Springfield, IL · Remote
$100K/yr
This is a remote/traveling position. Candidates must reside in Northern Illinois and live a ... Minimum of two years of experience in health information, quality, utilization or risk management
Springfield, IL · Remote
$100K/yr
This is a remote/traveling position. Candidates must reside in Northern Illinois and live a ... Minimum of two years of experience in health information, quality, utilization or risk management
Medicaid Business / QA Analyst * 7-12+ Month Contract | Remote | No ThirdParty Firms | Medicaid SME ... Review inbound data from core systems (eligibility, provider, claims, managed care) for accuracy ...
Quick apply
Medicaid Business / QA Analyst * 7-12+ Month Contract | Remote | No ThirdParty Firms | Medicaid SME ... Review inbound data from core systems (eligibility, provider, claims, managed care) for accuracy ...
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
Quick apply
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
$21.20 - $25.49
2% of jobs
$25.49 - $29.78
9% of jobs
$32.71 is the 25th percentile. Wages below this are outliers.
$29.78 - $34.07
21% of jobs
The median wage is $37.54 / hr.
$34.07 - $38.36
23% of jobs
$38.36 - $42.65
13% of jobs
$45.98 is the 75th percentile. Wages above this are outliers.
$42.65 - $46.93
10% of jobs
$46.93 - $51.22
8% of jobs
$51.22 - $55.51
5% of jobs
$55.51 - $59.80
5% of jobs
$59.80 - $64.09
2% of jobs
$64.09 - $68.38
2% of jobs
$21
$41
$68
| Aspect | Remote Utilization Review Nurse | Remote Case Manager |
|---|---|---|
| Certifications | RN license, possibly CCM or UR certifications | RN license, CCM or case management certifications |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Insurance companies, healthcare organizations, telehealth |
| Job Focus | Review medical necessity, approve or deny services | Coordinate patient care, arrange services, discharge planning |
Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.
As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.
$100K/yr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 8 days ago
6.4
Based on 139 frontline employees who took The Breakroom Quiz
644th of 890 rated healthcare providers
Salary up to $100k (depending on experience)
Centurion is proud to be the provider of comprehensive services to the Illinois Department of Corrections. We are currently seeking a Full-time CQI Specialist to join our Regional Office team. This is a remote/traveling position. Candidates must reside in Northern Illinois and live a commutable distance to our sites for visits as needed (approximately 2-4 days/week). Occasional travel to Springfield, IL for regional meetings is also required.
Based out of the regional office, the Statewide CQI Specialist develops and implements the Continuous Quality Improvement (CQI) program in accordance with the mission and strategic goals of the company, federal and state laws and regulations, accreditation standards and specific contractual requirements.
We offer excellent compensation and comprehensive benefits for our full-time team members including:
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