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Supervisor Utilization Review Remote Jobs in Ohio

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 ...

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 ...

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 ...

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 ...

Open to remote candidates in Eastern or Central time zones. What Accounting contributes to Cardinal ... Review and approve journal entries and accounting transactions prepared by the Genpact team ...

Open to remote candidates in Eastern or Central time zones. What Accounting contributes to Cardinal ... Review and approve journal entries and accounting transactions prepared by the Genpact team ...

Open to remote candidates in Eastern or Central time zones. What Accounting contributes to Cardinal ... Review and approve journal entries and accounting transactions prepared by the Genpact team ...

Showing results 21-40

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 cities in Ohio are hiring for Supervisor Utilization Review Remote jobs? Cities in Ohio with the most Supervisor Utilization Review Remote job openings:

Optometrist - Remote

Health Partners of Western Ohio

Elyria, OH • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago


Job description

Optometrist (Remote) - School Based Outreach
This is a full-time position following the assigned school districts school year and paid all year round.
(Monday through Friday 7:30am - 4:00pm)
The school year includes all working days for teachers, including remote work days, and is subject to potential modifications throughout the school year.
POSITION PURPOSE
The Optometrist is primarily responsible for examining the eyes and other parts of the visual system. In addition, the Optometrist will also diagnose and treat visual problems and manage diseases, injuries, and other disorders of the eyes. The Optometrist will also prescribe eyeglasses or contact lenses as needed. The Optometrist will promote eye health and counsel patients on how general health can affect eyesight. Position can be located remote or hybrid.
QUALIFICATIONS
EDUCATION/CERTIFICATION: Must complete a Doctor of Optometry (O.D.) degree program from an accredited optometry school and complete all sections of the National Board of Examiners in Optometry exam. Current license to practice as a Doctor of Optometry (O.D.).
REQUIRED KNOWLEDGE: Successful completion of in-house training.
EXPERIENCE REQUIRED: Minimum of 5 years as a practicing Doctor of Optometry (O.D).
BENEFITS:
  • Paid Time Off (PTO)
  • Insurance (Medical, Dental, and Vision)
  • Paid Holidays
  • 403b Retirement with up to 8% match (starts at 3% and increases with time of service at HPWO)
  • Eligible to Apply for National Health Service Corps Loan Repayment
  • Continuing Education Money ($3,000) that can be used for license, DEA, memberships, CE classes and travel expenses.
  • Annual Raises
  • Training Opportunities
ESSENTIAL FUNCTIONS AND BASIC DUTIES:
  • Assist with establishing vision policies, quality improvement procedures, and evaluating current practices, policies, and procedures.
  • Staying abreast of changing healthcare landscape and opportunities for utilization of technologies to support the enhanced provision of vision services for patients.
  • Maintain supervision and communication with optical and support staff to optimize quality clinical care and services.
  • Provides leadership in developing the vision care plan and review of the program requirements; and recommends changes when necessary to carry out the vision plan as required.
  • Assist the Clinical Director in designing, implementing, and evaluating educational programs for the Health Partners of Western Ohio patients and vision staff.
  • Assume quality care for all patients.
  • Complete patient history and conduct eye examinations using optometric equipment and general diagnostic interpretation.
  • Diagnose sight problems, such as nearsightedness or farsightedness, and eye diseases, such as glaucoma.
  • Prescribe eyeglasses, contact lenses, and other visual aids, and if state law permits, medications.
  • Provide treatments such as vision therapy or low-vision rehabilitation.
  • Evaluate patients for the presence of other diseases and conditions, such as diabetes or hypertension, and refer patients to other healthcare providers as needed.
  • Promote eye and general health by counseling patients.
  • Analyze test results and develop a treatment plan.
  • Adhere to the highest standards of vision practice, ethics, and professionalism.
  • Recommend changes in all vision areas, and/or general areas to improve the patient flow, medical records, billing practices, and appointment practices.
  • Document all patient care provided according to policy.
  • Formulate and direct a plan of care for the patient.
  • Refer to physicians or specialists, as needed.
  • Respond to vision emergencies.
  • Other duties as required by the funding agencies to carry out contractual agreements and/or as established by the Health Partners of Western Ohio, Management and Board of Directors.
  • Must become familiar with the Federal and State rules, regulations, and practices in a Community Health Center.
  • Become familiar with Federal and State Health care program requirements and assist in carrying out these programs.
  • Assist in developing the vision care plan and review of the program requirements; and recommend changes when necessary to carry out the vision plan as required.
  • Adhere to the Health Partners of Western Ohio Integrated Health Care Philosophy.
  • Participate in Performance Improvement/Risk Management Program.
  • Utilize supplies cost-effectively while ensuring that the vision department stays within budget.
  • Participate in continuing education and professional growth.
  • Maintain knowledge of, and complies with, personnel and Vision policies and procedures.
  • Adhere to the standards and policies of the Organizational Privacy/ Security and Compliance Programs, including the duty to comply with applicable laws and regulations (HIPAA, OSHA, OIG guidelines, and other State and Federal laws).
  • Promote eye and general health by counseling patients.
  • Analyze test results and develop a treatment plan.
  • Adhere to the highest standards of vision practice, ethics, and professionalism.
  • Recommend changes in all vision areas, and/or general areas to improve the patient flow, medical records, billing practices, and appointment practices.
  • Document all patient care provided according to policy.
  • Formulate and direct a plan of care for the patient.
  • Refer to physicians or specialists, as needed.
  • Respond to vision emergencies.
  • Other duties as required by the funding agencies to carry out contractual agreements and/or as established by the Health Partners of Western Ohio, Management and Board of Directors.
  • Must become familiar with the Federal and State rules, regulations, and practices in a Community Health Center.
  • Become familiar with Federal and State Health care program requirements and assist in carrying out these programs.
  • Assist in developing the vision care plan and review of the program requirements; and recommend changes when necessary to carry out the vision plan as required.
  • Adhere to the Health Partners of Western Ohio Integrated Health Care Philosophy.
  • Participate in Performance Improvement/Risk Management Program.
  • Provide services in office and throughout community in an outreach manner.
  • May be responsible for driving HPWO vehicle to provide services.
  • Employee is to follow all policies and procedures regarding company vehicle.
  • The position is responsible for other duties as assigned.
WORK ENVIRONMENT
Work is primarily sedentary, demanding sitting, walking, lifting, and bending. Those physical movements and the degree of mobility, manual dexterity, and hand-eye coordination commonly associated with duties in an office setting will be performed repetitively. This also includes bending, twisting, reaching, lifting, pulling, pushing, and walking. The ability to distinguish letters and symbols and utilize telephones, computer terminals, fax machines, and copiers is required. The work environment characteristics described here represent those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Working under stressful conditions, as well as irregular hours, may be required.