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Supervisor Utilization Review Remote Jobs in Toronto, ON

Cayenta

(Remote) Application Consultant

Guelph, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Markham, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Toronto, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Oakville, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Brafton

Remote Full-Time Travel Writer

Toronto, ON · Remote

CA$48K - CA$56K/yr

Your immediate supervisor would be based out of our Boston Office in the US; however, you'll be ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

Avalere Health

Copy Supervisor

Toronto, ON · On-site +1

CA$115K - CA$135K/yr

Review material produced by direct reports, as applicable, including review of final manuscripts ... Enjoy flexible working arrangements, including hybrid and remote work, along with the option to ...

True Environmental

Manager - Hydrogeology

Toronto, ON · On-site +1

CA$120K - CA$180K/yr

Remote - Regular-Full Time As the Manager - Hydrogeology, this role will be responsible for ... This role also acts as a supervisor who oversees day-to-day delivery of work of junior team members.

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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 Toronto, ON?

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

What job categories do people searching Supervisor Utilization Review Remote jobs in Toronto, ON look for?

The top searched job categories for Supervisor Utilization Review Remote jobs in Toronto, ON are:

Supervisor Utilization Review Remote jobs near you

Healthcare Workflow Specialist - Fully Remote | Upto $80/hr

Toronto, ON • Remote

Mercor
See more jobs at Mercorexternal

CA$80/hr

Full-time

Re-posted 27 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Registered Nurses (Data labelling and training)
Type: Contract
Compensation: $60–$80/hour
Location: Remote

Role Responsibilities

  • Review and assess clinical documentation for accuracy, completeness, and quality.
  • Analyze healthcare workflows and recommend process improvements.
  • Interpret patient records and clinical notes to support product development.
  • Identify documentation gaps, inconsistencies, and edge cases.
  • Collaborate with product, engineering, and operations teams to refine AI-driven healthcare tools.
  • Ensure adherence to healthcare regulations, policies, and best practices.

Qualifications

Must-Have

  • Active Registered Nurse (RN) license.
  • 3–5+ years of clinical nursing experience.
  • Strong understanding of clinical documentation and healthcare workflows.
  • Experience working with EHR systems (Epic, Cerner, Meditech, etc.).
  • Excellent analytical, communication, and problem-solving skills.

Preferred

  • Experience in CDI, case management, utilization review, or quality improvement.
  • Exposure to healthcare technology, AI tools, or digital health products.
  • Ability to collaborate effectively with cross-functional teams.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.