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Remote Utilization Review Social Worker Jobs in California

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Knowledge of the workers' compensation claims process preferred * Knowledge of outpatient ...

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Remote Utilization Review Social Worker information

What does a remote utilization review social worker do?

A Remote Utilization Review Social Worker evaluates patient care plans and medical records to ensure that healthcare services are medically necessary, appropriate, and cost-effective. Working remotely, they collaborate with healthcare providers, insurance companies, and patients to review treatment plans and make recommendations on care approvals or alternatives. Their goal is to help manage healthcare costs while ensuring patients receive the care they need, often working within hospitals, insurance companies, or third-party review organizations.

What are the key skills and qualifications needed to thrive as a remote utilization review social worker?

To thrive as a Remote Utilization Review Social Worker, you need a background in social work (often a MSW and relevant licensure), knowledge of medical terminology, and experience in patient care coordination. Familiarity with utilization management software, electronic health records (EHRs), and certification such as ACM or CCM is typically required. Strong analytical thinking, communication skills, and the ability to work independently are vital soft skills for this position. These skills ensure effective patient advocacy, compliance with regulations, and optimal resource utilization in a remote healthcare environment.

How does a remote utilization review social worker typically collaborate with interdisciplinary teams while working off-site?

Remote Utilization Review Social Workers regularly communicate with physicians, nurses, case managers, and insurance representatives through virtual meetings, secure emails, and electronic health record systems. Despite working remotely, they play a key role in ensuring appropriate patient care by reviewing cases, discussing treatment plans, and advocating for necessary services. Collaboration often involves scheduled case conferences and prompt responses to queries, requiring strong organizational and digital communication skills. Building effective working relationships remotely is crucial for delivering coordinated, patient-centered care.

What are the most commonly searched types of Utilization Review Social Worker jobs in California?

The most popular types of Utilization Review Social Worker jobs in California are:

What are popular job titles related to Remote Utilization Review Social Worker jobs in California?

For Remote Utilization Review Social Worker jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Social Worker jobs in California look for?

The top searched job categories for Remote Utilization Review Social Worker jobs in California are:

What cities in California are hiring for Remote Utilization Review Social Worker jobs?

Cities in California with the most Remote Utilization Review Social Worker job openings:

Remote Utilization Review Social Worker jobs near you
Infographic showing various Remote Utilization Review Social Worker job openings in California as of August 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% Remote job distribution.

Oncology Utilization Review - Remote - 1099 (contract)

Los Angeles, CA • On-site, Remote

MRIoA
See more jobs at MRIoAexternal

Contractor

Re-posted 13 days ago

Job description

Description
Oncology Utilization Review State Medical Licenses required: Arizona, Florida, Minnesota, North Dakota, Oregon or Tennessee
Flexible Independent Contractor (1099) Opportunity
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Oncology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current State Medical License in one of the above listed states.
  • Current Board Certification in Medical Oncology
  • Must have 5 years of clinical experience, residency can be included
  • Daytime availability is required for peer-to-peer conversations

California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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