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Remote Utilization Review Manager Jobs in Portage, WI

This position may be eligible for remote work in select geographic locations, subject to approval ... Reviews transactions and related documents and verifies work processes to ensure completeness ...

Showing results 41-46

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:

Senior ServiceNow Business Process Consultant- ITSM

System One

Arlington, WI • Remote

$107K - $131K/yr

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 24 days ago


Job description

Job Title: Senior ServiceNow Business Process Consultant- ITSM Type: Contract Work Model: Remote – offsite

Responsibilities

  • Support workshops, interviews, and process mapping sessions to capture as-is and to-be workflows.
  • Support documentation of functional and non-functional requirements for ServiceNow implementations.
  • Translate business needs into clear, actionable user stories and acceptance criteria.
  • Partner with ServiceNow developers, architects, and platform owners to translate requirements into configuration, workflows, and automation.
  • Design, configure, and implement core ITSM capabilities including Incident, Problem, Change, Request, and Knowledge.
  • Analyze and document existing applications to be transitioned into custom ServiceNow applications.
  • Participate in sprint planning, backlog grooming, and UAT cycles within an Agile or hybrid delivery framework.
  • Define and execute test cases; coordinate user acceptance testing and issue resolution.
  • Support solution design and configuration activities by clarifying requirements, validating prototypes, reviewing workflows, and confirming that ServiceNow ITOM and ITSM solutions align with documented business needs.
  • Ensure delivered solutions meet defined requirements and quality standards.
  • Contribute to process documentation, training materials, and continuous improvement initiatives.
  • Support Agile, Waterfall, and Hybrid development methodologies across diverse client environments.
  • Provide project updates, status reports, and documentation for decision-making and governance.
  • Conduct training sessions and create user guides as needed.
Requirements
  • 5+ years of business analysis experience, with 1+ year focused on ServiceNow implementations.
  • Strong Experience with ITSM, CSM and one or more additional ServiceNow modules (e.g., HRSD, CSM, SPM, or custom applications).
  • Familiarity with ServiceNow data structures, tables, and workflows.
  • Experience producing BA deliverables such as business requirements documents, process flows, user stories, acceptance criteria, requirements traceability matrices, UAT test scripts, and stakeholder sign-off documentation.
  • Bachelor’s degree or better in Information Systems, Business Administration, Computer Science, or related field.
  • Project management and/or business process experience in a business context.
  • Demonstrated experience in requirements gathering, process design, and user story creation in an Agile environment.
  • Familiarity with Agile, Waterfall, and Hybrid development methodologies.
  • Strong analytical and problem-solving skills with attention to detail.
  • Excellent communication, facilitation, and stakeholder management skills.
  • ServiceNow Certified System Administrator

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M- #LI-

Ref: #856-Baltimore-S1


System One logo

About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US