We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
Utilization Management Nurse Consultant
Homer, AK · Remote
$26.01 - $68.55/hr
This is a full time remote Utilization Management opportunity. As a Utilization Management Nurse ... This includes reviewing written clinical records. * Gathers clinical information and applies the ...
Utilization Management Nurse Consultant
Homer, AK · Remote
$26.01 - $68.55/hr
This is a full time remote Utilization Management opportunity. As a Utilization Management Nurse ... This includes reviewing written clinical records. * Gathers clinical information and applies the ...
... Record Reviews. This is a fully remote opportunity offering flexible scheduling, allowing you to ... Enhanced industry expertise in medical necessity, utilization review, and claims support * Expanded ...
... Record Reviews. This is a fully remote opportunity offering flexible scheduling, allowing you to ... Enhanced industry expertise in medical necessity, utilization review, and claims support * Expanded ...
Claims Representative - Workers Compensation | Jurisdiction: AK | Licensing: AK - Remote
Anchorage, AK · On-site +1
AK - Remote Are you looking for an impactful job requiring no prior experience that offers an ... utilization review. * Maintains professional client relationships. QUALIFICATIONS Education ...
Claims Representative - Workers Compensation | Jurisdiction: AK | Licensing: AK - Remote
Anchorage, AK · On-site +1
AK - Remote Are you looking for an impactful job requiring no prior experience that offers an ... utilization review. * Maintains professional client relationships. QUALIFICATIONS Education ...
Claims Representative - Workers Compensation | Jurisdiction: AK | Licensing: AK - Remote
Anchorage, AK · On-site +1
AK - Remote Are you looking for an impactful job requiring no prior experience that offers an ... utilization review. * Maintains professional client relationships. QUALIFICATIONS Education ...
Claims Representative - Workers Compensation | Jurisdiction: AK | Licensing: AK - Remote
Anchorage, AK · On-site +1
AK - Remote Are you looking for an impactful job requiring no prior experience that offers an ... utilization review. * Maintains professional client relationships. QUALIFICATIONS Education ...
Case Manager, Registered Nurse (Oncology experience required)
Homer, AK · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Case Manager, Registered Nurse (Oncology experience required)
Homer, AK · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Clinical Admissions Therapist (Alaska)
Juneau, AK · Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
Quick apply
Clinical Admissions Therapist (Alaska)
Juneau, AK · Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
Project Engineer
Palmer, AK · On-site +1
Palmer Office / Remote Projects Reports To: VP of Operations Status:Temporary to Regular, Full-Time ... Read and review project blueprints and structural specifications to determine dimensions of ...
Project Engineer
Palmer, AK · On-site +1
Palmer Office / Remote Projects Reports To: VP of Operations Status:Temporary to Regular, Full-Time ... Read and review project blueprints and structural specifications to determine dimensions of ...
Finance Manager - Security Services
Anchorage, AK · Remote
$91K - $119K/yr
Finance Manager - Security Services Location - Remote The Essential Duties and Responsibilities are ... Monitor staffing levels, labor utilization, and scheduling effectiveness in a labor-intensive ...
Quick apply
Finance Manager - Security Services
Anchorage, AK · Remote
$91K - $119K/yr
Finance Manager - Security Services Location - Remote The Essential Duties and Responsibilities are ... Monitor staffing levels, labor utilization, and scheduling effectiveness in a labor-intensive ...
Civil Engineer - ACES
Anchorage, AK · On-site +1
... in remote and often challenging environments. The Senior Civil Engineer serves as a technical ... utilization. * Lead interdisciplinary document reviews, coordination meetings, and technical ...
Civil Engineer - ACES
Anchorage, AK · On-site +1
... in remote and often challenging environments. The Senior Civil Engineer serves as a technical ... utilization. * Lead interdisciplinary document reviews, coordination meetings, and technical ...
IDIQ/Schedule Manager
Anchorage, AK · Remote
About this position: IDIQ/Schedule Manager Location - Remote The Essential Duties and ... review RFPs/RFQs, assess fit, and support bid/no-bid decisions · Maintain and enhance IDIQ ...
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IDIQ/Schedule Manager
Anchorage, AK · Remote
About this position: IDIQ/Schedule Manager Location - Remote The Essential Duties and ... review RFPs/RFQs, assess fit, and support bid/no-bid decisions · Maintain and enhance IDIQ ...
The Care Management Associate (CMA) role is a remote telework position, with a field expectation ... Responsible for initial review and triage of members. * Manages population health member enrollment ...
The Care Management Associate (CMA) role is a remote telework position, with a field expectation ... Responsible for initial review and triage of members. * Manages population health member enrollment ...
Case Manager Registered Nurse
Homer, AK · Remote
$60K - $129K/yr
Remote RN Case Manager (Nationwide | Monday-Friday, No Weekends) Join a mission-driven team helping members achieve better health outcomes-100% remote. We're seeking an experienced Registered Nurse ...
Case Manager Registered Nurse
Homer, AK · Remote
$60K - $129K/yr
Remote RN Case Manager (Nationwide | Monday-Friday, No Weekends) Join a mission-driven team helping members achieve better health outcomes-100% remote. We're seeking an experienced Registered Nurse ...
Registered Nurse
Anchorage, AK · On-site +1
$38K - $228K/yr
Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP ...
Registered Nurse
Anchorage, AK · On-site +1
$38K - $228K/yr
Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP ...
Remote Utilization Review information
What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?
To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.
What does a typical day look like for someone in a Remote Utilization Review role?
A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.
What is a Remote Utilization Review job?
A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

Contractor
Posted 26 days ago
Job description
Flexible Independent Contractor (1099)
Require a DC or Maryland State Medical License
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 RADIOLOGY to conduct independent Utilization Reviews. This is a flexible 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 DC or Maryland
- Current Board Certification in Radiology
- Must have 5 years of clinical experience residency to 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.