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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 popular job titles related to Remote Utilization Review Social Worker jobs in Puerto Rico?

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

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

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

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

Cities in Puerto Rico 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 Puerto Rico as of August 2026, with employment types broken down into 5% Internship, 57% Full Time, 18% Part Time, and 20% Contract. Highlights an 100% Remote job distribution.

Licensed Clinical Social Worker

Vivo HealthStaff

San Juan, PR • Remote

Full-time

Medical, Dental, Vision, PTO

Re-posted 10 days ago

Job description

Vivo HealthStaff is recruiting a licensed telemedicine LCSW for a group practice in California. Our client is willing to help obtain licensure in California. Must be licensed in Puerto Rico.

Job Summary:
We are seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our team and provide telemedicine services to patients in California. This remote position allows you to work from Puerto Rico while making a meaningful impact on the lives of individuals and families through virtual therapy sessions.

Key Responsibilities:
- Provide individual, group, and family therapy sessions via telemedicine to patients located in California.
- Conduct initial assessments, develop treatment plans, and provide ongoing therapy to clients.
- Utilize evidence-based practices and therapeutic interventions to address a wide range of mental health issues, including anxiety, depression, trauma, and substance abuse.
- Maintain accurate and timely clinical documentation in compliance with state and federal regulations.
- Collaborate with other healthcare providers, case managers, and support staff to ensure comprehensive patient care.
- Participate in regular supervision, team meetings, and continuing education opportunities to stay current with best practices and professional development.

Qualifications:
- Master's degree in Social Work from an accredited institution.
- Current LCSW license in Puerto Rico and eligibility to obtain California licensure
- Minimum of 1 year of clinical experience, preferably in a telehealth setting.
- Strong communication, interpersonal, and organizational skills.
- Ability to work independently and manage a flexible schedule.
- Proficiency in using telemedicine platforms and electronic health record (EHR) systems.

Benefits:
- Competitive compensation package.
- Health, dental, and vision insurance for employees working 30 hours per week or more.
- Paid time off and holidays.
- Continuing education and professional development opportunities.
- Flexible work schedule to promote work-life balance.
- Supportive and collaborative team environment.

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About Vivo HealthStaff

Sourced by ZipRecruiter

Vivo HealthStaff provides permanent recruitment services for both clinical and administrative positions in the healthcare sector. Over the past 2 years, our clients have seen a 98% retention rate with Vivo HealthStaff placements.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Dublin, CA, US

Year founded

2016

Social media

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