Utilization Management Specialist
Remote · USContract$27–30/hrSeen todaySeen in employer's feed today
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At a glance
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Job overview
The Utilization Management Specialist conducts non-clinical authorization reviews and supports timely, accurate decisions for members, providers, and care management teams. The role includes communicating outcomes, gathering information, documenting decisions, routing cases for clinical evaluation, and supporting prior authorization activities. It is a remote contract opportunity with a stated pay rate of $27–$30 per hour and requires at least three years of relevant experience.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Make an impact behind the scenes in healthcare by helping ensure members receive timely access to the medications and services they need. If you're detail-oriented, thrive in a high-volume environment, and have experience in utilization management, healthcare insurance, or pharmacy operations, this remote opportunity offers a chance to grow with a leading healthcare organization.
Location: Remote*
Pay Rate: $27-$30/hour
Employment Type: Contract
Schedule: Monday-Friday, 8:00 AM-5:00 PM
Why This Role Matters
As a Utilization Management Specialist, you'll play a key role in the authorization review process, helping ensure accurate and timely decisions while supporting providers, members, and internal care management teams. Your work will directly contribute to operational efficiency, regulatory compliance, and a positive healthcare experience for members.
What You'll Do
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Conduct non-clinical reviews of authorization requests using established criteria and guidelines
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Communicate review outcomes to providers and members according to department protocols
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Document review decisions accurately and analyze non-clinical information to support determinations
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Reach out to providers and members to obtain information needed to complete reviews
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Refer cases requiring clinical evaluation to nurses or Medical Directors
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Review authorizations for accuracy to help prevent claims payment issues
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Support care management activities by completing member and provider outreach to meet CMS requirements
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Process and route incoming faxed documentation to appropriate teams for review and action
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Serve as a subject matter expert on non-clinical utilization management processes
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Handle periodic inbound calls from Tier 1 support teams and assist with prior authorization activities
What We're Looking For
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A current, up-to-date resume
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High school diploma or GED
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3+ years of experience in utilization management, healthcare insurance, retail pharmacy, or a related healthcare field
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Experience working in a high-volume, fast-paced environment
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Strong utilization management experience
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Exceptional attention to detail and documentation accuracy
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Ability to navigate multiple systems and portals while managing competing priorities
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Medicare experience preferred
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Retail Pharmacy Technician experience preferred
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Strong verbal and written communication skills
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Ability to meet compliance requirements
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Must be eligible and provide proof of eligibility to work in the US
What's In It For You
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Competitive pay rate of $27-$30/hour
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Fully remote work opportunity with preference for North Carolina candidates
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Structured training and onboarding program
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Opportunity to gain experience with a leading healthcare organization
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Collaborative team environment with ongoing quality and performance support
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Meaningful work supporting member care and access to healthcare services
Benefits for Manpower Associates (Upon Eligibility)
Upon completion of waiting period associates are eligible for:
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Medical and Prescription Drug Plans
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Dental Plan
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Supplemental Life Insurance
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Short Term Disability Insurance
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401(k)
*** Remote Eligibility:** Remote workers must reside in one of the following states to be eligible for this remote opportunity: North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, Wyoming
ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.
How this job compares
Set against the 1,048 open Healthcare Operations jobs on Olive Jobs, counted November 3, 2026.
- Pay
- This posting$27–30/hr
- US median$28–43/hr126 hourly ranges
This range's midpoint, $28.50/hr, is 20% below the US median midpoint ($36/hr) — in the middle half of Healthcare Operations hourly ranges across the US.
- Openings
- Olive Jobs lists 27 open Healthcare Operations jobs in North Carolina and 1,048 across the US. 8% of them nationwide are listed as remote or flexible.
- Hiring the most in North Carolina
- Advocate Health6 open
- CenterWell5 open
- CVS Health2 open
- Experience
- This posting asks for at least 3 years of experience; Healthcare Operations postings that state a minimum ask for 4 years at the median (887 postings).
- Education
- This posting asks for a high school diploma; 420 of the 1,048 open Healthcare Operations jobs (40%) ask for a high school diploma or higher.
Counted across the open, public US postings on Olive Jobs on November 3, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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