Utilization Management Remote Jobs

Find remote jobs requiring Utilization Management skills. Apply now and work from anywhere.

Utilization Management is the practice of making sure health care services are used appropriately and effectively. It involves reviewing requests for treatment, comparing care plans to clinical guidelines, coordinating among providers and payers, and following up on outcomes. The role blends clinical judgment with careful documentation and clear communication.

This skill works well for remote jobs because many tasks are digital. Reviews, record analysis, authorization decisions, and conversations with clinicians can be done by phone or video and through secure systems. Remote UM roles reward strong written communication, attention to detail, time management, and respect for patient privacy.

Industries that need Utilization Management

  • Health insurance plans and managed care organizations
  • Hospitals and health systems
  • Outpatient clinics and physician groups
  • Behavioral health and rehabilitation services
  • Telehealth providers and case management firms

How to develop or improve this skill

  • Build clinical knowledge relevant to the population you serve and learn common clinical guidelines
  • Practice clear documentation and concise written decisions
  • Gain familiarity with electronic health records and utilization review software
  • Complete training or certification in case management or utilization review when available
  • Develop data review skills to spot trends and support decisions

With experience and ongoing learning, Utilization Management can open paths to roles in care coordination, quality improvement, and remote clinical operations. Focus on communication, clinical understanding, and working securely with patient information to grow in this field.

Remote Healthcare Specialist (USRN)

Philippines
2 weeks ago
Bedside Nursing
Clinical Review
Communication
WNS Global Services
Full-Time
Experienced

Medical Director, Health Plan

United States
1 month ago
Clinical Guidelines (MCG)
Clinical Leadership/Medical Oversight
Managed Care/Health Plan Experience
Evry Health
Other
Senior Manager

Nurse, Concurrent Review

Remote
1 month ago
Clinical Collaboration
Inpatient Clinical Nursing
InterQual Criteria
WNS Global Services
Full-Time
Experienced
YEAR $75000 - $75000

Utilization Management Nurse I (Remote)

Sioux Falls, SD
5 months ago
Clinical Review
Communication
Medical Necessity
Wellmark, Inc.
Full-Time
Experienced

Medical Director – Inpatient Utilization Management

Cedar Rapids, IA
5 months ago
Clinical Review
Communication Skills
Inpatient Care
Wellmark, Inc.
Full-Time
Experienced

Medical Director, Utilization Management

USA
6 months ago
Clinical Review
Managed Care
Medical Review
UPMC
Full-Time
Experienced

Sr Medical Director – Utilization Management

Cedar Rapids, IA
6 months ago
Analytical Skills
Clinical Expertise
Communication Skills
Wellmark, Inc.
Full-Time
Senior Manager

Sr Medical Director – Utilization Management

Cedar Rapids, IA
6 months ago
Clinical Experience
Communication
Leadership
Wellmark, Inc.
Full-Time
Senior Manager

Sr Medical Director – Utilization Management (Remote)

Cedar Rapids, IA
7 months ago
Clinical Leadership
Data Analysis
Medical Appeals
Wellmark, Inc.
Full-Time
Senior Manager

Sr Medical Director – Utilization Management

Cedar Rapids, IA
8 months ago
Clinical Leadership
Data Analysis
Medical Appeals
Wellmark, Inc.
Full-Time
Manager

Sr Medical Director – Utilization Management

Des Moines, IA
8 months ago
Analytical Skills
Clinical Expertise
Communication
Wellmark, Inc.
Full-Time
Senior Manager

Utilization Management Nurse I

Des Moines, IA
9 months ago
Attention To Detail
Clinical Expertise
Clinical Knowledge
Wellmark, Inc.
Full-Time
Experienced

Sr Nurse - Clinical Education

Houston, NA
9 months ago
Clinical Education
Communication Skills
Microsoft Office Suite
WNS Global Services
Full-Time
Experienced
YEAR $80000 - $95000

Sr Nurse - Clinical Review

Houston, NA
10 months ago
Clinical Training
Communication Skills
Microsoft Office Suite
WNS Global Services
Full-Time
Experienced

Case Management Nurse I (Remote)

Des Moines, IA
1 year ago
Care Coordination
Case Management
Communication
Wellmark, Inc.
Full-Time
Experienced

Psychiatrist Physician Reviewer

Lombard, IL
1 year ago
Medicaid
Peer Review
Physician Consultation
CNSI
Part-Time
Experienced
HOUR $70 - $125

Utilization Management Nurse I

Des Moines, IA
1 year ago
Clinical Expertise
Communication Skills
Medical Policy
Wellmark, Inc.
Full-Time
Experienced

Case Management Nurse I (Remote)

Des Moines, IA
1 year ago
Care Coordination
Case Management
Communication
Wellmark, Inc.
Full-Time
Experienced

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