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Utilization Review 1099 Jobs in Rio Rancho, NM (NOW HIRING)

Alta Mira NM

Registered Nurse

Albuquerque, NM · On-site

Routine review of MAR * Tracking/reporting all adverse medication events/errors * Monitor utilization of PRN medications. * Monitor the accuracy and implementation of an individuals healthcare plan ...

Altamira NM

Registered Nurse

Albuquerque, NM · On-site

$43/hr

Routine review of MAR * Tracking/reporting all adverse medication events/errors * Monitor utilization of PRN medications. * Monitor the accuracy and implementation of an individual's healthcare plan ...

divvyDOSE

Registered Nurse - Albuquerque, NM

Albuquerque, NM · On-site

$43.53 - $65.29/hr

Adheres to and participates in the agency's utilization management model You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction ...

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All JobsUtilization Review 1099 JobsUtilization Review 1099 Jobs in Rio Rancho, NM

Utilization Review 1099 information

See Rio Rancho, NM salary details

$20

$39

$64

How much do utilization review 1099 jobs pay per hour?

As of Jul 12, 2026, the average hourly pay for utilization review 1099 in Rio Rancho, NM is $39.77, according to ZipRecruiter salary data. Most workers in this role earn between $31.44 and $45.67 per hour, depending on experience, location, and employer.

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 Rio Rancho, NM? For Utilization Review 1099 jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Utilization Review 1099 jobs in Rio Rancho, NM look for? The top searched job categories for Utilization Review 1099 jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Utilization Review 1099 jobs? Cities near Rio Rancho, NM with the most Utilization Review 1099 job openings:
Utilization Review 1099 jobs near you
Registered Nurse

Registered Nurse

Alta Mira Specialized Family Services

Albuquerque, NM • On-site

Other

Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Alta Mira Specialized Family Services

Alta Mira is a non-profit organization that has been supporting individuals with developmental or intellectual delays or disabilities, and their families, since 1985. We provide services to all age groups. We support over 800 children annually in our Early Intervention Program and 1500 adults in our Family Support Services. We employ over 70 people and have 250 independent contractors. We are an excellent employer with a high level of schedule flexibility and very rich benefits. We are one of New Mexico's Top Workplaces in the category of work/life balance.

Some of our benefits include:

  • Paid Time Off – from 150 to 304 hours a year
  • Paid Sick Leave - 1 hour for every 30 hours worked
  • Paid Holidays – 5 holidays per year
  • Winter Break – agency is closed from December 24th through New Year's Day (paid)
  • Educational Leave – 40 hours after 6 months of employment
  • Bereavement Leave – up to 24 hours
  • Medical – 3 plans to choose from through BCBS, ranging in premiums from $0 to $159.21.
  • Dental - free
  • Vision – vision through VSP at $2.05
  • SIMPLE IRA – Matched $1 for $1 by the agency for the first 3% of an employee's annual pay
  • Roth IRA - employees can also contribute to a Roth IRA
  • Group life and Long-Term Disability – agency pays for 25K
  • Individual life and Short-Term Disability – available, paid by employee
  • Mileage reimbursement - $0.70 per mile, if required to drive during work hours for work purposes
  • Discount Program
  • Public Service Loan Forgiveness through the Federal government.
Position Summary

Consults with and provides nursing services to families within the Alta Mira Specialized Family Services. Acts as a consultant and trainer for staff and families regarding health issues and concerns.

Skills

Bilingual in Spanish and English preferred. Reliable transportation required. Able to travel up 50% of the time. Able to work as a trans-disciplinary team member.

Experience/Education

A current New Mexico Registered Nurse License is a must. CPR Certification. Exposure Category: III. The normal work routine may involve exposure to blood, body fluids, or tissues.

Position Responsibilities

Position Specific Essential Job Functions

Performs essential job functions with or without reasonable accommodation at an acceptable level.

  1. Collect accurate data regarding health status for individuals served.
  2. Oversight and monitoring of medications
    • Routine review of MAR
    • Tracking/reporting all adverse medication events/errors
  3. Monitor utilization of PRN medications.
  4. Monitor the accuracy and implementation of an individual's healthcare plan and other medical documents.
  5. Train agency direct support staff and Service Coordinators on individual health care plans.
  6. Develop client-specific crisis prevention plans for clients with chronic conditions that have the potential to move into a life-threatening situation.
  7. Serve as a resource for the treatment team on diagnosis, medications, tests, treatments, or service options.
  8. Responsible for taking on-call when needed.
  9. Perform and document clinical nursing assessments as needed whenever a client's clinical or functional status changes.
  10. Maintain, evaluate, and interpret cumulative health data.
  11. Take on-call once a month.
  12. Attend ISP meetings on all individuals with 4, 5, or 6 on HAT or who have active, unstable medical conditions.
  13. Complete and maintain American Heart Association CPR certification.
  14. Performs other duties as required or assigned.

Position will be open until filled

At Alta Mira Specialized Family Services, we value the diversity of our workforce and actively seek opportunities within our agency. We believe a diverse workforce enriches our environment and helps us better meet the needs of our employees, customers, and providers. We remain committed to attracting and embodying the agency's purpose.

Alta Mira Specialized Family Services is an Equal Opportunity/Affirmative Action employer. Women, minorities, people with disabilities, and veterans are encouraged to apply.

Apply