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Remote Utilization Review Manager Jobs in Sheboygan, WI

Sargento

Tax Manager

Plymouth, WI · On-site +1

$111K - $146K/yr

You'll lead the preparation and review of federal and state filings, while managing quarterly and ... Remote ½ day Fridays * Onsite Health & Wellness Center * Employer 401K contribution in the top 1% ...

Sargento Foods

Tax Manager

Plymouth, WI · On-site +1

$111K - $146K/yr

You'll lead the preparation and review of federal and state filings, while managing quarterly and ... Remote ½ day Fridays * Onsite Health & Wellness Center * Employer 401K contribution in the top 1% ...

Sargento

Tax Manager

Plymouth, WI · On-site +1

$111K - $146K/yr

You'll lead the preparation and review of federal and state filings, while managing quarterly and ... Remote ½ day Fridays * Onsite Health & Wellness Center * Employer 401K contribution in the top 1% ...

Sargento

Associate Brand Manager

Plymouth, WI · On-site +1

$87K - $113K/yr

Remote ½ day Fridays * Onsite Health & Wellness Center * Employer 401K contribution in the top 1% ... For further information, please review the Know Your Rights notice from the Department of Labor.

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

Remote Utilization Review Manager information

See Sheboygan, WI salary details

$38.9K

$90.7K

$166.9K

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

As of Sep 6, 2026, the average yearly pay for remote utilization review manager in Sheboygan, WI is $90,700.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,300.00 and $109,100.00 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 Sheboygan, WI?

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

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

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

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

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

Remote Utilization Review Manager jobs near you

Electronic Record Specialist - Remote

Sheboygan County, WI

Plymouth, WI • On-site, Remote

$26.02 - $27.84/hr

Full-time

Re-posted 14 days ago

Job description

Salary: $26.02 - $27.84 Hourly
Location : N7135 Rocky Knoll Pkwy, Plymouth, WI
Job Type: Full Time
Remote Employment: Remote Only
Job Number: RK-2026-095
Department: Rocky Knoll Health Care Center
Opening Date: 07/20/2026
Purpose and Summary
We love our residents! It's the number one reason anyone says for why they love working at Rocky Knoll. With a campus nestled on 62 acres and 149 beds in the facility, Rocky Knoll is a beautiful place to work. Currently, we are seeking a Electronic Medical Record (EMR) Specialist. The EMR Specialist is responsible for the accurate management of electronic health records in a skilled nursing facility setting. This role ensures compliant diagnosis coding, supports Medicare processes, and maintains data integrity across clinical systems. The position is fully remote and requires prior experience in skilled nursing health information management and proficiency with PointClickCare (PCC).
Essential Duties
  • Perform accurate ICD-10-CM diagnosis coding in accordance with regulatory and payer requirements.
  • Conduct MDS diagnosis reviews to ensure consistency and alignment with coding and clinical documentation.
  • Monitor and track physician visit schedules to ensure compliance with regulatory timelines.
  • Manage and review Medicare certifications and recertifications for accuracy and timeliness.
  • Participate in and contribute to weekly Medicare meetings, providing coding and documentation insight.
  • Maintain EMR integrity, including adding and managing user access in PCC.
  • Collaborate with interdisciplinary teams to resolve documentation discrepancies.
  • Ensure compliance with federal, state, and facility policies related to health information management.
  • Support audits and quality assurance initiatives as needed.
  • Performs other varied duties/responsibilities per facility needs.

Qualifications
  • Certified coder required (e.g., CCS, CPC, or equivalent). RHIT preferred.
  • Minimum of 2 years of experience in a skilled nursing facility health information or medical records role.
  • Demonstrated experience with PointClickCare (PCC).
  • Strong knowledge of ICD-10-CM coding guidelines and Medicare regulations.
  • Experience with MDS processes and documentation standards.
  • High level of accuracy, attention to detail, and organizational skills.
  • Ability to work independently in a fully remote environment.
  • Strong communication and collaboration skills.

Work Environment & Physical Requirements
Fully remote position.
Standard business hours with flexibility.
Sheboygan County offers a wide range of employee benefits. to view benefit overview.

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