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Remote Utilization Review Jobs in Walton, KY (NOW HIRING)

Dove Recovery

Clinical Director

Cincinnati, OH · On-site +1

$76K - $104K/yr

Coordinate and collaborate with the contracted billing company and any internal utilization review ... Remote & Field-Based Work Expectations * Travel to assigned facility locations as needed for direct ...

Medpace, Inc.

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

Produce coding reports for team review and utilization *Stable schedule with no weekends, no work on Medpace holidays, and flexible work schedule* Qualifications * BSN and RN with applicable ...

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Walton, KY

Remote Utilization Review information

See Walton, KY salary details

$19

$39

$63

How much do remote utilization review jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for remote utilization review in Walton, KY is $39.01, according to ZipRecruiter salary data. Most workers in this role earn between $30.82 and $44.81 per hour, depending on experience, location, and employer.

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 cities near Walton, KY are hiring for Remote Utilization Review jobs?

Cities near Walton, KY with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Walton, KY as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $81,137 per year, or $39 per hour.

Clinical Director

Dove Recovery

Cincinnati, OH • On-site, Remote

$76K - $104K/yr

Full-time

Medical, PTO

Posted 5 days ago

Job description

ROBIN RECOVERY
Clinical Director DepartmentClinical ServicesReports ToExecutive DirectorFLSA StatusExempt (Salaried)LocationRemote / Field-Based - Oversees Multi-Site LocationsEffective DateTBDClassificationFull-Time Position Summary
The Clinical Director is responsible for the overall clinical operation of assigned outpatient sites within the Robin Recovery network, including daily clinical management, ensuring clinical supervision is available during all operational hours, developing a quality improvement plan for each site, and monitoring adherence to applicable regulations and licensing requirements. The Clinical Director oversees all clinical programming and collaborates with the Leadership team on administrative functions, including providing clinical services, supervising and evaluating clinical staff, and coordinating all program services. This is a remote, field-based role: the Clinical Director travels to assigned facility locations as needed for direct oversight, staff supervision, and site-based clinical activity, while conducting administrative, planning, and documentation review functions remotely. The Clinical Director assists in program development (clinical curriculum, programming, group facilitation and documentation, treatment planning, etc.), financial management, program marketing, hiring and supervising clinical staff, and evaluating program policies for clinical operations. This role also supports the Executive Director in problem-solving, conflict resolution, and readiness for State visits and other areas as assigned.
SECTION I - Duties & Essential Job Functions A. Clinical Supervision & Staff Oversight
  • Provide supervision for clinical staff, facilitating weekly/biweekly individual and group supervision with each counselor, documenting supervision notes, and assisting counselors in effective, individualized treatment through regular case conceptualization consults and treatment team meetings
  • Supervise all clinical staff activities, including monitoring groups, individual therapy, documentation practices, and charting, to maintain the highest standards of quality and effectiveness
  • Provide direct clinical care to clients in individual and group settings as needed
  • Function as Leader/Liaison of the multi-disciplinary Clinical Treatment Team
B. Program Development & Compliance
  • Develop and implement policies and procedures for the clinical operation of assigned outpatient sites
  • Coordinate and collaborate with the contracted billing company and any internal utilization review staff
  • Assist in implementation and full collaboration with the Electronic Health Record system, building data and compliance infrastructure (clinical forms, assessments, screeners, consents, and reports)
  • Participate in monthly medical records meetings and quality assurance/performance improvement meetings; develop and lead clinical performance improvement strategies as applicable
  • Evaluate program quality on an ongoing basis and develop cost-effective methods to provide services
C. Staffing & Personnel Management
  • Participate in the overall employment process for clinical staff, including recruiting, interviewing, hiring, supervising, and discharging, according to established personnel policies
  • Complete performance appraisals for clinical and administrative staff annually and work with Human Resources on employee performance management throughout the year
  • Provide supervision and documentation of clinical staff training and development, and monitor compliance of staff credentialing, including initial onboarding and ongoing required trainings
  • Foster a healthy, positive team-approach with staff and promote a positive workplace culture to effectively recruit and retain high-quality staff
D. Networking & External Relations
  • Network with other organizations to increase the referral base
E. Remote & Field-Based Work Expectations
  • Travel to assigned facility locations as needed for direct clinical oversight, staff supervision, treatment team participation, and State visit readiness
  • Complete supervision documentation, policy development, quality assurance review, and other administrative duties remotely outside of on-site time
  • Maintain a secure, HIPAA-compliant remote work environment for any clinical work performed off-site
  • Communicate proactively with the Executive Director regarding travel schedule, site coverage, and any scheduling conflicts
SECTION II - Other Functions & Responsibilities
  • Perform other duties as assigned
Qualifications
  • Master's Degree in a Behavioral Health related field
  • Active, unrestricted Ohio licensure with clinical supervision certification/licensure required: LICDC, LPCC, or LISW (or equivalent independent-level clinical licensure)
  • Minimum of 2 years of supervisory experience required
  • ASAM experience and knowledge
  • Minimum of 5 years of Mental Health and/or Substance Use Treatment experience required, preferably in an outpatient setting
  • Experience with startup organizations preferred
  • Demonstrated computer proficiency
  • Reliable transportation and ability to travel to assigned facility locations as needed
  • Comfort working in a remote/field-hybrid role with independent time management
Competencies
  • Leadership expertise: the Clinical Director leads the clinical team and is responsible for oversight of all clinical programming, developing and implementing policies and procedures, and maintaining compliance with regulatory and accreditation bodies.
  • Clinical expertise: the Clinical Director must be competent in assessing, diagnosing, providing, and documenting appropriate clinical care in an outpatient substance use treatment setting.
  • Emergency and safety: understand and follow facility emergency and safety procedures, respond to emergencies in a safe and effective manner, provide first aid and CPR as needed, and maintain a safe and secure environment for clients and staff.
  • Overdose prevention: recognize the signs and symptoms of an overdose and respond appropriately; maintain training in the use of naloxone and other overdose reversal medications.
  • Suicide risk and prevention: recognize the signs and symptoms of suicide risk and respond appropriately; maintain training in suicide prevention strategies.
Knowledge, Skills, and Experience
  • Cultural Competency: Must be able to understand and work effectively with clients from a variety of cultural backgrounds, and adapt approach to meet the needs of each client.
  • Communication Skills: Must be able to effectively communicate with clients and staff, both verbally and in writing, listen actively, and provide clear and concise feedback.
  • Problem-Solving Skills: Must be able to identify and solve problems that arise in the treatment process, thinking critically and creatively to develop and implement effective solutions.
  • Organizational Skills: Must be able to effectively manage time and resources across multiple remote and on-site responsibilities.
  • Flexibility: Must be able to adapt to change, adjust approach to treatment and oversight as needed, and handle unexpected situations across a multi-site, remote role.
  • Self-Awareness: Must be aware of personal biases and limitations, identify strengths and weaknesses, and use this knowledge to improve practice.
  • Empathy: Must be able to understand and empathize with clients and staff, offering support and understanding.
  • Respect: Must respect clients' and staff members' unique experiences and perspectives, treating all with dignity regardless of background or circumstances.
  • Professionalism: Must maintain a professional demeanor at all times and uphold the ethical standards of the profession.
Physical Demands
  • Ability to lift up to 25 pounds
  • Ability to walk up and down stairs during emergency drills or situations
Benefits
  • More detailed information regarding benefits (including medical insurance and PTO) will be provided upon employment
Acknowledgment
By signing below, the employee acknowledges receipt of this job description and understands that the duties outlined may be revised at the discretion of organizational leadership based on operational need.
Employee Signature & DateExecutive Director Signature & Date Printed Name

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