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Utilization Review 1099 Jobs in Iowa (NOW HIRING)

ESSENTIAL DUTIES AND RESPONSIBILITIES • The Utilization Review Tech/Nurse is responsible for the utilization review for preadmission screenings of patients, monitoring of patient status/needs, and ...

New

Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

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Utilization Review 1099 information

What is a utilization review 1099?

A Utilization Review 1099 position refers to a healthcare professional, often a nurse or therapist, who works as an independent contractor (not a direct employee) to review medical cases for necessity and efficiency. The '1099' designation means they receive a Form 1099 for tax purposes and are responsible for their own taxes. Utilization Review specialists evaluate patient records to ensure treatments are appropriate and meet insurance or regulatory guidelines. These roles are often remote and offer flexible hours, but do not provide traditional employee benefits.

What are the key skills and qualifications needed to thrive as a utilization review 1099?

To thrive as a Utilization Review 1099 professional, you need a strong clinical background (often as a registered nurse or similar), experience with medical necessity criteria, and familiarity with insurance guidelines. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory requirements are typically required, along with URAC or CCM certification being advantageous. Excellent analytical thinking, attention to detail, and effective communication skills are essential for collaborating with healthcare providers and payers. These skills ensure accurate, efficient review of patient care for coverage decisions, compliance, and cost-effective healthcare delivery.

What are some typical challenges faced by utilization review 1099 contractors, and how can they be managed?

Utilization Review professionals working as 1099 contractors often face challenges such as fluctuating caseloads, varying client requirements, and the need to stay current with changing regulations independently. Unlike full-time employees, contractors must also manage their own schedules, billing, and sometimes provide their own resources and training. To succeed, it's important to establish clear communication with clients, maintain up-to-date credentials, and leverage professional networks or continuing education resources to stay informed about industry changes.

What is the difference between Utilization Review 1099 vs Utilization Review Nurse?

AspectUtilization Review 1099Utilization Review Nurse
CredentialsVaries; often self-employed or independent contractorsRegistered Nurse (RN) license required
Work EnvironmentRemote or freelance; contract basisHealthcare facilities, insurance companies, or clinics
Employer/Industry UsageFreelance or independent consulting in healthcareHospitals, insurance providers, healthcare organizations
Work FocusReviewing medical necessity for insurance claimsAssessing patient records, making clinical decisions

Utilization Review 1099 typically refers to independent contractors reviewing insurance claims, often working remotely. Utilization Review Nurse is a licensed RN performing clinical assessments within healthcare settings. While both roles involve utilization review, the 1099 role emphasizes independent contracting, whereas the nurse role requires clinical credentials and direct patient or clinical record involvement.

What cities in Iowa are hiring for Utilization Review 1099 jobs?

Cities in Iowa with the most Utilization Review 1099 job openings:

Infographic showing various Utilization Review 1099 job openings in Iowa as of August 2026, with employment types broken down into 89% Full Time, and 11% Contract. Highlights an 79% In-person, 5% Hybrid, and 16% Remote job distribution.

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

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Job description

Utilization Tech/Nurse
M-F 1st shift, 32 biweekly hours
8-4:30
Clinical background preferred

About VGH
Virginia Gay Hospital, established in Vinton in 1923, is an independent, nonprofit critical access hospital supported by a strong local community. The organization includes a 25-bed hospital and four family medical clinics located throughout Benton County, Iowa, offering high-quality, local healthcare and opportunities for professional growth and meaningful patient relationships.

Position Summary
  • ESSENTIAL DUTIES AND RESPONSIBILITIES
•The Utilization Review Tech/Nurse is responsible for the utilization review for preadmission screenings of patients, monitoring of patient status/needs, and notification of third-party payors, precertification of outpatient procedures, medication preauthorization and auditing charts as requested. The UR Tech/Nurse is responsible for the InterQual review of charts to assist with determination of appropriate level and length of stay.
MINIMUM QUALIFICATIONS (from job description)
•Current Iowa nursing license, preferred. Graduated from a state approved nursing program if applicable. Maintains current BCLS if indicated. Would prefer candidate to have previous education and experience as an MA/RN/LPN, Utilization Review Nurse and/or have experience in physician office preauthorization and utilization review.

Compensation amp; Benefits
  • Competitive salary
  • Health, dental, vision, life insurance, supplemental insurance
  • Retirement plan with match
  • Paid time off
  • License and Continuing Education Reimbursement available.

Equal Opportunity Statement
Virginia Gay Hospital is an equal opportunity employer.