Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Dental UM Clinician — Prior Authorizations and Reviews

Avesis Incorporated

Brooklyn, NY
  • Remote job

Avēsis seeks a skilled Utilization Management Clinical Dental Processor to review dental x-rays and patient histories, ensuring medical necessity for prior authorizations. You will work remotely, complete 13–18 cases per hour, and document decisions per client contracts. You will import documents into our system, review histories, and collaborate with the UM team to optimize processes. Overtime may be required during peak periods. #J-18808-Ljbffr Avesis Incorporated

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Dental UM Clinician — Prior Authorizations and Reviews in Brooklyn, NY vacancy
  •  ...Provides support for clinical member services review assessment processes. Responsible for...  .... Conducts reviews to determine prior authorization/financial responsibility for Molina and...  .... Adheres to utilization management (UM) policies and procedures. Required Qualifications... 
    Remote job
    Work at office

    Molina Healthcare

    San Francisco, CA
    3 days ago
  • $40 - $42 per hour

     ...agency currently looking for a  Care Review Clinician I to work with our Managed Care Client...  ...Holidays ***This is a fully remote role but candidates must have a valid...  ...benefits and eligibility and Process prior authorization determinations within regulatory timelines... 
    Remote work
    Hourly pay
    Local area
    Monday to Friday

    AltaStaff, LLC

    Chicago, IL
    19 days ago
  •  ...Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit... 
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    2 days ago
  • $90k - $107k

     ...Health Plan Holding Company, Inc. is seeking a Remote UM Nurse to support network adequacy review and authorization activities for members in ACO, HMO, and EPO products...  ...The role requires clinical knowledge to review prior authorization requests, assess medical necessity... 
    Remote work

    your Jared

    Brooklyn, NY
    5 days ago
  • $57 per hour

    ProPivotal Staffing is seeking a Clinical Pharmacist Reviewer to work from home in Massachusetts. This role supports clinical pharmacy services and involves optimizing treatments with healthcare teams. Candidates should have 1-2 years of experience and an active Massachusetts... 
    Remote job
    Hourly pay
    Work from home
    Flexible hours

    ProPivotal Staffing

    Hingham, MA
    2 days ago
  • $23.76 - $51.49 per hour

     ...Provides support for clinical member services review assessment processes. Responsible for...  .... Conducts reviews to determine prior authorization/financial responsibility for Molina and...  ...model. Adheres to utilization management (UM) policies and procedures. Required Qualifications... 
    Remote work
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Brooklyn, NY
    2 days ago
  • $39k - $49.4k

     ...UM Administration Coordinator The UM...  ...processes. This role reviews and processes...  ...independently in a remote environment and maintain...  ...related field. Prior customer service,...  ...Management, Prior Authorization, Care Management,...  ...provides medical, dental and vision... 
    Remote work
    Bi-weekly pay
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office

    Minnesota Jobs

    Saint Paul, MN
    3 days ago
  •  ...seeking an experienced Utilization Management (UM) Registered Nurse to support outpatient utilization review and prior authorization activities for a leading healthcare...  ...interdisciplinary teams.Ability to work independently in a remote environment.Comfortable using multiple... 
    Remote work
    Contract work

    US Tech Solutions

    Canton, MA
    2 days ago
  • $30 - $34 per hour

     ...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway...  ...- $34.00 / hour Department: HS - UM This is a fully remote position....  ...One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient... 
    Remote work
    Hourly pay
    Monday to Friday

    Astrana Health

    California, MO
    4 days ago
  • $40k - $52.3k

     ...for the Bilingual Telephonic UM Coordinator role at...  ...Experience with Utilization Review and/or Prior Authorization, preferably within a managed...  .... Travel: While this is a remote position, occasional travel...  ..., Humana provides medical, dental and vision benefits, 401(k)... 
    Remote work
    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office
    Monday to Friday
    Night shift
    Weekend work

    CarePlus Health Plans

    Columbus, OH
    3 days ago
  •  ...Job Title External Physician Reviewer Job Type Occasional Category Medical Services Location Work from Home...  ...AFMC is looking to contract with physicians to complete prior authorizations and retrospective reviews on a home laptop or desktop computer... 
    Remote work
    Full time
    Contract work
    Local area
    Work from home

    Arkansas Foundation for Medical Care

    United States
    2 days ago
  •  ...Utilization Review NurseThis position has a remote option for those living close and will be able to come...  ...admission, concurrent, and retrospective UM related reviews and functions....  ...Others, or Leader of Leaders.The prior authorization role completes an assessment of a... 
    Remote work
    Full time

    CHRISTUS Health

    Alamogordo, NM
    2 days ago
  •  ...UM Review Assistant Location: CA (remote) Duration: 6 months Provide primary non-clinical program support by encompassing provider training, customer service, call triaging, authorization preparation, data entry, and the development and tracking of functions for... 
    Remote work
    Contract work
    Work experience placement
    Work at office
    Flexible hours

    Hire Talent

    McLean, VA
    15 hours ago
  •  ...consulting. We are seeking an experienced Case Reviewer to join our healthcare consulting practice. The role is fully remote within the US, however must be located in...  ...review and medical management of prior authorizations for plans of service. This position requires... 
    Remote work
    Local area
    Work from home

    Jobless

    Columbia, MD
    3 days ago
  •  ...healthcare staffing firm is seeking a Pharmacy Technician to support retail pharmacy operations remotely. This role involves processing prescriptions, performing prior authorization reviews, and coordinating care for patients. Candidates should have at least 2 years in retail... 
    Remote work

    The Judge Group

    United States
    1 day ago
  • $27.02 - $48.55 per hour

     ...Position Purpose: Performs concurrent reviews, including determining member's overall...  ...member. Key Details: The position is remote/work from home; applicants must hold an...  ...inpatient only, and will be cross trained for Prior Authorization. The work schedule is Monday -... 
    Remote work
    Hourly pay
    Full time
    Part time
    Work at office
    Work from home
    Monday to Friday
    Flexible hours

    Centene Corporation

    Springfield, IL
    5 days ago
  •  ...Detail-oriented and knowledgeable, the full-time remote Utilization Review Coordinator will manage client insurance authorization processes for Spravato and TMS services,...  ...guidelines. Key responsibilities Obtain and manage prior authorizations for Spravato and TMS services... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    3 days ago
  • A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and 2-4 years experience in... 
    Remote work
    Contract work

    SPECTRAFORCE

    United States
    1 day ago
  • $85.99k - $105.34k

     ...-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams. Applicants... 
    Remote work
    Full time

    Umpqua Health

    Roseburg, OR
    4 days ago
  • A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy...  ...will be responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a... 
    Remote work

    Global Channel Management

    United States
    1 day ago
  •  ...Resources Management Location: 100% Remote Schedule: M-F 9:00am to 5:30pm with...  ...benefits and eligibility Process prior authorization determinations within regulatory timelines...  ...medical necessity/utilization review and other utilization management activities... 
    Remote work
    Contract work

    Integrated Resources

    Springfield, IL
    15 hours ago
  • American Health Holding, Inc. (AHH) offers a fully remote Utilization Management Nurse Consultant role focused on medical review for members. You will apply clinical judgment to assess necessity and collaborate with providers to ensure timely care. This desk-based position... 
    Remote job

    Santa Barbara Cottage Hospital

    New York, NY
    3 days ago
  •  ...Position Title: Clinical Review Nurse - Prior Authorization Assignment Duration: 6 months; potential to extend/convert Work Schedule: OT as...  ...Mon - Fri / Possible holiday shifts Work Arrangement: Remote-Central Time Zone preferred Responsibilities: Centralized... 
    Remote work
    Shift work

    Spectraforce Technologies

    Raleigh, NC
    15 hours ago
  •  ...Washington DC area, is seeking an experienced Case Reviewer to join our healthcare consulting practice. This fully remote role allows you to work from anywhere in the...  ...perform utilization review and medical management of prior authorizations, ensuring #J-18808-Ljbffr Jobless
    Remote job

    Jobless

    Brooklyn, NY
    3 days ago
  • $150 per hour

    Mercor is seeking a Prior Authorisation Manager to manage end-to-end workflows for medical...  ...in San Francisco, the role entails reviewing clinical documentation and coordinating with...  ...communication skills are essential. This is a remote contract position offering $150/hour. #J... 
    Remote job
    Contract work

    Mercor Inc

    San Francisco, CA
    2 days ago
  • $47 - $65 per hour

     ...service team focused on prior authorization and pre-service utilization review. This role oversees day-...  ...processes. Support the UM Pre-Service Director and...  ...including when working remotely from another state....  ...the following: Medical, dental & vision Critical Illness... 
    Remote job
    Contract work
    Temporary work
    Monday to Friday

    Actalent

    Redlands, CA
    4 days ago
  •  ...Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization...  ...will manage a caseload, communicate with clinicians and patients, and help minimize delays... 
    Remote job
    Full time

    University of Miami

    New York, NY
    4 days ago
  •  ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential for Extension) About the Role We are seeking an experienced Clinical Review Nurse for Prior Authorization... 
    Remote work
    Contract work

    SPECTRAFORCE

    Washington DC
    2 days ago
  •  ...About the job Remote Coverage Review Pharmacist Remote Coverage Review Pharmacist needs 3 years and Doctor of Pharmacy (PharmD...  ...and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances focused on medications... 
    Remote work
    Work at office

    Global Channel Management

    United States
    3 days ago
  •  ...Behavioral Health Utilization Management Clinician Location Florida (Remote) Job Description This...  ...medical necessity/utilization review and other utilization management...  ...hospitalization and/or procedures, providing prior authorizations and/or concurrent review. The... 
    Remote work
    Work at office

    Saviance

    United States
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Dental UM Clinician — Prior Authorizations and Reviews. Be the first to apply!