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Supervisor Utilization Review Remote Jobs in Oklahoma

Tax Senior

Oklahoma City, OK · On-site +1

$90K - $125K/yr

... or fully remote work model. Key Responsibilities: * Prepare and review federal, state, and local ... and supervising staff * Identify tax planning opportunities and help implement tax-saving ...

Tax Manager

Oklahoma City, OK · On-site +1

$125K - $200K/yr

... remote arrangements for the right candidate. Key Responsibilities: * Lead client engagements, including planning, budgeting, and supervising tax preparation and review processes * Provide expert ...

$50K - $150K/yr

Review and authorize prescriptions, including controlled substances when legally permitted and clinically appropriate. * Be available during agreed working hours and at the end of PMHNP shifts when ...

Alabama Title Searcher (Remote)

Kansas, OK · Remote

$20.34 - $27.12/hr

No supervisory responsibilities Impact * Work under general supervision applying well established ... First American intends to conduct a review of an applicant's criminal history in connection with a ...

This role will be performed at one location (Remote) * Comfortable working in a high-volume ... Actively participate in all training that is assigned to you by your supervisor * Maintain high ...

WI Commercial Searcher (Remote)

Kansas, OK · On-site +1

$23.37 - $31.15/hr

No formal supervisory responsibility but may be a resource to less experienced team members Impact ... First American intends to conduct a review of an applicant's criminal history in connection with a ...

Showing results 21-40

Supervisor Utilization Review Remote information

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 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 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 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 cities in Oklahoma are hiring for Supervisor Utilization Review Remote jobs?

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

Chronic Care Manager (Remote - Compact States)

Harris

Kansas, OK • Remote

$10/hr

Part-time

Re-posted 27 days ago


Harris Computer rating

8.5

Company rating: 8.5 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

80th of 247 rated software companies


Job description

Remote Care Manager

Location: Remote

The Care Manager will be assigned a patient panel based on skill and efficiency level and is expected to carry a patient panel of a minimum of 30- 50 patients per calendar month within the first three months of assignment (depending on patient availability at the assigned practice location). Care Managers are expected to complete due diligence on 100% of their assigned patients and complete billable encounters on 90% of the patients they are assigned each month unless patients are unable to participate due to current health conditions.

Compensation Structure

Esrun Health utilizes a productivity-based pay structure:

$10.00 per completed patient encounter up to 99 encounters/month.

$10.25 100-149 encounters/month

$12.00 150-199 encounters/month,

$14.00 200-249 encounters/month

$16.00 >250 encounters/month.

Payment tier increases require 2 months consistency to achieve and are awarded in third month.

There is a $1/encounter incentive compensation for bilingual contractors equal to $3/hr but is only applied if hired into a bilingual position.

  • Monthly outreach will consist of cumulative time to include chart review, contact attempts (calls/texts/emails), actual call time, care coordination, and documentation/billing.
  • This time is billed out in 20-minute units of service referred to as "encounters" and each patient can be billed for up to three units of service or "encounters" each month.
  • (20-39m=1 encounter, 40-59m=2 encounters, >60m=3 encounters)
    • EXAMPLE: Chart Review 8 min

Outreach Attempts: 6 min

Actual Call:11 min

Care Coordination:9 min

Total Time Spent:44 min = 2 encounters

  • As a productivity-based position - there is no compensation outside of the billable encounters described in the compensation structure other than goal bonuses, referral bonuses, and employee engagement activities resulting in monetary prizes.
  • There is no pay for onboarding until care manager completes billable encounters. Onboarding is self-led and can be completed in as little as 3 days (2-3hrs total time for initial orientation and 1-2 days for workflow training once assigned) - but can, depending on individual schedule, take up to 14 days.

What your impact will be:

  • The role of the Care Manager is to abide by the plan of care and orders of the practice.
  • Ability to provide prevention and intervention for multiple disease conditions through motivational coaching.
  • Develops a positive interaction with patients on behalf of our practices.
  • Improve revenue by creating billable Care Management episodes, increasing visits for management of chronic conditions.
  • Develop detailed care plans for both the doctors and patients. The care plans exist for prevention and intervention purposes.
  • Understand health care goals associated with chronic disease management provided by the practice.
  • Attend regularly scheduled meetings (i.e., Monthly Clinical Update Meeting, monthly 1:1 with supervisor, etc.). These "mandatory" meetings will be important to define the current scope of work.

What we are looking for:

  • Graduates from accredited Schools of Nursing (LPN, LVN, RN, BSN, etc.)
  • Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no disciplinary actions noted or licensed in the non-compact state where the applicable practice is located.
  • A minimum of two (2) years of clinical experience in a clinic setting, Med/Surg, Case Management, and/or home health care.
  • Hands-on experience with Electronic Medical Records as well as an understanding of Windows desktop and applications (Microsoft Office 365, Teams, Excel, etc), also while being in a HIPAA compliant area in home to conduct Care Management duties.
  • Ability to exercise initiative, judgment, organization, time-management, problem-solving, and decision-making skills.
  • Ability to quickly learn new technology through video tutorials and resources in a self-led environment
  • High Speed Internet (Minimum Download - 18mbps/Upload 6mbps) and either a Desktop or Laptop computer in good working order (Has to be operation system of Windows or Mac) NO Chromebooks, iPads, or tablets
  • Excellent verbal, written and listening skills are a must.

What will make you stand out:

  • Quickly recognize condition-related warning signs.
  • Organized, thorough documentation skills.
  • Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills.
  • Clear diction. Exemplary phone etiquette applies to every call.
  • Committed to excellence in patient care and customer service.
  • Ability to troubleshoot minor technological issues related to remote working environment.

What we offer:

  • Streamline designed technology for your Chronic Care operations
  • Established and secure company since 1976, providing critical software solutions for many verticals in countries ranging from North America, Europe, Asia, and Australia.
  • Core Values that unite and guide us
  • Autonomous and Flexible Work Environments
  • Opportunities to learn and grow
  • Community Involvement and Social Responsibility

What Harris Computer employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Harris Computer Systems

Sourced by ZipRecruiter

Harris Computer Systems, based in Ottawa, ON, CA, is an established player in the field of public sector software technology. Since its inception in 1976, the company has been striving to make clients' operations more efficient through reliable, practical, and flexible software solutions. Its extensive portfolio primarily serves utility, healthcare, public sector, and educational institutions, contributing to the betterment of public services through technology. Harris strongly believes in the value of forward-thinking technology and the power it has to drive progress for the public sector. This methodology is entirely in line with their mission to ensure customer success by providing reliable, practical, and robust software solutions.

Industry

Accounting services

Company size

1,001 - 5,000 Employees

Headquarters location

Ottawa, ON, CA

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