Preparing and presenting regular client performance reviews, including identification of cost drivers, recommendations for cost savings opportunities, utilization and cost reports * Prioritizes and ...
Preparing and presenting regular client performance reviews, including identification of cost drivers, recommendations for cost savings opportunities, utilization and cost reports * Prioritizes and ...
Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time)
Austin, TX · On-site +1
This position is located Remote United States* *This position is weekday evening shift (Part Time ... Five (5) years conducting or overseeing Medicare appeals, medical review, or utilization management ...
Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time)
Austin, TX · On-site +1
This position is located Remote United States* *This position is weekday evening shift (Part Time ... Five (5) years conducting or overseeing Medicare appeals, medical review, or utilization management ...
Part-Time Remote Insurance Representative
Austin, TX · On-site +1
$39K - $54K/yr
We promote from within! • Annual Performance Reviews. We reward your good work with more money ... including weekends and some holidays, between 7:30am - 12:30am EST. • Must pass a background ...
Part-Time Remote Insurance Representative
Austin, TX · On-site +1
$39K - $54K/yr
We promote from within! • Annual Performance Reviews. We reward your good work with more money ... including weekends and some holidays, between 7:30am - 12:30am EST. • Must pass a background ...
Medical Records Development Clerk - Remote TX
Austin, TX · On-site +1
$11 - $14/hr
... weekends! Must reside in Texas. medical providers. In this role you will: * Contact medical ... Review, approve, or deny invoices for medical records * Submit medical records to Office of ...
Medical Records Development Clerk - Remote TX
Austin, TX · On-site +1
$11 - $14/hr
... weekends! Must reside in Texas. medical providers. In this role you will: * Contact medical ... Review, approve, or deny invoices for medical records * Submit medical records to Office of ...
Sr. Network Security Engineer
Bastrop, TX · Remote
$58.25 - $76/hr
Comfortable reading and reviewing Go code, particularly in the context of understanding upstream ... Hybrid or remote work will not be considered. * Willingness to work extended hours and weekends as ...
Sr. Network Security Engineer
Bastrop, TX · Remote
$58.25 - $76/hr
Comfortable reading and reviewing Go code, particularly in the context of understanding upstream ... Hybrid or remote work will not be considered. * Willingness to work extended hours and weekends as ...
HEDIS Performance Improvement Specialist
Austin, TX · Remote
$30 - $39.75/hr
Remote - Must reside in Texas Facility: Ascension Care Management Insurance Department: Quality ... of medical record review and abstraction. Must be able to analyze HEDIS data to develop ...
HEDIS Performance Improvement Specialist
Austin, TX · Remote
$30 - $39.75/hr
Remote - Must reside in Texas Facility: Ascension Care Management Insurance Department: Quality ... of medical record review and abstraction. Must be able to analyze HEDIS data to develop ...
Systems Analyst, Supply Chain (Starlink)
Bastrop, TX · On-site +1
... utilization (includes developing planning models and decision-making tools) * Create dashboards ... This position requires being on site - remote work not considered
Systems Analyst, Supply Chain (Starlink)
Bastrop, TX · On-site +1
... utilization (includes developing planning models and decision-making tools) * Create dashboards ... This position requires being on site - remote work not considered
Manager, Channel Sales
Austin, TX · On-site +1
$150K/yr
... pipeline reviews, deal escalations, and career development. • Own the North America channel ... utilization, events, and campaigns that drive measurable partner-sourced pipeline. • Drive ...
Manager, Channel Sales
Austin, TX · On-site +1
$150K/yr
... pipeline reviews, deal escalations, and career development. • Own the North America channel ... utilization, events, and campaigns that drive measurable partner-sourced pipeline. • Drive ...
Triage Medical Assistant (MA) / Registered Nurse (RN) - Virtual Care - Pediatrics (Remote)
Austin, TX · Remote
You can find some of our patient reviews here to get a better feel. At the end of the day, Modern ... Weekends: 8:00am - 8:00pm * These hours aren't set in stone - let's talk! * Clinical * Triaging ...
Quick apply
Triage Medical Assistant (MA) / Registered Nurse (RN) - Virtual Care - Pediatrics (Remote)
Austin, TX · Remote
You can find some of our patient reviews here to get a better feel. At the end of the day, Modern ... Weekends: 8:00am - 8:00pm * These hours aren't set in stone - let's talk! * Clinical * Triaging ...
Software Developer 3
Austin, TX · Remote
Austin, TX 78752 (Remote) Duration: 12 months contract The following describes the work that will ... Analyze logs, system messages, thread connectivity, memory utilization, disk input\/output, and ...
New
Software Developer 3
Austin, TX · Remote
Austin, TX 78752 (Remote) Duration: 12 months contract The following describes the work that will ... Analyze logs, system messages, thread connectivity, memory utilization, disk input\/output, and ...
New
Senior Software Engineer - SAI/SDK
Austin, TX · On-site +1
$121K - $160K/yr
Conduct code reviews, mentor junior engineers, and establish best practices for SAI/SDK development ... This is a remote position for employees residing within the United States. We offer a competitive ...
Senior Software Engineer - SAI/SDK
Austin, TX · On-site +1
$121K - $160K/yr
Conduct code reviews, mentor junior engineers, and establish best practices for SAI/SDK development ... This is a remote position for employees residing within the United States. We offer a competitive ...
Staff Engineer
Austin, TX · On-site +1
$80K - $400K/yr
... review cycle, and shape and contribute to the engineering culture as a place to learn and grow ... Definition, utilization and implementation of CI/CD pipelines * Experience with SOA, Microservices ...
Quick apply
Staff Engineer
Austin, TX · On-site +1
$80K - $400K/yr
... review cycle, and shape and contribute to the engineering culture as a place to learn and grow ... Definition, utilization and implementation of CI/CD pipelines * Experience with SOA, Microservices ...
Staff Engineer
Austin, TX · On-site +1
$80K - $400K/yr
... review cycle, and shape and contribute to the engineering culture as a place to learn and grow ... Definition, utilization and implementation of CI/CD pipelines * Experience with SOA, Microservices ...
Staff Engineer
Austin, TX · On-site +1
$80K - $400K/yr
... review cycle, and shape and contribute to the engineering culture as a place to learn and grow ... Definition, utilization and implementation of CI/CD pipelines * Experience with SOA, Microservices ...
Java Developer
Austin, TX · On-site +1
$51.50 - $66.50/hr
Analyze logs, system messages, thread connectivity, memory utilization, disk input/output, and disk ... Remote** Minimum Requirements: Candidates that do not meet or exceed the minimum stated ...
Java Developer
Austin, TX · On-site +1
$51.50 - $66.50/hr
Analyze logs, system messages, thread connectivity, memory utilization, disk input/output, and disk ... Remote** Minimum Requirements: Candidates that do not meet or exceed the minimum stated ...
Java Developer
Austin, TX · On-site +1
$51.50 - $66.50/hr
Analyze logs, system messages, thread connectivity, memory utilization, disk input/output, and disk ... Remote** Qualifications Minimum Requirements: Candidates that do not meet or exceed the minimum ...
Java Developer
Austin, TX · On-site +1
$51.50 - $66.50/hr
Analyze logs, system messages, thread connectivity, memory utilization, disk input/output, and disk ... Remote** Qualifications Minimum Requirements: Candidates that do not meet or exceed the minimum ...
Sr. Marketing Manager GTM
Austin, TX · Remote
Remote Department: Portfolio Marketing Reports to: Senior Manager, Marketing (GTM) Why Join ... Facilitate sales briefings, launch readiness reviews, field activation sessions, and post-launch ...
Sr. Marketing Manager GTM
Austin, TX · Remote
Remote Department: Portfolio Marketing Reports to: Senior Manager, Marketing (GTM) Why Join ... Facilitate sales briefings, launch readiness reviews, field activation sessions, and post-launch ...
Remote Registered Nurse (RN) Case Manager
Austin, TX · Remote
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Austin, TX · Remote
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Austin, TX · On-site +1
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Austin, TX · On-site +1
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Senior Account Manager, SMB
Austin, TX · On-site +1
$68K - $94K/yr
WHAT YOU\'LL DO * Own the commercial relationship, empowering Braze utilization and value ... LI-Remote WHAT WE OFFER Braze benefits vary by location, and we encourage you to review our ...
Senior Account Manager, SMB
Austin, TX · On-site +1
$68K - $94K/yr
WHAT YOU\'LL DO * Own the commercial relationship, empowering Braze utilization and value ... LI-Remote WHAT WE OFFER Braze benefits vary by location, and we encourage you to review our ...
Project Scheduler
Lockhart, TX · On-site +1
... utilization. * Perform other scheduling functions in support of Project Services and broader ... remote project teams. Skills & Competencies * Ability to review, analyze, and update project ...
Project Scheduler
Lockhart, TX · On-site +1
... utilization. * Perform other scheduling functions in support of Project Services and broader ... remote project teams. Skills & Competencies * Ability to review, analyze, and update project ...
Remote Weekend Utilization Review information
See Austin, TX salary details
$21.21 - $25.50
2% of jobs
$25.50 - $29.78
9% of jobs
$32.72 is the 25th percentile. Wages below this are outliers.
$29.78 - $34.07
21% of jobs
The median wage is $37.54 / hr.
$34.07 - $38.36
23% of jobs
$38.36 - $42.65
13% of jobs
$45.99 is the 75th percentile. Wages above this are outliers.
$42.65 - $46.94
10% of jobs
$46.94 - $51.23
8% of jobs
$51.23 - $55.52
5% of jobs
$55.52 - $59.81
5% of jobs
$59.81 - $64.10
2% of jobs
$64.10 - $68.38
2% of jobs
$21
$41
$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.
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- Flex Schedule Remote Utilization Review Nurse
- Flexible Cvs Utilization Management Nurse
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Full-time
Retirement
Re-posted 17 days ago
UnitedHealth Group rating
7.6
Based on 146 frontline employees who took The Breakroom Quiz
189th of 887 rated healthcare providers
Job description
We seek a Senior PBM Strategic Account Executive who is responsible for managing the overall relationship with a health plan client.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Managing assigned accounts with a focus on client trend management, strategic plan development and execution, cultivating multi-level client relationships and management staff
- Managing client contract renewal activities with the primary goals of retaining client, obtaining multiple-year agreements and maintaining or improving profitability
- Maintaining consistent and regular client communications. Preparing and presenting regular client performance reviews, including identification of cost drivers, recommendations for cost savings opportunities, utilization and cost reports
- Prioritizes and conducts regular onsite or telephonic client meetings as appropriate to proactively review client benefits, drug utilization and trend management strategies
- Ensure that all client specific requirements are met, including but not limited to:
- Maintaining documentation of most current benefit designs, including exclusions, inclusions, formularies and co-pay structures and that information is accessible to Customer Service Pharmacy Technicians
- Documenting plan change requests from clients and obtains appropriate approval, updates the Benefit Design Summary on the web, and confirms the plan change is completed and accurate
- Following all audit requirements. Reviews Benefit Design Summary documents at least annually with clients and receives appropriate client signature approval
- Maintaining a complete understanding of client contract terms including but not limited to the monitoring and reporting of performance guarantees. Ensuring that all assigned contracts are monitored and reported as stated in the terms
- Cultivating in-group growth through these relationships
- Staying abreast of industry trends and developments and demonstrating solid communication skills in presenting these to clients and staff
- Demonstrating expertise in pharmacy benefit strategies and clinical programs
- Supervising and assisting in the development of client specific implementation plans and managing overall client implementations
- Providing leadership to client services team members in departmental and corporate initiatives
- Providing regular feedback to management team regarding client requirements and business development opportunities
- Participating in sales preparation meetings and finalist sales presentations as necessary
- Ensuring quick response and follow-up to client inquiries per contract requirements, e.g. returning phone calls and emails within 2 hours and attempted resolution of all issues in less than 48 hours
- Follows-up with client within 24 hours after issue resolution
- Regularly attending and actively participating in company meetings as requested
- Participating as preceptor/mentor to new staff as requested. Assisting in the development of ongoing training topics and materials for staff
- Following all policies and procedures relating to job responsibilities and participates in the development and maintenance of departmental policies and procedures for Client Services, as appropriate
- Performing other duties as assigned to meet corporate objectives
- Providing support to other departments as requested
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- 4+ years of strategic PBM client account and contract management
- 2+ years of experience in the Health Plan Commercial Market
- Understanding of pharmacy benefit strategies and pricing practices
- Advanced proficiency in delivering presentations to various audiences, including executive leadership
- Proficient with MS suite - Word, Excel, PowerPoint
- Proven ability to handle complex client issues
- Proven solid PBM business and financial acumen
- Proven excellent negotiation skills
- Demonstrates a high degree of client focus and attention to service
- Ability to travel up to 10% of the time
Preferred Qualifications:
- Project Management Experience/Certification
- 3+ years of experience with upsell programs to clients
- 2+ years of PBM operations experience
- Familiarity with RxClaim; Tracker and Navigator
- Experience with pharmacy rebate management and a strong understanding of rebate program operations and strategy
- Medicare Part D experience and a working knowledge of Centers for Medicare & Medicaid Services (CMS) regulations, compliance requirements, and the evolving Medicare landscape
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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About UnitedHealth Group
Sourced by ZipRecruiter
Industry
Insurance services
Company size
10,000+ Employees
Headquarters location
Minnetonka, MN, US
Year founded
1977