portage, WI with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Remote Managing Pharmacist

The Hometown Pharmacy

De Forest, WI • On-site, Remote

$58.50 - $70.50/hr

Full-time

Posted 4 days ago

Job description

Hometown Pharmacy is seeking a Remote Managing Pharmacist to provide leadership, regulatory oversight, and operational support to multiple retail pharmacy locations. This unique position combines the flexibility of primarily remote work with the opportunity to stay connected to pharmacy teams through scheduled on-site visits.
You'll serve as a trusted resource for pharmacists, technicians, and store teams, helping our pharmacies operate safely, efficiently, and in compliance while identifying opportunities to improve workflows, strengthen teams, and enhance patient care.
This is an excellent opportunity for an experienced retail pharmacist who enjoys leadership, problem-solving, coaching, compliance, and process improvement and is ready to make an impact across multiple pharmacy locations.
What You'll Do
Lead & Support Multiple Pharmacy Locations
  • Provide centralized pharmacist leadership and oversight for assigned retail pharmacies.
  • Build strong working relationships with pharmacists, technicians, and store teams.
  • Serve as a resource for questions related to pharmacy operations, workflow, regulatory compliance, and patient safety.
  • Conduct regular check-ins with assigned pharmacy teams and provide timely support and guidance.
  • Coach and educate pharmacy staff while promoting accountability and continuous improvement.
  • Identify opportunities to improve pharmacy workflows, efficiency, consistency, and patient care.
  • Help implement standardized pharmacy procedures and best practices across locations.
  • Partner with pharmacy and organizational leadership to address operational concerns and develop practical solutions.

Oversee Pharmacy Compliance & Patient Safety
  • Ensure assigned pharmacies comply with applicable Wisconsin and federal pharmacy laws, Board of Pharmacy requirements, controlled-substance regulations, and company policies.
  • Monitor required pharmacy records, documentation, licenses, registrations, inventories, and regulatory requirements.
  • Review medication safety, dispensing processes, controlled-substance procedures, medication storage, security, and documentation practices.
  • Identify potential compliance or patient-safety concerns and coordinate appropriate follow-up.
  • Develop and monitor corrective action plans when opportunities for improvement are identified.
  • Help pharmacy teams prepare for regulatory inspections, audits, and compliance reviews.
  • Maintain accurate documentation of inspections, findings, follow-up activities, and corrective actions.

Monthly On-Site Pharmacy Visits
Although this position is primarily remote, staying connected to our pharmacy teams is important.
The Remote Managing Pharmacist will conduct monthly on-site inspections of assigned pharmacy locations according to an established schedule. Dedicated inspection time will be provided to complete these visits.
During pharmacy visits, you will:
  • Complete standardized pharmacy inspections.
  • Review pharmacy security, medication storage, and temperature monitoring.
  • Review controlled-substance processes and required documentation.
  • Evaluate inventory practices and required inventory records.
  • Check expired, recalled, and quarantined medications.
  • Review prescription processing and dispensing practices.
  • Confirm required licenses, postings, and regulatory documentation.
  • Review technician credentials and applicable training requirements.
  • Evaluate patient privacy, confidentiality, and medication-safety practices.
  • Meet with pharmacy teams to answer questions, provide education, and discuss opportunities for improvement.
  • Recognize successful practices that could benefit other Hometown Pharmacy locations.
  • Establish appropriate follow-up plans when deficiencies are identified.

What Your Remote Workday May Look Like
When you're not visiting one of your assigned pharmacies, you'll work remotely to:
  • Connect with pharmacy teams and leadership.
  • Review operational and compliance information.
  • Respond to pharmacy questions and provide pharmacist-level guidance.
  • Track outstanding compliance items and corrective actions.
  • Coordinate follow-up from pharmacy inspections.
  • Participate in pharmacy, operational, and leadership meetings.
  • Assist with pharmacist and technician training and development.
  • Support consistent implementation of pharmacy policies and procedures.
  • Collaborate with Human Resources and operational leadership regarding staffing, training, and performance matters when appropriate.
  • Provide additional pharmacist support based on organizational and patient-care needs.

What We're Looking For
Required
  • Bachelor of Science in Pharmacy or PharmD degree.
  • Current and unrestricted pharmacist license in the State of Wisconsin.
  • Ability to travel to assigned Wisconsin pharmacy locations for required on-site visits.
  • Strong knowledge of retail pharmacy operations and applicable pharmacy regulations.
  • Strong communication, organization, and problem-solving skills.
  • Ability to independently manage multiple priorities, locations, and deadlines.
  • Ability to provide effective leadership and accountability in a primarily remote environment.

Preferred
  • 3+ years of pharmacy leadership, supervisory, process-management, or quality-improvement experience.
  • Wisconsin vaccination certification.
  • Experience with PioneerRx.
  • Experience supporting multiple pharmacy locations.
  • Experience with pharmacy compliance, inspections, audits, or regulatory oversight.
  • Proficiency with Google Workspace and/or Microsoft Office.

You'll Be Successful in This Role If You Are:
  • A strong and approachable leader.
  • Highly organized and detail-oriented.
  • Comfortable working independently.
  • Proactive rather than reactive.
  • A confident problem-solver.
  • Able to balance accountability with a supportive leadership style.
  • Comfortable managing multiple priorities and pharmacy locations.
  • Passionate about community pharmacy and patient care.
  • Interested in improving processes and finding better ways to work.
  • An effective communicator who enjoys developing and supporting others.

Why Hometown Pharmacy?
At Hometown Pharmacy, we believe community pharmacy should be about more than filling prescriptions. Our teams have the opportunity to build meaningful relationships with patients, provide personalized care, and make a difference in the communities we serve.
This role offers a unique opportunity to expand your impact beyond a single pharmacy. You'll help support multiple teams, strengthen pharmacy operations, promote patient safety, and contribute to the continued success of independent community pharmacy.
We provide:
  • Primarily remote work environment
  • Company-provided computer and required software
  • Company-provided telephone/communication resources
  • Dedicated time for required pharmacy inspections
  • Collaborative and knowledgeable pharmacy team
  • Opportunity to influence pharmacy operations across multiple locations
  • Leadership opportunity outside of a traditional full-time dispensing role

Additional Responsibilities
The Remote Managing Pharmacist is expected to maintain a strong leadership presence while working primarily remotely. This includes communicating expectations clearly, providing timely follow-up, addressing concerns consistently, and holding assigned locations accountable for operational and compliance standards.
The position is largely self-directed, with major issues, policy changes, and significant recommendations reviewed with appropriate organizational leadership.
Additional duties may be assigned based on organizational and patient-care needs.
Professional Expectations
The Remote Managing Pharmacist is expected to:
  • Maintain the highest standards of professional and business ethics.
  • Practice in accordance with all applicable pharmacy laws and regulations.
  • Follow Hometown Pharmacy's Standards of Conduct and organizational policies.
  • Protect the confidentiality of patient, employee, and company information.
  • Successfully complete required training and continuing education.
  • Demonstrate professionalism, accountability, collaboration, and a commitment to exceptional patient care.

Physical Requirements
This position combines remote administrative responsibilities with work inside retail pharmacy locations. During on-site visits, the employee must be able to perform the physical requirements associated with the pharmacy environment, including standing for periods of time and lifting/carrying up to 20 pounds.
Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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