In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Supervisory Acquisition & Utilization Specialist
Detroit, MI · On-site +1
$98K - $128K/yr
Establishes, expedites, and reviews the micro-purchase orders and consolidation of all procurement ... Supervisory Acquisition & Utilization Specialist / PD99867-A Relocation/Recruitment Incentives: Not ...
Supervisory Acquisition & Utilization Specialist
Detroit, MI · On-site +1
$98K - $128K/yr
Establishes, expedites, and reviews the micro-purchase orders and consolidation of all procurement ... Supervisory Acquisition & Utilization Specialist / PD99867-A Relocation/Recruitment Incentives: Not ...
Remote Prior Authorization Pharmacist
Ypsilanti, MI · Remote
$52.75 - $63.25/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Ypsilanti, MI · Remote
$52.75 - $63.25/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Detroit, MI · Remote
$53.25 - $64/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Detroit, MI · Remote
$53.25 - $64/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote - Associate must reside in the state of Michigan (MI) Responsibilities: * Serves as a single ... Utilization Review Accreditation Commission (URAC) standards Education & Experience: * Bachelor ...
Remote - Associate must reside in the state of Michigan (MI) Responsibilities: * Serves as a single ... Utilization Review Accreditation Commission (URAC) standards Education & Experience: * Bachelor ...
Registered Nurse
Detroit, MI · On-site +1
$30 - $35/hr
Two to four years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population ...
Registered Nurse
Detroit, MI · On-site +1
$30 - $35/hr
Two to four years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population ...
Appeals Pharmacist (Remote)
Ypsilanti, MI · On-site +1
$51.75 - $63/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Ypsilanti, MI · On-site +1
$51.75 - $63/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Detroit, MI · On-site +1
$52.50 - $63.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Detroit, MI · On-site +1
$52.50 - $63.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
Remote Accounting & Tax Director
Detroit, MI · Remote
$150K - $160K/yr
Review and sign federal/state tax returns and monthly financial statements. Ensure technical ... Monitor team utilization and realization. Identify workflow bottlenecks and implement process ...
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Apply Early
Remote Accounting & Tax Director
Detroit, MI · Remote
$150K - $160K/yr
Review and sign federal/state tax returns and monthly financial statements. Ensure technical ... Monitor team utilization and realization. Identify workflow bottlenecks and implement process ...
Apply Early
Dealer Success Manager
Detroit, MI · On-site +1
$90K - $115K/yr
S. (Mobile and Remote Service). With Curbee., it's simple: dealerships send the right van to the ... Perform MBRs and QBRs, track key metrics like appointments, utilization, and review results on a ...
Dealer Success Manager
Detroit, MI · On-site +1
$90K - $115K/yr
S. (Mobile and Remote Service). With Curbee., it's simple: dealerships send the right van to the ... Perform MBRs and QBRs, track key metrics like appointments, utilization, and review results on a ...
Supervisor, Clinical Documentation Integrity (CDI) - Remote
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... sets and optimal utilization of the 3M CDI software. Responsible for scheduling and work ... May perform CDI reviews to support program during high volume, short staffing periods. Maintains a ...
Supervisor, Clinical Documentation Integrity (CDI) - Remote
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... sets and optimal utilization of the 3M CDI software. Responsible for scheduling and work ... May perform CDI reviews to support program during high volume, short staffing periods. Maintains a ...
Supervisor, Clinical Documentation Integrity (CDI) - (Remote)
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... sets and optimal utilization of the 3M CDI software. Responsible for scheduling and work ... May perform CDI reviews to support program during high volume, short staffing periods. Maintains a ...
Supervisor, Clinical Documentation Integrity (CDI) - (Remote)
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... sets and optimal utilization of the 3M CDI software. Responsible for scheduling and work ... May perform CDI reviews to support program during high volume, short staffing periods. Maintains a ...
Oracle Service Delivery Manager
Troy, MI · On-site +1
Location: 100% Remote Employment Type: Full Time Day to Day Responsibilities : * Coordination of ... This includes regular reviews and management of resources time and timesheets. * Define and ...
Oracle Service Delivery Manager
Troy, MI · On-site +1
Location: 100% Remote Employment Type: Full Time Day to Day Responsibilities : * Coordination of ... This includes regular reviews and management of resources time and timesheets. * Define and ...
Lead Regional Maintenance Specialist
Ann Arbor, MI · On-site +1
$110K - $130K/yr
This is a remote position with travel requirements of up to 50%. For optimal support and ... Asset & Labor Utilization * Overall Equipment Effectiveness * Remaining useful life * 5-year ...
Lead Regional Maintenance Specialist
Ann Arbor, MI · On-site +1
$110K - $130K/yr
This is a remote position with travel requirements of up to 50%. For optimal support and ... Asset & Labor Utilization * Overall Equipment Effectiveness * Remaining useful life * 5-year ...
Lead Regional Maintenance Specialist
Ann Arbor, MI · Remote
$110K - $130K/yr
This is a remote position with travel requirements of up to 50%. For optimal support and ... Asset & Labor Utilization * Overall Equipment Effectiveness * Remaining useful life * 5-year ...
Lead Regional Maintenance Specialist
Ann Arbor, MI · Remote
$110K - $130K/yr
This is a remote position with travel requirements of up to 50%. For optimal support and ... Asset & Labor Utilization * Overall Equipment Effectiveness * Remaining useful life * 5-year ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · Remote
$26.50 - $31/hr
In this role, you'll ensure Peer Review case reports meet the highest standards of quality ... Why This Role Rocks: * 100% Remote - Enjoy the flexibility of working from home! * Impactful Work ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · Remote
$26.50 - $31/hr
In this role, you'll ensure Peer Review case reports meet the highest standards of quality ... Why This Role Rocks: * 100% Remote - Enjoy the flexibility of working from home! * Impactful Work ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · Remote
$26.50 - $31/hr
In this role, you'll ensure Peer Review case reports meet the highest standards of quality ... Why This Role Rocks: * 100% Remote - Enjoy the flexibility of working from home! * Impactful Work ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · Remote
$26.50 - $31/hr
In this role, you'll ensure Peer Review case reports meet the highest standards of quality ... Why This Role Rocks: * 100% Remote - Enjoy the flexibility of working from home! * Impactful Work ...
Remote Utilization Review information
See Michigan salary details
$18.65 - $22.42
2% of jobs
$22.42 - $26.19
9% of jobs
$28.77 is the 25th percentile. Wages below this are outliers.
$26.19 - $29.96
21% of jobs
The median wage is $33.01 / hr.
$29.96 - $33.73
23% of jobs
$33.73 - $37.50
13% of jobs
$40.44 is the 75th percentile. Wages above this are outliers.
$37.50 - $41.28
10% of jobs
$41.28 - $45.05
8% of jobs
$45.05 - $48.82
5% of jobs
$48.82 - $52.59
5% of jobs
$52.59 - $56.36
2% of jobs
$56.36 - $60.13
2% of jobs
$18
$36
$60
How much do remote utilization review jobs pay per hour?
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.
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Other
Posted 10 days ago
Job description
In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
- RHIT, RHIA, or related coding certification required.
- Minimum 3-5 years of clinical experience preferred.
- Previous utilization management or case management experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- RHIT, RHIA, or related coding certification required.
- Organization: Corporate Services
- Department: Central Utilization Mgt
- Shift: Day Job
- Union Code: Not Applicable