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Utilization Review Coordinator Remote Jobs in California

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...

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Utilization Review Coordinator Remote information

What does a utilization review coordinator do when working remotely?

A Utilization Review Coordinator working remotely is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and procedures. They review medical records, treatment plans, and insurance policies to ensure compliance with regulations and that patients receive proper care without unnecessary costs. Remote UR Coordinators collaborate with healthcare providers, payers, and patients primarily through electronic records and virtual communication, maintaining strong organizational and analytical skills. Their goal is to optimize patient outcomes while managing healthcare resources effectively.

How does a utilization review coordinator typically collaborate with healthcare providers and insurance companies?

As a remote Utilization Review Coordinator, you will regularly communicate with healthcare providers and insurance representatives via phone, email, and secure digital platforms. Your main responsibilities include reviewing patient records, making coverage determinations, and ensuring compliance with regulatory guidelines. Collaboration often involves clarifying medical necessity, gathering additional documentation, and participating in virtual team meetings to discuss complex cases. Strong communication skills and comfort with digital tools are essential for seamless coordination across remote teams.

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

To thrive as a Utilization Review Coordinator Remote, you need a strong background in healthcare, knowledge of medical terminology, and often an active RN or LPN license. Familiarity with utilization management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and collaborating with providers. These skills ensure accurate, efficient case reviews and compliance with regulations, which are vital for optimizing patient care and managing healthcare costs.

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Utilization Review Coordinator Remote jobs near you
Infographic showing various Utilization Review Coordinator Remote job openings in California as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Oncology Utilization Review - Remote - 1099 (contract)

MRIoA

Los Angeles, CA • On-site, Remote

Contractor

Re-posted 21 days ago

Job description

Description
Oncology Utilization Review State Medical Licenses required: Arizona, Florida, Minnesota, North Dakota, Oregon or Tennessee
Flexible Independent Contractor (1099) Opportunity
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Oncology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current State Medical License in one of the above listed states.
  • Current Board Certification in Medical Oncology
  • Must have 5 years of clinical experience, residency can be included
  • Daytime availability is required for peer-to-peer conversations

California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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