Remote Utilization Management Specialist
Avesis
Avsis is seeking a detail-oriented Utilization Management Administrative Support professional for a remote US-based role. You will handle email requests from provider offices, gather missing information for claims processing, and prepare correspondence for enrollees and providers to support clinical processors.
You will manage data entry, maintain letter templates, and coordinate with the UM team to ensure regulatory and contractual requirements are met.
#J-18808-Ljbffr$65k - $88.6k
...Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document, and communicate medical... ...with providers and members to ensure optimal care. The remote position includes standard hours, occasional travel for meetings...Remote work- ...Capturis, part of Conservice and a national utility management leader, is seeking an Invoice Specialist. In this remote/hybrid role, you will request payment extensions, ask for expedited payments, and verify payments with providers to prevent service disconnection. You...Remote work
- ...Utility Vegetation Management Specialist Job Type – Full Time Who You Are: You’re energetic and enjoy working outdoors. You understand that... ...vehicle operation and foot patrol of utility power lines; remote locations as well as urban, city environment; physical...Remote workFull time
$80k - $150k
...Asset Management SpecialistOrbital Engineering, Inc. is currently seeking an Asset Management Specialist with experience in CASCADE and ELECTRIC UTILITIES for a REMOTE WORK role for our Utility Services team to support the implementation of DNV Cascade 4 utility asset...Remote workTemporary workWork at officeWork from home- ...Trillium Health Resources is seeking an Utilization Management Specialist III - MH/SU to perform comprehensive clinical review of service requests... ...Carolina licensure; travel within the NC catchment is expected. Remote work options are available for many roles. #J-18808-...Remote work
- ...Humana, Inc. is seeking a remote UM Administration Coordinator to support utilization management operations. You will handle provider and member phone interactions, perform back-office tasks, and assist with prior authorizations while reporting to the Supervisor, UM Management...Remote work
$90.9k - $129.9k
...for this role, rather you will provide utilization review and quality assurance. Your role... ...outcomes into the Medicaid Management Information System (MMIS) for processing... ...you should expect in this role ~100% Remote home office. ~ Full-time position....Remote workFull timeWork experience placementHome officeFlexible hours$53.19k - $82.43k
...Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization... ...information is current and complete. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia,...Remote workFull time$78k - $112.84k
...Clinical Expertise to Logan Health’s Utilization Management Team! Our Mission : Quality, compassionate... ...for a Utilization Management Specialist to join our dedicated team! Our Utilization... ...and person-centered care! Fully remote opportunity - Must currently reside in...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift- ...UnitedHealth Group in the DC area is seeking an HCBS Utilization Management Nurse to perform pre-service coverage reviews for PDN and PCS, reporting to the DC Manager of Utilization Management. This role emphasizes coordination with internal and external partners to determine...Remote work
$63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt Unit : UAW Department/Location : Utilization Management Compensation: $63,102.73-$83,647.81 The Final... ...position. While the position is remote, the individual in this...Remote workFull timeTemporary workMonday to Friday- ...Utility Forester - Vegetation Management SpecialistClear Path Utility Solutions plays a critical leadership role... ...one year of employment.ISA Utility Specialist certification preferred.Additional... ...to hike long distances and work in remote locations.Ability to stand, walk, and...Remote workFor contractorsWork at officeLong distance
- ...Logan Health is seeking a Utilization Management Specialist to join our dedicated team. You’ll review admissions across the Logan Health system, collaborate... .... The position offers a four 10-hour shift schedule, remote work with Montana residency, and a competitive benefits...Remote workShift work
- ...CVS Health is seeking an experienced Registered Nurse to join our Utilization Management team in a remote capacity. The role focuses on ensuring members receive appropriate, high-quality services across the continuum of care. The ideal candidate will have an unrestricted...Remote work
- ...Logan Health Medical Center is seeking a Utilization Management Specialist to review admissions across the system and determine appropriate status.... ..., case management and insurers. The position is fully remote for Montana residents and offers a four-day work week with...Remote work
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation... ...communication and EMR proficiency, with a four-day work week and remote options for Montana residents. #J-18808-Ljbffr...Remote work
- Cedars-Sinai seeks a detail-oriented Utilization Management Specialist to support UR Nurses and manage the authorization lifecycle using EPIC/CS-Link. You will ensure timely, accurate documentation and compliance with CMS and payer requirements, collaborating with Case...Remote job
$25 - $32 per hour
Us Tech Solutions in Canton, MA is seeking a Utilization Management Specialist to oversee non-clinical review activities and coordinate coverage determinations... ...teams. The position is a contract role for 6 months, remote from Canton, MA, offering hourly compensation in the $25-...Remote jobHourly payContract work- Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation... ...with providers, and adherence to policy guidelines. This is a remote nationwide position with standard working hours and...Remote job
- ...Utility Forester - Vegetation Management Specialist Position Summary Clear Path Utility Solutions plays a critical leadership role bridging construction... .... Ability to hike long distances and work in remote locations. Ability to stand, walk, and work on...Remote workFull timeFor contractorsWork at officeWork visaLong distanceFlexible hours
- Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance...Remote jobHourly payFull time
- Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document and communicate medical services and benefit determinations. The role requires clinical judgment, strong communication, and independence, with travel...Remote jobFull timeWork at office
$46.76 - $51.76 per hour
...references. Follows NCQA Standards and departmental SOPS to manage member assignments. Conducts research and analysis of... ...internal stakeholders. Nice to Have: Prior experience in utilization management, care management, or payer-side review of ABA services...Remote jobWork at office- ...offers industry-leading revenue cycle management services for healthcare providers.... ...streamlined manner. We are seeking a ABA Utilization Review Specialist The ABA Utilization Review Specialist... ...environment. This is a fully remote or office/home hybrid position. Your...Remote workWork at officeFlexible hours
- ...: Under the direction of the Precertification Team Manager, the Utilization Management (UM) Specialist is responsible for managing daily non-clinical review... ..., hospitals, and internal stakeholders. Location: Remote (Canton, MA) Candidate Location: Locals to New England...Remote workWork experience placementWork at officeLocal area
- ...talented, compassionate people are united in bringing the most advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through accurate certification and complete chart documentation ensuring that...Remote workTemporary workWork experience placementLive outFlexible hours
- ...Posted : October 27, 2026 Full-Time Remote Locations Showing 1 location... ...Tennessee Texas Wyoming The Utilization Review Specialist assumes responsibility and accountability... ...level appeals. Consults with managers on problem cases and interfaces with...Remote workFull time
- ...on behalf of a partner company, who manages all applications and next steps. Our... ...partner is looking for a Case Manager – Utilization Review Specialist based in the United States. Join a... ...and payer requirements. In this remote role, you will oversee admission and...Remote workFull timeLive in
$28.5 - $38.5 per hour
...Rotation (Saturday only) - Training on-site with consideration of remote work after 6 months to 1 year Job Summary Conduct level... ...reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure compliance...Remote workFull timeLocal areaMonday to FridayShift workWeekend workDay shift- ...Utility Project Support Specialist ERM is hiring remote Utility Project Support Specialists to support our client based in the Danville, IL area. In this critical... ...of 12 months, extendable. Responsibilities Manage large amount of inbound and outbound phone calls...Remote workPart timeFixed term contractCasual workShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Specialist. Be the first to apply!
- graduation specialist United States
- specialist teaching assistant United States
- cybersecurity specialist United States
- irb specialist United States
- deduction specialist United States
- entry level safety specialist United States
- disclosure specialist United States
- junior specialist United States
- partner success specialist United States
- gaming specialist United States

