Remote Medicaid Ops Specialist III-Epic Utilization Review
$30 - $45 per hourPyramid Consulting, Inc
Long Beach, CA
- Remote job
A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various employee benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr Pyramid Consulting, Inc
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medicaid Ops Specialist III-Epic Utilization Review in Long Beach, CA vacancy
$30 - $45 per hour
Immediate need for a talented Operations Specialist III - Medicaid / Medi-Cal (Epic + Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Long Beach , CA(Remote). Please review the job description below and contact me...Remote workEpicContract workLocal areaImmediate start$80 per hour
...experienced in prior authorization, utilization management, clinical review, medical necessity... ...current and upcoming remote consulting opportunities focused... ..., Medicare Advantage, Medicaid, and other payer authorization... ...and EHR platforms such as Epic, Cerner, or similar...Remote workEpicHourly payPart timeFor contractorsWork at officeFlexible hours24-MAG LLC
New York, NY4 days ago- ...Experience Required - Remote work for TX, AR, WI and... ...purpose of the Coding Specialist III is to code and verify... ...reimbursement (Medicare and Medicaid) principles. •... ...CAC). •Knowledge of Epic EHR and 3M 360 coding... ...% accuracy on quality reviews and meet assigned productivity...Remote workEpicContract workLocal area
Parkland Health and Hospital System (PHHS)
Dallas, TX1 day ago $28.72 - $36.92 per hour
...position is primarily remote, candidates must reside... ...: The AR Follow-Up Specialist III, Coding and Complex... ...requiring advanced coding review to appropriate CPCs or... ...HMOs, PPOs, Medicare, Medicaid and compliance program... ...etc.) Experience in Epic and or other...Remote jobEpicHourly payFull timeWork at officeLocal area- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines....Remote work
Bradford Health Services
United States4 days ago - ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers... ...provider collaboration, and adherence to Medicaid contracts. Qualifications include a Bachelor...Remote workFull time
Alliance Health in
Morrisville, NC2 days ago - ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities...Remote workPart time
ADDICTION AND MENTAL
United States5 days ago $41.6k - $47k
...Utilization Review SpecialistAt Umpqua Health, we're more than a healthcare... ...community.The Utilization Review Specialist supports Umpqua Health... ...organized and productive in a remote, independent work... ...healthcare programs (e.g., Medicare/Medicaid)Preferred Qualifications:1+...Remote workWork at officeLocal areaImmediate startMonday to FridayShift workUmpqua Health
Roseburg, OR5 days ago- ...this role? The Revenue Cycle Specialist III works under general supervision... ...assessment of charge review. Inputs specialty or cosmetic... ...documentation of appeal activity in Epic, ensuring compliance with... ...audit readiness. *Approved Remote States: Arizona, California,...Remote workEpic
- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical... ...hospital-based) ~ Skilled experience with remote work Length of assignment: 13... ...fifth weekend rotation Systems: Epic, Dragonfly - DragonFly experience is required...Remote workEpicShift workWeekend work
AMN Healthcare
United States4 days ago - ...Job Description: The Utilization Review Specialist nurse (UR RN) is responsible for monitoring adherence to the Utilization Review Plan (UR Plan... ...On-site required Must be proficient in in both EPIC and InterQual programs Position Urgency: Normal...EpicContract workMonday to FridayFlexible hoursShift workWeekend work
Varite
Moses Lake, WA2 days ago - ...Registered Nurse Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...candidates without this will not be considered. Proficient in Epic, with recent use within the last 612 months. Experience...Remote workEpic
- ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services,... ...while collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform...Remote workPart time
Virtual Vocations Inc
United States17 hours ago - ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a liaison between clinical operations...Remote workFull time
Virtual Vocations Inc
United States5 days ago - ...Prime Healthcare is seeking a Utilization Review Technician to coordinate UR and appeals within denial management. This role collaborates with... ...reviews (RAC, MAC, CERT, ADR) and audits, serve as SME to remote counterparts, and assist with Release of Information and discharge...Remote workWork at office
Prime Healthcare
Ontario, CA1 day ago - ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle... ...to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL5 days ago $50k
...the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote workAdvanced Recovery Systems LLC
New York, NY4 days ago$45k - $55k
...below to learn more. If you are a current employee wanting to apply for a different position, clickhere . Back to jobs Utilization Review Specialist Remote Weekly outpatient therapy isn't always enough, and a trip to the ER isn't the only answer. Patients and their...Remote workWork at officeCOMPASS HEALTH CENTER, LLC.
Brooklyn, NY17 hours ago$2,131 per month
...131 Job Title Registered Nurse - Utilization Review Weekly Pay $2131.0 Shift... ...Must-Have: - EMR experience with Epic - Experience with UM tool Dragonfly - Experience working remotely - Degree accreditation verification or 5 years...Remote workEpicWeekly payMonday to FridayShift workWeekend workTalent4Health
Fort Myers, FL4 days ago- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing...Remote workTemporary work
Banyan Treatment Centers
Pompano Beach, FL17 hours ago $70k - $100k
...of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position is ideal... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two...Remote workPermanent employment2 days per weekTEKsystems
Addison, TX4 days ago- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The... ...requiring clinical expertise and knowledge of Medicaid guidelines. Candidates must have an... ...setting, and the ability to work in a remote environment. Comprehensive benefits are...Remote workContract workWork from home
Mass Digital Health
Quincy, MA1 day ago - Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and... .... After a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide-ChildrenRemote jobWork at officeWork from home
- ...excellence.Who We're Looking ForWe are seeking an experienced specialist who is passionate about making a difference in the lives of... ...Health or related field required preferred.2-3 years of utilization review experience in behavioral health, addiction treatment, or managed...Remote workDaily paidFull time
The Florida House
Deerfield Beach, FL2 days ago $39.4 - $53 per hour
...Central Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job function include:... ...Knowledge, Skills, and Abilities Required: This is a remote role which requires access to high speed internet Excellent...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend workRemote Jobs
New York, NY2 days ago- ...employers, and Medicare and Medicaid members. SHP operates a portfolio... ...Together.This is a remote position in which we are able... ...following experience:Health plan utilization managementMedicare and Medicaid... ...documentation (e.g., MS Office, EPIC, Clinical Care Advanced)....Remote workEpic
Aya Healthcare
Newport, OR5 days ago - Compass Health Center is seeking a Remote Utilization Review Specialist to obtain insurance authorization for patients receiving Behavioral Health treatment at high levels of care. The UR Specialist serves as a liaison between the clinical team and insurers, helping patients...Remote job
$24.65 - $30.03 per hour
...corporate team! Responsibilities The Utilization review tech essentially works to... ...CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific...Remote workFull timeWork at officeLocal areaShift work- Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
- FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance....Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicaid Ops Specialist III-Epic Utilization Review. Be the first to apply!
Related searches
- junk removal specialist Long Beach, CA
- continuous improvement specialist Long Beach, CA
- loss prevention specialist Long Beach, CA
- hospitality specialist Long Beach, CA
- medical prior authorization specialist Long Beach, CA
- utilization review specialist Long Beach, CA
- fabrication specialist Long Beach, CA
- process specialist Long Beach, CA
- community health specialist Long Beach, CA
- credit specialist Long Beach, CA