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Remote Utilization Review Jobs in Minnesota (NOW HIRING)

Appeals Pharmacist (Remote)

Saint Paul, MN · On-site +1

$58 - $70.50/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)

Minneapolis, MN · On-site +1

$57 - $69.25/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Responsibilities includes preparation, review and negotiation of prospective reinsurance term ... Utilization of artificial intelligence tools and resources (e.g. generative Al). What you bring:

Pharmacist Informaticist

Brainerd, MN · On-site +1

$133K - $170K/yr

Contribute to guideline development, medication utilization reviews, and other medication processes ... Remote/Hybrid Option: Hybrid Shift Rotation: Day Rotation (United States of America) Shift Start ...

Pharmacist Informaticist

Detroit Lakes, MN · On-site +1

$133K - $170K/yr

Contribute to guideline development, medication utilization reviews, and other medication processes ... Remote/Hybrid Option: Hybrid Shift Rotation: Day Rotation (United States of America) Shift Start ...

Underwriter Senior - Actuary | Remote

Minneapolis, MN · On-site +1

$102K - $121K/yr

... reviews at counter-party locations Industry & Partner Coordination: • Attend meetings with ... Utilization of artificial intelligence tools and resources (e.g. generative AI). What you bring ...

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Remote Utilization Review information

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$41

$67

How much do remote utilization review jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for remote utilization review in Minnesota is $41.41, according to ZipRecruiter salary data. Most workers in this role earn between $32.74 and $47.55 per hour, depending on experience, location, and employer.

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.

What are the most commonly searched types of Utilization Review jobs in Minnesota? The most popular types of Utilization Review jobs in Minnesota are:
What cities in Minnesota are hiring for Remote Utilization Review jobs? Cities in Minnesota with the most Remote Utilization Review job openings:
Infographic showing various Remote Utilization Review job openings in Minnesota as of June 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 100% Remote job distribution, with an average salary of $86,136 per year, or $41.4 per hour.
Behavioral Health Care Advocate - Utilization Management Remote

Behavioral Health Care Advocate - Utilization Management Remote

UnitedHealth Group

Eden Prairie, MN • Remote

$60K - $107K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 1 hour ago


UnitedHealth Group rating

7.5

Company rating: 7.5 out of 10

Based on 140 frontline employees who took The Breakroom Quiz

225th of 871 rated healthcare providers


Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

*** This is a telephonic, queue based position in which you will respond to provider and facility treatment requests, as well as manage and deescalate crisis calls from members  ***

As a Care Advocate you will be responsible for Utilization Review of mental health and substance use disorder services. You'll have a direct impact on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan.

You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

The hours for this position are Monday - Friday, 8:30 am - 5:30 pm CT and include 1 national holiday per year to be worked.

 Why Optum Behavioral Care

At Optum Behavioral Care, we prioritize clinician wellbeing, career growth, and innovation in care delivery. We offer a comprehensive benefits and rewards package that may include:

  • Competitive salary
  • Generous paid time off
  • Medical, dental, vision, and behavioral health benefits
  • 401(k) with company match
  • Family support and wellness resources
  • Tuition reimbursement and dedicated learning time
  • Career development opportunities across a fastgrowing organization

Primary Responsibilities:

  • Perform utilization management, utilization review, or concurrent review of behavioral health admissions and continued stay
  • Ensure that behavioral health care services provided are medically necessary, per standard guidelines
  • Ensure that behavioral health care services are provided in the most appropriate setting
  • Integrates a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet the enrollee's health needs, using education, communication, and all available resources to promote quality, cost-effective outcomes
  • Discharge planning or management of transitions between care settings to ensure the appropriate services/resources are in place for quality outcomes

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Master's or doctoral degree in psychology, social work, counseling or related field
  • Active, unrestricted, independent license in a behavioral health field (i.e., LP, LPC, LPCC, LCSW, LISCW, LMFT, LMHC, etc.) 
  • 3 years of post-licensure clinical experience in a related behavioral health environment
  • Proficiency in MS Office Suite
  • Availability to work 1 national holiday that falls on a weekday per calendar year
  • Access to install secure, high-speed internet and a dedicated, distraction free workspace at home
  • Ability to work in a telephonic, queue based position in which you will respond to provider and facility treatment requests, as well as manage and deescalate crisis calls from members

 

Preferred Qualifications:

  • Licensed Alcohol and Drug Counselor
  • Managed Care experience
  • Substance abuse experience
  • Experience working with children, adolescents, and families
  • Experience working in a hospital setting
  • Experience with medical or behavioral health collaboration within different organizations
  • Proven excellent customer service skills
  • Proven excellent organizational skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.    

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. 


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