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Remote Utilization Review Jobs in Oklahoma (NOW HIRING)

CSAA

Marketing Engagement Partner - Remote

Kansas, OK · Remote

Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements

Chloeta

Management Analyst

Oklahoma City, OK · On-site +1

$35 - $40/hr

... utilization, and program performance. Supervisory Responsibilities : No Job Classification ... Remote / Virtual Travel: Travel up to 50% Compensation: This pay band reflects Chloeta's good faith ...

Irby Construction Company

Project Scheduler

Tulsa, OK · On-site +1

... utilization. * Perform other scheduling functions in support of Project Services and broader ... remote project teams. Skills & Competencies * Ability to review, analyze, and update project ...

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Remote Utilization Review information

See Oklahoma salary details

$19

$39

$63

How much do remote utilization review jobs pay per hour?

As of Jul 30, 2026, the average hourly pay for remote utilization review in Oklahoma is $39.04, according to ZipRecruiter salary data. Most workers in this role earn between $30.87 and $44.86 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 Oklahoma? The most popular types of Utilization Review jobs in Oklahoma are:
What are popular job titles related to Remote Utilization Review jobs in Oklahoma? For Remote Utilization Review jobs in Oklahoma, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Oklahoma look for? The top searched job categories for Remote Utilization Review jobs in Oklahoma are:
What cities in Oklahoma are hiring for Remote Utilization Review jobs? Cities in Oklahoma with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Oklahoma as of July 2026, with employment types broken down into 80% Full Time, 10% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $81,204 per year, or $39 per hour.

Manager, Utilization Management (51741)

GLOBALHEALTH HOLDINGS LLC

Oklahoma City, OK • On-site, Remote

Full-time

Medical

Posted 28 days ago

Job description

WHO WE ARE:
GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high touch, high value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We work hard to offer affordable health insurance coverage with the benefits people truly want and need. It is our hope to be more than just a health insurance company we want to be long-term partners with our members. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.
WHO YOU ARE:
This position, under the guidance of the Vice President, Health Services is responsible for the operational oversight of the Utilization Management department. This includes tracking and trending of utilization data, development and update of policy and procedures, regulatory reporting and supervisory staff. The position also may include collaboration with internal teams and external providers.
ESSENTIAL DUTIES AND RESPONSBILITIES:
  • Accountable for the functions of the Utilization Management department.
  • Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines.
  • Integrates quality improvement activities within utilization management.
  • Communicates regularly with employees through participation in regular staff meetings to share information appropriate to their job functions and development.
  • Serves as a resource to both lines of business in relation to Utilization Management.
  • Plays an active role in both internal and external committees along with contract delegated responsibilities.
  • Collaborates with network facilities to improve concurrent and discharge plans for our members.
  • Performs retrospective review for the claims department.
  • Assists in providing information for the appeals department.
  • Provides information to reinsurance for members pending transplantation.
  • Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.

EDUCATION AND EXPERIENCE:
  • Current Oklahoma state RN license
  • Experience in Managed Care, Case Management and Concurrent Review
  • Previous experience in a supervisory role
  • CPHQ, CPUR and previous insurance experience preferred

KNOWLEDGE, SKILLS AND ABILITIES:
  • Ability to communicate, both orally and written, and manage complex working relationships.
  • Excellent organizational, leadership, problem-solving, and decision-making skills.
  • Knowledge of Microsoft software programs including Word, Excel, PowerPoint and Power BI
  • Knowledge of quality improvement and utilization management

WORK ENVIRONMENT:
Current work environment is remote, however, some state exclusions apply.
Must have access to a reliable and secured internet connection source. Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.
TRAVEL:
Travel may be required for this position
SUPERVISORY RESPONSIBILITY:
This position is in a supervisory role over Utilization Management leadership and staff
OTHER DUTIES:
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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