ZipRecruiter

Log In

2

Supervisor Utilization Review Remote Jobs in Ohio

Miami University

Remote work is not a right, but a working arrangement that can be modified or revoked by Miami ... supervisor to follow up if necessary. * Check and correct or recalculate all incorrect GPAs in ...

New

Miamioh

Application Review Coordinator

Oxford, OH · On-site +1

Remote work is not a right, but a working arrangement that can be modified or revoked by Miami ... supervisor to follow up if necessary. * Check and correct or recalculate all incorrect GPAs in ...

New

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

RN Care Manager PRN

Cleveland, OH · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

The Ohio State University

BCBA Supervisor

Columbus, OH · On-site +1

$67K - $82K/yr

You can review the additional section on postings for documents that may be required. You will be ... Remote Location Position Type: Regular Scheduled Hours: 10 Shift: First Shift The Ohio State ...

Revel Staffing

IT Support Supervisor

Sandusky, OH · Remote

$85K - $115K/hr

We are seeking an experienced IT Support Supervisor to lead a remote team responsible for ... Review recurring support issues and identify opportunities to improve processes, reduce errors, and ...

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 ...

Relevate Health

Group Account Supervisor

OH · On-site +1

Manages finance reports and tracks project budget utilization, shares updates with team in a timely ... Participates in medical, regulatory and legal reviews as needed and owns the process by offering ...

next page

Showing results 1-20

All JobsSupervisor Utilization Review JobsSupervisor Utilization Review Remote JobsSupervisor Utilization Review Remote Jobs in Ohio

Supervisor Utilization Review Remote information

What are the key skills and qualifications needed to thrive as a supervisor utilization review remote?

To thrive as a Supervisor Utilization Review Remote, you need a solid background in clinical healthcare (often as an RN or similar), experience with utilization management, and knowledge of regulatory guidelines. Familiarity with utilization review software, electronic medical records (EMR), and certifications like CCM or URAC accreditation are typically required. Strong leadership, critical thinking, and effective communication skills help in managing teams and collaborating across departments. These skills ensure efficient review processes, compliance with regulations, and high-quality patient care management in a remote setting.

What is the difference between Supervisor Utilization Review Remote vs Utilization Review Nurse?

AspectSupervisor Utilization Review RemoteUtilization Review Nurse
CredentialsRN license, possibly supervisor certificationRN license, certification in utilization review often preferred
Work EnvironmentRemote, supervisory role overseeing review teamsRemote or onsite, performing case assessments
Employer & IndustryHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare providers

The Supervisor Utilization Review Remote typically oversees review teams and manages processes, requiring leadership skills and certifications. In contrast, Utilization Review Nurses focus on case assessments and approvals, often with similar certifications but less managerial responsibility. Both roles are essential in healthcare utilization management, often working remotely within the same industry.

What are some common challenges faced by remote supervisor utilization review professionals, and how can they be effectively managed?

Remote Supervisor Utilization Review professionals often encounter challenges such as coordinating with distributed team members, ensuring consistent application of review criteria, and maintaining clear communication with both clinical staff and payers. To manage these, it's important to establish regular virtual meetings, utilize secure and efficient digital platforms for case tracking, and foster a culture of transparency and accountability. Additionally, investing time in ongoing training and encouraging peer collaboration can help supervisors stay updated on regulatory changes and best practices.

What does a supervisor utilization review remote do?

A Supervisor Utilization Review (Remote) oversees a team responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients—often for insurance or healthcare organizations. This role ensures that utilization review processes comply with regulatory requirements and organizational standards, while also guiding and supporting staff in their daily activities. Working remotely, the supervisor collaborates with clinicians, case managers, and other stakeholders to facilitate quality patient care and manage healthcare costs. The supervisor may also handle escalated cases and ensure timely completion of reviews.

What are popular job titles related to Supervisor Utilization Review Remote jobs in Ohio?

For Supervisor Utilization Review Remote jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Supervisor Utilization Review Remote jobs in Ohio look for?

The top searched job categories for Supervisor Utilization Review Remote jobs in Ohio are:

What cities in Ohio are hiring for Supervisor Utilization Review Remote jobs?

Cities in Ohio with the most Supervisor Utilization Review Remote job openings:

Supervisor Utilization Review Remote jobs near you

Pre Access Specialist

Akron Children's Hospital

Akron, OH • On-site, Remote

Full-time

Re-posted 17 days ago

Akron Children's Hospital rating

7.4

Company rating: 7.4 out of 10

Based on 97 frontline employees who took The Breakroom Quiz

348th of 1,059 rated hospitals

Job description

Full-time, 40 hours/week
11:30am-8:00pm
Fully Remote but Onsite in Mahoning Valley for 60 days training
Summary:
Pre Access Specialist is responsible for performing functions to facilitate the patient's seamless movement through the Revenue Cycle process. This role ensures demographic and insurance requirements are current, supports reimbursement processes, and minimizes claim denials by verifying coverage and communicating details downstream accurately and efficiently.
Responsibilities:
1. Manage Epic work queues and reports for Pre-Access tasks; to make outbound calls or send communications to patients and/or responsibility parties to collect information to update Epic and/or share information within required timeframes, etc.
2. Register complete and accurate demographic, guarantor and financial information to create the patient's record in the system for billing purposes.
3. Verify patient insurance coverage and eligibility using electronic systems or payer portals or phone calls.
4. Process, triage and document incoming calls, voicemails, faxes, and/or emails per standard protocols in the appropriate system or tool.
5. Apply approved scripting for patient interactions and handle unique scenarios professionally.
6. Collaborate with Patient Access team members, clinical departments, case management, utilization review, and clinical teams to gather necessary information and expedite services when needed.
7. Escalate issues related to coverage, status, denials, delays or repeated trends to leadership for review.
8. Create and send estimates as needed or refer cases to Financial Counseling when potential for patient liability exists.
9. Meet departmental standards for productivity, quality, and timeliness.
10. Other Duties as assigned
Other information:
Technical Expertise
1. Knowledge of medical terminology, CPT/ICD-10 codes, and pediatric insurance benefits
2. Strong interpersonal communication skills to support families with empathy and clarity
3. Ability to navigate multiple systems (EHR, payer portals); Epic experience preferred
4. Strong understanding of insurance types (Medicare, Medicaid, commercial, managed care)
5. Excellent communication, organizational, and time management skills
6. Ability to work independently in a fast-paced environment.
7. Familiarity with EHR systems (e.g., Epic, Cerner) and payer portals and guidelines (i.e. Medicaid, managed care, and commercial plans)
Education and Experience
1. High school diploma or equivalent required; associate degree or healthcare certification preferred.
2. Minimum 1 year in a Clinical, Revenue Cycle, Patient Access or Insurance company role that perform work related to; registration, insurance verification, billing, scheduling, patient service rep, customer service, etc. required.
3. Pediatric healthcare access roles preferred.
4. Certification in healthcare access (e.g., CHAA or CMAA) preferred.
5. Experience in hospital admissions or emergency department settings preferred.
• Familiarity with pediatric insurance policies, including Medicaid, managed care, and commercial plans preferred.
Full Time
FTE: 1.000000
Status: Remote

What Akron Children's Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Akron Children's Hospital logo

About Akron Children's Hospital

Sourced by ZipRecruiter

Akron Children's Hospital has been caring for children since 1890, and our pediatric specialties are ranked among the nation's best by U.S. News & World Report. With two hospital campuses, regional health centers and more than 50 primary and specialty care locations throughout Ohio, we're making it easier for today's busy families to find the high-quality care they need. In 2020, our health care system provided more than 1.1 million patient encounters. We also operate neonatal and pediatric units in the hospitals of our regional health care partners. Every year, our Children's Home Care Group nurses provide thousands of in-home visits, and our School Health nurses manage clinic visits for students from preschool through high school. With our Quick Care Online virtual visits and Akron Children's Anywhere app, we're here for families whenever and wherever they need us. Learn more at akronchildrens.org.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Akron, OH, US

Year founded

1890

View All Akron Children's Hospital Jobs

Apply