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Utilization Review 1099 Jobs in Puerto Rico (NOW HIRING)

Through medical record review and consultation, you will identify the medical, social, emotional ... utilization management experience * Spanish-speaking preferred in some markets DaVita IKC ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter. Additional ...

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Utilization Review 1099 information

What are some typical challenges faced by Utilization Review professionals working as 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 are the key skills and qualifications needed to thrive as a Utilization Review 1099, and why are they important?

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 is a Utilization Review 1099 position?

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 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 are popular job titles related to Utilization Review 1099 jobs in Puerto Rico? For Utilization Review 1099 jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Utilization Review 1099 jobs in Puerto Rico look for? The top searched job categories for Utilization Review 1099 jobs in Puerto Rico are:
RN Case Manager - Dallas, TX

RN Case Manager - Dallas, TX

DaVita

San Juan, PR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 16 hours ago


DaVita rating

6.9

Company rating: 6.9 out of 10

Based on 1,146 frontline employees who took The Breakroom Quiz

451st of 872 rated healthcare providers


Job description

Posting Date

04/24/20262800 N Loop WestSte 800,Houston,Texas,77092-8838,United States of America

DaVita Integrated Kidney Care (IKC) is looking for a Full-Time RN Case Manager (RN)to join us in Dallas, TX region. * Must live locally*

As a DaVita Integrated Kidney Care Registered Nurse (RN) Case Manager you will support some of our most complex patients, assisting them in navigating a challenging healthcare system. Through medical record review and consultation, you will identify the medical, social, emotional, and financial needs of your patients with CKD/ ESKD and implement appropriate interventions. You'll work autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, consistent, cost-effective care.

Position Details:

  • Location: Hybrid-Remote. Work from home (telehealth) and travel within an assigned geography for in-person visits (dialysis clinics and nephrology practices).

  • Monday- Friday schedule with the ability to accommodate patient and nephrology partner's availability. Must be flexible.

  • Full-time position.

  • Quickly build empathetic relationships with patients and families.

  • Coordinate care for patients' care including care transitions, management of complex/at risk patients, managing ongoing needs and establishing a treatment plan in partnership with the care team.

  • Identify and address social determinants of health including medical, emotional, education, community, and financial concerns.

  • Coordinate for streamlined/effective transition of care when needed.

  • Assesses patients and work to identify unreported medical conditions or changes that may lead to adverse outcomes.

Requirements:

  • Passion for delivering care to patients with complex, chronic illnesses.

  • You are flexible and are willing to pivot quickly on priorities.

  • Current RN License is required, BSN preferred.

  • Minimum of 2 years RN experience required with healthcare performance coaching.

  • Current Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS) certification.

  • Current driver's license and willingness to travel within an assigned territory.

  • Intermediate computer skills and proficiency in MS Word, Excel & Outlook required.

  • Home office with internet connectivity at a minimum of 1MB upload and 1MB download speed required.

Preferred Qualifications:

  • 2+ years of Case Management or Chronic Care Management

  • 1+ years of utilization management experience

  • Spanish-speaking preferred in some markets

DaVita IKC (Integrated Kidney Care) is comprised of an innovative team who is committed to improving patient outcomes and improving quality of life. Come work with a team of passionate professionals to transform kidney care through a value-based, person-centered, comprehensive approach to kidney care.

We provide comprehensive care and complex chronic condition management to patients nationwide, whether they are in the early stages ofkidney disease,transitioning to dialysis, seeking akidney transplant,or receiving life-sustaining dialysis.

27,000+ patients receiving IKC services every month

20 years of Integrated Kidney Care Experience

We're on a mission to revolutionize kidney care, with a vision of making integrated care the standard of care for all renal patients. To help us achieve our vision, we're investing extensively in developing both our model of care and our team. When you join DaVita IKC, you're joining a compassionate team committed to quality patient care. Through our commitment to training, growth and quality we consistently achieve superior clinical outcomes while giving teammates the opportunity to excel in an award-winning environment that enables them to thrive both professionally and personally.

What We'll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

  • Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out

  • Support for you and your family: Family resources, EAP counseling sessions, access Headspace, backup child and elder care, maternity/paternity leave and more

  • Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.

This position will be open for a minimum of three days.

The Salary Range for the role is $68,400.00-$100,400.00 per year.

For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits

Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.


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About DaVita

Sourced by ZipRecruiter

DaVita is a healthcare company that provides compassionate, quality healthcare. The company’s mission is to be the Provider, Partner, and Employer of Choice. DaVita serves more than 200,000 dialysis patients in 10 countries outside the U.S. and has over 55,000 teammates in the U.S. Since 2011, DaVita teammates have donated $11 million to local nonprofits and have volunteered over 180,000 hours since 2006. DaVita has been on Fortune’s list of the world’s most admired companies for 15 years in a row.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Denver, CO, US

Year founded

1994