Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Quick apply
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Quick apply
Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
Data Science, AI Compute Strategy, Canada
Toronto, ON · On-site +1
We are open to candidates in Canada, either hybrid or remote. Responsibilities * Build analytical ... Analyze GPU demand, utilization, and unit economics to identify opportunities to improve ...
Data Science, AI Compute Strategy, Canada
Toronto, ON · On-site +1
We are open to candidates in Canada, either hybrid or remote. Responsibilities * Build analytical ... Analyze GPU demand, utilization, and unit economics to identify opportunities to improve ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Quick apply
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Quick apply
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Mining Project Manager
Toronto, ON · Remote
The Project Manager is responsible for maintaining a high level of utilization, consistently ... This will involve a high degree of business travel to remote and/or hardship sites for up to eight ...
Lead Infrastructure Engineer
Toronto, ON · Remote
CA$220K - CA$260K/yr
This is a fully remote position that offers a competitive salary range of $220,000 to $260,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Lead Infrastructure Engineer
Toronto, ON · Remote
CA$220K - CA$260K/yr
This is a fully remote position that offers a competitive salary range of $220,000 to $260,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Delivery Director
Toronto, ON · On-site +1
Ensure delivery performance, resource utilization, and profitability align with contractual ... Represent MiraCloud in executive-level customer discussions, implementation reviews, and delivery ...
Delivery Director
Toronto, ON · On-site +1
Ensure delivery performance, resource utilization, and profitability align with contractual ... Represent MiraCloud in executive-level customer discussions, implementation reviews, and delivery ...
Infrastructure Engineer
Toronto, ON · Remote
CA$140K - CA$190K/yr
This is a fully remote position that offers a competitive salary range of $140,000 to $190,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Infrastructure Engineer
Toronto, ON · Remote
CA$140K - CA$190K/yr
This is a fully remote position that offers a competitive salary range of $140,000 to $190,000 USD ... Monitor infrastructure utilization and cost, identifying opportunities to improve efficiency ...
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Quick apply
Review strategist work for technical accuracy and strategic quality before client delivery ... Maintain visibility into project health, capacity, utilization, and delivery risks across the team.
Remote Utilization Review information
What is a remote utilization review?
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 does a remote utilization review do?
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 are the key skills and qualifications needed to thrive in remote utilization review?
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 are the most commonly searched types of Utilization Review jobs in Toronto, ON?
The most popular types of Utilization Review jobs in Toronto, ON are:
What are popular job titles related to Remote Utilization Review jobs in Toronto, ON?
For Remote Utilization Review jobs in Toronto, ON, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Toronto, ON look for?
The top searched job categories for Remote Utilization Review jobs in Toronto, ON are:
- Remote Chiropractic Utilization Review
- Remote Dental Utilization Review
- Remote Aetna Utilization Review
- Remote Insurance Utilization Review
- Full Time Anthem Utilization Review Nurse
- Remote Cigna Utilization Review Nurse
- Remote Bcba Utilization Review
- Optum Utilization Review Nurse
- Temporary Aetna Utilization Review Nurse
- Full Time Navihealth Utilization Review
What cities near Toronto, ON are hiring for Remote Utilization Review jobs?
Cities near Toronto, ON with the most Remote Utilization Review job openings:
CA$80/hr
Full-time
Re-posted 27 days ago
Job description
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.
Position: Registered Nurses (Data labelling and training)
Type: Contract
Compensation: $60–$80/hour
Location: Remote
Role Responsibilities
- Review and assess clinical documentation for accuracy, completeness, and quality.
- Analyze healthcare workflows and recommend process improvements.
- Interpret patient records and clinical notes to support product development.
- Identify documentation gaps, inconsistencies, and edge cases.
- Collaborate with product, engineering, and operations teams to refine AI-driven healthcare tools.
- Ensure adherence to healthcare regulations, policies, and best practices.
Qualifications
Must-Have
- Active Registered Nurse (RN) license.
- 3–5+ years of clinical nursing experience.
- Strong understanding of clinical documentation and healthcare workflows.
- Experience working with EHR systems (Epic, Cerner, Meditech, etc.).
- Excellent analytical, communication, and problem-solving skills.
Preferred
- Experience in CDI, case management, utilization review, or quality improvement.
- Exposure to healthcare technology, AI tools, or digital health products.
- Ability to collaborate effectively with cross-functional teams.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
- For any help or support, reach out to: support@mercor.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.