This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
The department collaborates with internal stakeholders including Claims, Utilization Management, IT ... Days (0800-1700) Remote, no weekends Specialty Type: Clerical Sub Specialties: Clerical/Office ...
The department collaborates with internal stakeholders including Claims, Utilization Management, IT ... Days (0800-1700) Remote, no weekends Specialty Type: Clerical Sub Specialties: Clerical/Office ...
Software Engineer (Active Account)
Philomath, OR · On-site +1
$80K - $120K/yr
Write and maintain unit tests, and participate in code reviews to uphold high standards, share ... We offer flexible work hours and allow up to 20% remote work, including extended remote work ...
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Software Engineer (Active Account)
Philomath, OR · On-site +1
$80K - $120K/yr
Write and maintain unit tests, and participate in code reviews to uphold high standards, share ... We offer flexible work hours and allow up to 20% remote work, including extended remote work ...
Registered Nurse (Rn)
Salem, OR · On-site +1
$48 - $55/hr
Days, nights, and weekend shifts- we will work with your availability! * 24/7 Local support from operators and clinicians * Aveanna has a tablet in each patient's home allowing for electronic ...
Registered Nurse (Rn)
Salem, OR · On-site +1
$48 - $55/hr
Days, nights, and weekend shifts- we will work with your availability! * 24/7 Local support from operators and clinicians * Aveanna has a tablet in each patient's home allowing for electronic ...
Remote Weekend Utilization Review information
See Albany, OR salary details
$21.35 - $25.67
2% of jobs
$25.67 - $29.99
9% of jobs
$32.94 is the 25th percentile. Wages below this are outliers.
$29.99 - $34.30
21% of jobs
The median wage is $37.80 / hr.
$34.30 - $38.62
23% of jobs
$38.62 - $42.94
13% of jobs
$46.30 is the 75th percentile. Wages above this are outliers.
$42.94 - $47.26
10% of jobs
$47.26 - $51.57
8% of jobs
$51.57 - $55.89
5% of jobs
$55.89 - $60.21
5% of jobs
$60.21 - $64.53
2% of jobs
$64.53 - $68.85
2% of jobs
$21
$42
$68
How much do remote weekend utilization review jobs pay per hour?
What is the difference between Remote Weekend Utilization Review vs Remote Weekday Utilization Review?
| Aspect | Remote Weekend Utilization Review | Remote Weekday Utilization Review |
|---|---|---|
| Credentials | Typically requires a healthcare professional license and utilization review certification | Same as weekend role, healthcare license and utilization review certification |
| Work Environment | Remote, weekend hours, often part-time or flexible | Remote, weekday hours, standard business hours |
| Employer & Industry | Health insurance companies, third-party administrators | Same as weekend role, health insurance industry |
| Work Schedule | Primarily weekends, possibly evenings | Weekdays, regular business hours |
Remote Weekend Utilization Review and Remote Weekday Utilization Review roles are similar in credentials and industry but differ mainly in work schedule. Weekend roles focus on reviewing cases during weekends, offering flexibility, while weekday roles follow standard business hours. Both positions require healthcare licensing and utilization review certification, serving health insurance companies and third-party administrators.
Full-time
Re-posted 13 days ago
Samaritan Health Services rating
7.5
Based on 65 frontline employees who took The Breakroom Quiz
232nd of 887 rated healthcare providers
Job description
Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans.
As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
Our ideal candidate will have the following experience:
- Health plan utilization management
- Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
- Data analysis to include reporting results and developing improvement plans
- Quality Management experience in a healthcare setting
- JOB SUMMARY/PURPOSE
- Executes program(s) that meet the needs of the organization, employees and/or customers. Plans, initiates, oversees execution of all elements for assigned program(s). Leads the development, implementation and management of assigned program(s) and associated projects. Oversees process from planning to completion. Works with multiple internal teams, vendors, clients. Responsible for explaining, training, and mentoring the entire organization on the program. Collaborates with SHS system experts to ensure focus, alignment, and best practices for the program.
- EXPERIENCE/EDUCATION/QUALIFICATIONS
- Current unencumbered Oregon RN License required within 90 days of hire. BSN preferred. Master's degree in a related field preferred.
- One (1) year clinical nursing experience plus four (4) years health plan utilization management experience required.
- Experience or training in the following required:
- Health care delivery systems and/or managed care patients.
- Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
- Experience in the following preferred:
- Team leadership.
- Case management.
- Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
- KNOWLEDGE/SKILLS/ABILITIES
- Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
- Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
- Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
- Communication and team building – Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.
- PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)Occasionally
(11 - 33% of the time)Frequently
(34 - 66% of the time)Continually
(67 – 100% of the time)CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 – 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
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