Legal Counsel - USA & Canada
Calvert, AL · On-site +1
If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...
Calvert, AL · On-site +1
If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...
Calvert, AL · On-site +1
If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...
Chart Review and Documentation * Conduct structured reviews of clinical records to assess service utilization, client engagement, and treatment plan compliance. * Document all findings and ...
Chart Review and Documentation * Conduct structured reviews of clinical records to assess service utilization, client engagement, and treatment plan compliance. * Document all findings and ...
$21.23 - $25.52
2% of jobs
$25.52 - $29.82
9% of jobs
$32.76 is the 25th percentile. Wages below this are outliers.
$29.82 - $34.11
21% of jobs
The median wage is $37.59 / hr.
$34.11 - $38.41
23% of jobs
$38.41 - $42.70
13% of jobs
$46.04 is the 75th percentile. Wages above this are outliers.
$42.70 - $46.99
10% of jobs
$46.99 - $51.29
8% of jobs
$51.29 - $55.58
5% of jobs
$55.58 - $59.87
5% of jobs
$59.87 - $64.17
2% of jobs
$64.17 - $68.46
2% of jobs
$21
$41
$68
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.
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.
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.

Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 15 days ago
Objective: The Legal Counsel - USA & Canada will serve as a key member of the Business Area Americas legal team, providing strategic and practical legal support within Business Area with respect to the United States and Canada. This role is responsible for managing all day-to-day legal matters for Business Area Americas operations based on Calvert, Alabama, as well as advising all other business functions (i.e., sales, operations, procurement, finance, supply chain, human resources, and IT) on legal risks, compliance, and business initiatives. The Legal Counsel will also be part of the broader global legal team of Outokumpu Corporation, the parent company based on Helsinki, Finland, and will interact periodically with other members of the global legal team who are located throughout Europe. In addition to traditional legal responsibilities, this role plays a critical part in legal operations, including process design, legal intake management, and optimization of workflows within the company's contract lifecycle management (CLM) system, LawVu. The Legal Counsel will directly manage a Contracts Specialist and collaborate cross-functionally to improve how legal requests are triaged, tracked, and executed.
Travel : 1 time per year to Helsinki, Finland and 2-3 times per year to San Luis Potosi, Mexico
Requirements:
Technical & Operational Expertise
Competencies and skills:
Responsibilities:
Salary: USD.121,800-152,200
What we offer:
10 paid observed holidays plus 2 additional floating holidays to use at your discretion. 80 hours of paid time off annually, prorated based on hire date.
401(k) retirement plan with a 100% company match on the first 6% of your contributions
Medical coverage with HDHP and PPO plan options featuring affordable premiums and deductibles
Employer HSA contribution of $1,000 (individual) or $2,000 (family) for team members enrolled in the HDHP plan
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
Dental and Vision coverage
Employer paid Short Term and Long Term Disability Insurance
Employer paid Group Life and AD&D insurance equal to 2 times annual salary, with optional Supplemental Life and AD&D coverage
Voluntary benefits, including Aflac supplemental plans, Aura Identity and Fraud protection, and Legal Insurance
Employer paid wellness programs, including Calm Health, Hinge Health, and Lark
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Coal, metals and minerals mining
5,001 - 10,000 Employees
Calvert, AL, US