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Remote Utilization Review Manager Jobs in Waukee, IA

HealthCheck360

Bilingual RN Case Manager

Des Moines, IA · Remote

$21 - $26.50/hr

Remote. We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our ... Provide telephonic case management and utilization review for assigned consumers. * Develop ...

HealthCheck360

Bilingual RN Case Manager

Des Moines, IA · Remote

$21 - $26.50/hr

Remote. We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our ... Provide telephonic case management and utilization review for assigned consumers. * Develop ...

Fortive

Account Manager (Iowa)

Des Moines, IA · On-site +1

Drive market share through existing customer utilization assessments and contending for new ... Routinely update sales actions plans and forecasts for Territory Quarterly Reviews and Business ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Waukee, IA

Remote Utilization Review Manager information

See Waukee, IA salary details

$37.4K

$87.3K

$160.6K

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

As of Aug 23, 2026, the average yearly pay for remote utilization review manager in Waukee, IA is $87,280.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,100.00 and $105,000.00 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 Waukee, IA?

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

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

The top searched job categories for Remote Utilization Review Manager jobs in Waukee, IA are:

What cities near Waukee, IA are hiring for Remote Utilization Review Manager jobs?

Cities near Waukee, IA with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Bilingual RN Case Manager

HealthCheck360

Des Moines, IA • Remote

$21 - $26.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

Job description

Bilingual RN Case Manager

Location: Remote. 

We are seeking a compassionate and detail-oriented Bilingual RN Case Manager to join our team. This role is responsible for delivering comprehensive case management services across the continuum of care. The RN Case Manager will assess, plan, implement, coordinate, monitor, and evaluate care for assigned consumers, ensuring quality outcomes and cost-effective treatment. 

Key Responsibilities:

  • Provide telephonic case management and utilization review for assigned consumers.
  • Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
  • Collaborate with healthcare providers, payors, and internal teams to coordinate care.
  • Serve as a liaison between consumers and benefit administrators, ensuring clear communication and support.
  • Track and report case outcomes, including cost savings and quality improvements.

Qualifications:

  • Bilingual: the ability to speak Spanish
  • Education: RN licensure in the State of Iowa required. BSN or higher preferred.
  • Experience: Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred.
  • Skills: Strong communication, problem-solving, and computer skills. Ability to work independently.

Full-Time Benefits - Most benefits start day 1

  • Medical, Dental, Vision Insurance
  • Flex Spending or HSA
  • 401(k) with company match
  • Profit-Sharing/Defined Contribution (1-year waiting period)
  • PTO/Paid Holidays
  • Company-paid ST and LT Disability
  • Maternity Leave/Parental Leave
  • Subsidized Parking
  • Company-paid Term Life/Accidental Death Insurance

About HealthCheck360

HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.

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