Conduct monthly/quarterly business reviews for employer clients and their broker and consultant ... utilization, retention, etc) * Excellent project management and organizational skills to coordinate ...
Quick apply
Conduct monthly/quarterly business reviews for employer clients and their broker and consultant ... utilization, retention, etc) * Excellent project management and organizational skills to coordinate ...
Quick apply
Conduct monthly/quarterly business reviews for employer clients and their broker and consultant ... utilization, retention, etc) * Excellent project management and organizational skills to coordinate ...
... utilization of the Platform. Key Criteria: MS Dynamics - D365 Finance and Operations Module ... Participate and/ or lead quality management reviews including designs, prototypes and other stages ...
... utilization of the Platform. Key Criteria: MS Dynamics - D365 Finance and Operations Module ... Participate and/ or lead quality management reviews including designs, prototypes and other stages ...
... utilization of the Platform. Key Criteria: MS Dynamics - D365 Finance and Operations Module ... Participate and/ or lead quality management reviews including designs, prototypes and other stages ...
... utilization of the Platform. Key Criteria: MS Dynamics - D365 Finance and Operations Module ... Participate and/ or lead quality management reviews including designs, prototypes and other stages ...
Chicago, IL ยท Remote
$18.50 - $38.82/hr
The CMA plays a key role in promoting effective utilization of healthcare services, supporting ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Chicago, IL ยท Remote
$18.50 - $38.82/hr
The CMA plays a key role in promoting effective utilization of healthcare services, supporting ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Aurora, IL ยท Remote
$18.50 - $38.82/hr
The CMA plays a key role in promoting effective utilization of healthcare services, supporting ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Aurora, IL ยท Remote
$18.50 - $38.82/hr
The CMA plays a key role in promoting effective utilization of healthcare services, supporting ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Chicago, IL ยท On-site +1
$38K - $48K/yr
... and utilization of engineering expertise; manages team schedule to ensure efficient resource ... out Remote Performance Reviews; responsible for escalated case support which includes ...
Chicago, IL ยท On-site +1
$38K - $48K/yr
... and utilization of engineering expertise; manages team schedule to ensure efficient resource ... out Remote Performance Reviews; responsible for escalated case support which includes ...
Chicago, IL ยท Remote
$16.50 - $22.50/hr
Perk Of This Role * Fully remote position, where you can work from home. Rotational shifts ... reviews and process. * Answers the Beneficiary Helpline through the utilization of the hunt group ...
Chicago, IL ยท Remote
$16.50 - $22.50/hr
Perk Of This Role * Fully remote position, where you can work from home. Rotational shifts ... reviews and process. * Answers the Beneficiary Helpline through the utilization of the hunt group ...
Addison, IL ยท On-site +1
... review programming, property priorities, tenant engagement opportunities, marketing initiatives ... budget utilization, and strategic recommendations. โข Provide remote coaching, guidance, and ...
Addison, IL ยท On-site +1
... review programming, property priorities, tenant engagement opportunities, marketing initiatives ... budget utilization, and strategic recommendations. โข Provide remote coaching, guidance, and ...
United States - Remote Employment Type: 1 year contract Position Overview We are seeking a hands-on ... Track testing progress, findings workflows, report review, retesting, and remediation follow-up ...
United States - Remote Employment Type: 1 year contract Position Overview We are seeking a hands-on ... Track testing progress, findings workflows, report review, retesting, and remediation follow-up ...
United States - Remote Employment Type: 1 year contract Position Overview We are seeking a hands-on ... Track testing progress, findings workflows, report review, retesting, and remediation follow-up ...
United States - Remote Employment Type: 1 year contract Position Overview We are seeking a hands-on ... Track testing progress, findings workflows, report review, retesting, and remediation follow-up ...
Romeoville, IL ยท On-site +1
Our customers benefit from much better utilization of their warehouses (up to 70% more pallet ... If remote, occasional travel to our Romeoville, IL office (average 3 days at a time; approx. 6 ...
Quick apply
Romeoville, IL ยท On-site +1
Our customers benefit from much better utilization of their warehouses (up to 70% more pallet ... If remote, occasional travel to our Romeoville, IL office (average 3 days at a time; approx. 6 ...
Romeoville, IL ยท On-site +1
Our customers benefit from much better utilization of their warehouses (up to 70% more pallet ... If remote, occasional travel to our Romeoville, IL office (average 3 days at a time; approx. 6 ...
Romeoville, IL ยท On-site +1
Our customers benefit from much better utilization of their warehouses (up to 70% more pallet ... If remote, occasional travel to our Romeoville, IL office (average 3 days at a time; approx. 6 ...
Chicago, IL ยท Remote
$128K - $176K/yr
Review benefit premium rate contribution, claims and utilization data on an annual basis; analyze and interpret data for trends, improvements, and efficiencies * Coordinate and lead the 401(k) ...
Chicago, IL ยท Remote
$128K - $176K/yr
Review benefit premium rate contribution, claims and utilization data on an annual basis; analyze and interpret data for trends, improvements, and efficiencies * Coordinate and lead the 401(k) ...
Chicago, IL ยท Remote
$130K - $180K/yr
... Utilization Management, Provider Management, CFO, SIU) * Have a deep Health Plan knowledge * Have ... Flexible remote and hybrid working options * Competitive Salary and a variable component tied to ...
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Chicago, IL ยท Remote
$130K - $180K/yr
... Utilization Management, Provider Management, CFO, SIU) * Have a deep Health Plan knowledge * Have ... Flexible remote and hybrid working options * Competitive Salary and a variable component tied to ...
Chicago, IL ยท On-site +1
$114K - $149K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Chicago, IL ยท On-site +1
$114K - $149K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Chicago, IL ยท On-site +1
$114K - $149K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Chicago, IL ยท On-site +1
$114K - $149K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Remote position, preference for CST time zone Primary Function of Position The Technical Solutions ... Own the process of engaging with customer technical review boards, data and AI governance, and ...
Remote position, preference for CST time zone Primary Function of Position The Technical Solutions ... Own the process of engaging with customer technical review boards, data and AI governance, and ...
Chicago, IL ยท On-site +1
$150K - $190K/yr
The team is open to discussing hybrid or remote options in Minneapolis, Chicago, and St. Louis ... Solicits and reviews new and renewal account information required to evaluate a risk. * Identifies ...
Chicago, IL ยท On-site +1
$150K - $190K/yr
The team is open to discussing hybrid or remote options in Minneapolis, Chicago, and St. Louis ... Solicits and reviews new and renewal account information required to evaluate a risk. * Identifies ...
Downers Grove, Illinois Case Management Direct RN Remote Case Manager Supervisor - Chicago Area ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...
Downers Grove, Illinois Case Management Direct RN Remote Case Manager Supervisor - Chicago Area ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...
Chicago, IL ยท On-site +1
$150K - $190K/yr
The team is open to discussing hybrid or remote options in Minneapolis, Chicago, and St. Louis ... Solicits and reviews new and renewal account information required to evaluate a risk. * Identifies ...
Chicago, IL ยท On-site +1
$150K - $190K/yr
The team is open to discussing hybrid or remote options in Minneapolis, Chicago, and St. Louis ... Solicits and reviews new and renewal account information required to evaluate a risk. * Identifies ...
$21.05 - $25.31
2% of jobs
$25.31 - $29.56
9% of jobs
$32.47 is the 25th percentile. Wages below this are outliers.
$29.56 - $33.82
21% of jobs
The median wage is $37.27 / hr.
$33.82 - $38.08
23% of jobs
$38.08 - $42.33
13% of jobs
$45.64 is the 75th percentile. Wages above this are outliers.
$42.33 - $46.59
10% of jobs
$46.59 - $50.85
8% of jobs
$50.85 - $55.10
5% of jobs
$55.10 - $59.36
5% of jobs
$59.36 - $63.62
2% of jobs
$63.62 - $67.87
2% of jobs
$21
$41
$67
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.
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.
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.
For Remote Utilization Review jobs in Mokena, IL, the most frequently searched job titles are:
The top searched job categories for Remote Utilization Review jobs in Mokena, IL are:
Cities near Mokena, IL with the most Remote Utilization Review job openings:

Full-time
Retirement
Re-posted 13 days ago
RxSaveCard was founded in 2024 with a mission to reduce pharmacy costs for employers and their employees. Our innovative model is unique in the market, and we are building a modern, card-based approach to prescription benefits that simplifies a complicated system. Our innovative model is unique in the market, backed by financial partners at Distributed Ventures and Rock Health.
Position OverviewAs our first Manager of Client Success, you will be the primary day-to-day contact for our employer clients and their broker and consultant partners. You will join our team, responsible for accounts aasigned to you, where you will own the ongoing success, retention, and growth of our employer clients and their broker and consultant partners. This role is focused on ensuring clients achieve measurable value from RxSaveCard and continue to expand their engagement over time.
Key Responsibilities
Role Focus
If you're excited about making prescription drugs more affordable and want to be an early employee at a start-up company, we'd love to hear from you!