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Utilization Review 1099 Jobs (NOW HIRING)

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks ...

UHS

Utilization Review Coordinator

Augusta, GA

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

Franciscan Health

Utilization Review Coordinator

Work From Home Work From Home Work From Home, Indiana 46544 The Utilization Review Coordinator performs admission screening for patients in a bed for medical necessity, and reviews for ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

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All JobsUtilization Review 1099 Jobs

Utilization Review 1099 information

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How much do utilization review 1099 jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for utilization review 1099 in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.

More about Utilization Review 1099 jobs
What cities are hiring for Utilization Review 1099 jobs? Cities with the most Utilization Review 1099 job openings:
What states have the most Utilization Review 1099 jobs? States with the most job openings for Utilization Review 1099 jobs include:
What job categories do people searching Utilization Review 1099 jobs look for? The top searched job categories for Utilization Review 1099 jobs are:
Utilization Review 1099 jobs near you
Utilization Review Specialist

Utilization Review Specialist

Mindful Health

Remote

$25 - $30/hr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 17 days ago

Job description

Utilization Review Specialist
Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks and mortar locations and virtual service offerings across the state of Texas to create a high-end client experience.
Mindful Health creates an atmosphere that supports and values our clients and team members. Our commitment is to cultivate a place that provides intentional and exceptional care for our clients and a warm and nurturing environment for our team so we can make a lasting impact in our communities. We believe that health encompasses the whole person, mind, and body, and our clinical programming is built around this belief. We work to empower clients to live fuller and healthier lives. We maintain these same beliefs in developing and supporting our Mindful Health team. We seek enthusiastic individuals passionate about helping clients and value working in a team environment. Please visit our website for more information about our services, locations and team at www.mindful.health.
Job Summary:
Utilization Review Specialist: Responsible for ensuring adherence to Mindful Health’s utilization review plan by evaluating the efficiency, effectiveness, and medical necessity of outpatient services, including admissions and extended treatment. *Must reside in Texas*
Duties/Responsibilities:
  • Establish processes to verify the medical necessity and appropriateness of outpatient admissions
  • Conduct concurrent reviews to ensure extended stays are justified and properly documented
  • Track patient lengths of stay and continued-stay days
  • Refer non-compliant cases to the Physician Advisor for further evaluation
  • Collaborate with the Utilization Review Committee to identify and resolve review-related issues
  • Flag quality-of-care concerns and escalating them to the Quality Assurance Committee
  • Coordinate with Social Services to support timely discharge planning
  • Prepare and present monthly utilization reports and key metrics
Required Skills:
  • Strong verbal and written communication abilities
  • Exceptional organizational skills and keen attention to detail
  • Proven time management skills with the ability to meet deadlines consistently
  • Proficiency in Microsoft Office Suite and related software applications
Education and Experience:
  • Associate's or Bachelor’s degree in a healthcare related field preferred
  • 1–2 years of experience in utilization review
  • Active CPR certification
Physical Requirements:
  • Ability to sit at a desk and work on a computer for extended periods
  • Capable of lifting, holding, pushing, and pulling up to 15 pounds
  • Proficient in typing, navigating, and viewing monitors for prolonged durations
  • Visual acuity to view monitors with close vision, color perception, depth perception, and focus adjustment
  • Effective verbal and written communication skills to engage with patients, team members, and customers
  • Ability to read, write, and comprehend information through active listening
  • Consistent performance of essential job functions in accordance with ADA, FMLA, and applicable federal, state, and local regulations, including meeting productivity standards
  • Reliable and punctual attendance aligned with workplace standards
  • Flexibility to work at multiple locations during a scheduled work week
  • Mobility to move throughout the office or client sites to assist patients as needed
Mindful Health offers:
  • A healthy amp; positive atmosphere where everyone is valued.
  • Schedule: Monday-Friday, 8AM-5PM CST
  • Salary: $25.00 - $30.00 / hr

Benefits:
  • 120 hours (15 days) of paid time off annually
  • 9 paid holidays
  • 40 hours (5 days) of sick leave
  • 24 hours (3 days) of bereavement leave per occurrence
  • Comprehensive medical and supplemental health insurance, including vision, dental, life insurance, amp; both short- and long-term disability
  • Opportunities for professional development and continued education

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. Employee signature below indicates the employee’s understanding of the requirements, essential functions, and duties of the position.

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