Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Schedule: Monday-Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office ... Conducts utilization reviews of behavioral health cases to determine medical necessity ...
Care Review Nurse
Columbus, OH · On-site
... Utilization Review in hospital setting Nurses who are used to doing both production and review work All your information will be kept confidential according to EEO guidelines.
Care Review Nurse
Columbus, OH · On-site
... Utilization Review in hospital setting Nurses who are used to doing both production and review work All your information will be kept confidential according to EEO guidelines.
Care Review Nurse
Columbus, OH · On-site
... LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work Additional Information All your information will be kept confidential according to EEO ...
Care Review Nurse
Columbus, OH · On-site
... LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work Additional Information All your information will be kept confidential according to EEO ...
Work From Home Sales
Columbus, OH · On-site +1
This role is designed for individuals looking to learn a new skill and work from home with support. Responsibilities: * Connect with individuals requesting information * Provide guidance on coverage ...
Work From Home Sales
Columbus, OH · On-site +1
This role is designed for individuals looking to learn a new skill and work from home with support. Responsibilities: * Connect with individuals requesting information * Provide guidance on coverage ...
Utilization Review LVN/RN
Columbus, OH · On-site
Company Description Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a ... Analyzes clinical service requests from members or providers against evidence based clinical ...
Utilization Review LVN/RN
Columbus, OH · On-site
Company Description Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a ... Analyzes clinical service requests from members or providers against evidence based clinical ...
Work From Home - Insurance Representative
Grove City, OH · Hybrid
$57K - $72K/yr
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Insurance Representative
Grove City, OH · Hybrid
$57K - $72K/yr
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Newark, OH · On-site +1
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Newark, OH · On-site +1
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Grove City, OH · On-site +1
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Grove City, OH · On-site +1
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Grove City, OH · On-site +1
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Enrollment Specialist
Grove City, OH · On-site +1
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Benefits Representative
Newark, OH · Remote
$14.75 - $20/hr
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Benefits Representative
Newark, OH · Remote
$14.75 - $20/hr
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Benefits Representative
Newark, OH · On-site +1
$14.75 - $20/hr
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Benefits Representative
Newark, OH · On-site +1
$14.75 - $20/hr
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Services Representative
Grove City, OH · On-site +1
$15 - $20.50/hr
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Services Representative
Grove City, OH · On-site +1
$15 - $20.50/hr
With the option to work from home and enjoy a flexible schedule, you can balance your personal and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Services Associate
Newark, OH · On-site +1
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home - Client Services Associate
Newark, OH · On-site +1
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Are you looking for a work-from-home opportunity where you can grow with a company, help others ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...
Work From Home Utilization Review information
See salary details
$15.63 - $19.08
14% of jobs
$21.93 is the 25th percentile. Wages below this are outliers.
$19.08 - $22.53
14% of jobs
$22.53 - $25.98
17% of jobs
The median wage is $27.88 / hr.
$25.98 - $29.44
11% of jobs
$29.44 - $32.89
8% of jobs
$32.89 - $36.34
6% of jobs
$38.93 is the 75th percentile. Wages above this are outliers.
$36.34 - $39.79
7% of jobs
$39.79 - $43.25
7% of jobs
$43.25 - $46.70
5% of jobs
$46.70 - $50.15
5% of jobs
$50.15 - $53.61
5% of jobs
$15
$31
$53
How much do work from home utilization review jobs pay per hour?
As of Aug 28, 2026, the average hourly pay for work from home utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.
What are popular job titles related to Work From Home Utilization Review jobs?
For Work From Home Utilization Review jobs, the most frequently searched job titles are:
- Remote Utilization Review Social Worker
- Freelance Utilization Review Nurse
- Evening Optum Health Utilization Review
- Insurance Review Nurse
- Full Time Remote Utilization Review
- Per Diem Utilization Review Nurse
- Full Time Remote Utilization Review Nurse
- Behavioral Health Utilization Review Nurse
- Home Based Utilization Review Nurse
- Night Shift Remote Utilization Review Nurse
What job categories do people searching Work From Home Utilization Review jobs look for?
The top searched job categories for Work From Home Utilization Review jobs are:
- Remote Utilization Review
- Senior Specialist Cigna Utilization Review
- Full Time Utilization Review Specialist
- Remote Hca Utilization Review
- Insurance Utilization Review
- Remote Navihealth Utilization Review
- Utilization Review Coordinator Remote
- Utilization Review Salary
- Internship Remote Utilization Review
- Full Time Navihealth Utilization Review
What cities are hiring for Work From Home Utilization Review jobs?
Cities with the most Work From Home Utilization Review job openings:
What states have the most Work From Home Utilization Review jobs?
States with the most job openings for Work From Home Utilization Review jobs include:
Full-time
Re-posted 7 days ago
Nationwide Children's Hospital rating
6.9
Based on 131 frontline employees who took The Breakroom Quiz
552nd of 1,064 rated hospitals
Job description
Overview:
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
Experience:
Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
- Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
- Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
- Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
- Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
- Provides education and support regarding utilization review and management activities and processes.
- Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
- Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
- Excellent written and verbal communication and interpersonal skills.
- Excellent customer service and organizational skills.
- Working knowledge of CMS and other review agency standards.
- Proficient with software applications including CM, payer web applications, MITS, and others.
Experience:
- Three years of behavioral health experience, required.
- One year of experience in pediatric care or services, required.
- Utilization review or utilization management experience, preferred.
Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
What Nationwide Children's Hospital employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Nationwide Children's Hospital
Sourced by ZipRecruiter
Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Columbus, OH, US
Year founded
1892