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Supervisor Utilization Review Remote Jobs in West Virginia

Utilization Review; Case Management; UR; UM; remote; work from home; hospitalist; emergency ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Utilization Review; Case Management; UR; UM; remote; work from home; hospitalist; emergency ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

$20.75 - $28.50/hr

... utilization reviews, audits and more. We are looking for someone who can provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

$20.75 - $28.50/hr

... utilization reviews, audits and more. We are looking for someone who can provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

$17.25 - $23.25/hr

... coding audits, utilization reviews, demand package reviews, and provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

$17.25 - $23.25/hr

... coding audits, utilization reviews, demand package reviews, and provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

Nurse Case Manager

Charleston, WV · On-site +1

$55K - $110K/yr

One year of experience in nurse case management, medical case management, utilization review ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Member Services Processing Supervisor

WV · On-site +1

$23.30 - $28.75/hr

Review completed work for quality and completeness,identifyingtrends, gaps, or training needs ... Remote Clearance: Public Trust Travel: 0-10% Preferred Qualifications * Background supporting ...

Posted today

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

Review and correct incoming Release of Information (ROI) forms, which are incomplete or incorrect ... Assign requests to appropriate records team members based on workload and utilization metrics. 4. ...

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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 are popular job titles related to Supervisor Utilization Review Remote jobs in West Virginia?

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

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

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

Infographic showing various Supervisor Utilization Review Remote job openings in West Virginia as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Physician, Inpatient Denials Management (FT/M-F/REMOTE)

Remote


CorroHealth
Health Care and Social Assistance • 1 - 5K employees

8.1

Company rating: 8.1 out of 10

Based on 27 frontline employees who took The Breakroom Quiz

107th of 496 rated business services

People enjoy working here

Good employer

Paid breaks


Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago


Job description

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member. This is a remote position As a Medical Director, Denials Management you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to client hospitals. You will perform clinical case reviews and provide recommendations that focus on establishing the appropriate admission status. CorroHealth offers a career path that allows you to continue using your clinical knowledge, drive value to hospitals while providing you with a predictable schedule. This opportunity allows for the work/life balance you desire while expanding your knowledge base in Utilization Review. Because our workflows rely on multiple digital platforms, success in this role requires strong foundational computer skills and the ability to learn new technology quickly. The Impact You Will Have: CorroHealth is led by like-minded clinicians who share the same innate calling to help. Hospitals nationwide have recently struggled with managing complex and unforeseen challenges such as global pandemics, complex regulatory updates, and downstream policy changes set forth by Medicare and private payer organizations - resulting in financial difficulty. CorroHealth physicians lead challenging and rewarding careers by providing our hospital clients with guidance to improve compliance and ensure appropriate payment for the care delivered. The impact of your role will allow attending physicians to focus on what is most important, providing dedicated care to the patients they serve. Annual Compensation Range: Around 225k or greater (includes salary + uncapped bonus) (40-hour workweek) Your Schedule: Training (The first 3-4 weeks):
  • Training will occur Monday-Friday 9A-5P ET
After Completion of Training:
  • Schedule will be Monday-Friday, anywhere between 8a-5p ET to 10a-7p ET.
  • Each of your shifts will be 9 hours in length, which includes one hour of dedicated break time.
Working at CorroHealth:
  • All necessary hardware and software is provisioned to each of our Medical Directors
  • You have the ability to work remotely in a comfortable environment
In This Role You Will:
  • Perform Peer-to-Peer case discussions with payer medical directors
  • Utilize clinical expertise to identify the salient points within a case review
  • Perform focused real-time and post-discharge hospital case reviews in hospital's EMR
  • Identify areas of process improvements and inefficiencies
  • Perform related duties and projects as assigned
Do You Have What It Takes?
  • MD or DO degree with strong clinical knowledge
  • Active unrestricted medical license in at least one state within the United States
  • Required specialization in Adult Internal Medicine, Emergency Medicine, Hospitalist, Nephrology, HEM/ONC, General Surgery, Family Practice, Critical Care or Infectious Disease; Board certification (preferred)
  • At a minimum, 1 year of acute care adult hospital experience in a US hospital within the past 5 years or recent relevant physician advisor experience
  • Working knowledge of hospitals' EMR
  • Computer proficient
  • Excellent verbal and written communication skills
  • Team Player
We Offer:
  • Quality of life with a remote predictable, full-time schedule
  • Comprehensive training and education program
  • Opportunities for career growth within the organization
  • Salary plus bonus opportunities
  • Medical, Dental, Vision coverage, 401K
  • Holidays, paid time off, long-term disability insurance, and life insurance
  • Allowance for CME and/or license renewals
KEYWORDS: Physician; MD; DO; non-clinical; Physician Advisor; Utilization Management; Utilization Review; Case Management; UR; UM; remote; work from home; hospitalist; emergency medicine; inpatient; acute care; board certified PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member's function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.


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