Remote Case Manager: Utilization Review Specialist
Jobgether
- Remote job
Jobgether is seeking a Case Manager – Utilization Review Specialist for a fully remote role based in the United States. You will oversee admission and concurrent utilization reviews, assess medical necessity, and coordinate appeals to support patient care and financial performance. You will apply your clinical nursing expertise to evaluate records, collaborate with physicians and payer representatives, and drive continuous improvement in review processes and outcomes. #J-18808-Ljbffr Jobgether
- Jobgether, listing on behalf of a partner company, seeks a Case Manager - Utilization Review Specialist in the United States. The remote role focuses on admission and concurrent reviews, appeals coordination, and ensuring compliance with clinical and payer requirements....Remote job
- ...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 healthcare... ...and payer requirements. In this remote role, you will oversee admission and...Remote workFull timeLive in
- Jobgether, on behalf of a partner company, seeks an experienced Case Manager - Utilization Review Specialist to oversee admission and concurrent reviews remotely in the United States. You will evaluate medical records for medical necessity, coordinate appeals, and collaborate...Remote job
- ...Jobgether, in partnership with a healthcare team, seeks a Case Manager – Utilization Review Specialist based in the United States. This fully remote role focuses on admission and concurrent reviews, denials prevention, and coordinated appeals to support patient care and...Remote work
$60k - $62k
...Job Description Remote- Work From Home, Jackson, Jackson,... ...Position Overview The Utilization Review Specialist is responsible for all aspects... ...treatment via insurance and managed care companies. The... ...Five (5) years’ experience in Case Management/Utilization Review...Remote workFull timePart timeWork from homeFlexible hours- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Remote workPart timeWeekend work
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications with insurance payers. You will support patient access by securing initial and continued...Remote work
- ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...Remote work
- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating... ...with clinical staff to optimize authorization decisions, manage caseloads, and ensure accurate documentation while staying...Remote work
- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically... ...license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate degree (BSN...Remote workWork from homeMonday to FridayWeekend work
- The Case Manager/Utilization Review at Loretto Hospital oversees assessment and direction of clinical management for patient episodes, collaborating with physicians and staff to meet care outcomes. The role interfaces with payers to ensure proper authorization and billing...
$30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ...along with experience in Epic EHR and Utilization Review. The selected candidate will perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote workHourly payContract work- ...Looking For We are seeking an experienced specialist who is passionate about making a... ...challenges. What You'll Do Responsible for managing all clinical authorization processes... ...required preferred. 2-3 years of utilization review experience in behavioral health, addiction...Remote workDaily paidFull time
- ...As Utilization Review Specialists, we are the liaisons between insurance payors and... ...respective insurance carrier.Manage caseloads through initial analysis... ...of benefits for every case.Assist admission by... ..."recovering".Benefits100% remote first company to foster flexibility...Remote workWork at office
$24 - $26 per hour
...Utilization Review Specialist - Behavioral Health (Remote) PHP/IOP | Full-Time | Monday-Friday, 9 AM-5 PM ET | $24-$26/hour... ...Review (UR) Specialist to manage insurance authorizations for adolescent... ...CALOCUS criteria. Obtain Single Case Agreements (SCAs) with out-of-...Remote workFull timeMonday to Friday- University of Miami Health System is seeking a full-time Utilization Review Case Manager to work remotely. The role conducts initial and concurrent chart reviews for utilization and authorization, coordinating with the healthcare team to ensure timely patient care and...Remote jobFull time
- ...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know Your Team: INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking a...Remote workFull timeWork at officeWeekend work
$18 - $20 per hour
...compassionate professional to join our Utilization Review department. At Camber, we... ...As a Utilization Review Specialist, you serve as the vital link... ...and health plans. You will manage initial, concurrent, and... ...corporate office, 3 days remote. What You Will Do Act...Remote workHourly payFull timeWork at office- CorVel Corporation, a national provider of risk management solutions, seeks a Utilization Review Case Manager. You will gather demographic and clinical data for... ...to support the Case Management department. This remote role requires an RN license, 4+ years of clinical experience...Remote job
- ...Utilization Review Specialist The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each client through liaison... ...EMRs, and creating cases for presentation.... ...Satisfactory drug screen Part Time Remote Role...Remote workPart timeWork at officeFlexible hours
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA... ...Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time... ...Utilization Review Specialist manages the full lifecycle of... ...experience in utilization review, case management, or behavioral...Remote workFull timeMonday to FridayFlexible hours
$90.9k - $129.9k
...career development. Summary Review and evaluate prior authorization submissions utilizing multiple computer systems, and... ...outcomes into the Medicaid Management Information System (MMIS) for processing... ...expect in this role ~100% Remote home office. ~ Full-time...Remote workFull timeWork experience placementHome officeFlexible hours$60k - $70k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range:... ...the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization... ...providers, insurance companies, and case managers to facilitate timely approvals and...Remote workFull timePart timeWork at office- ...System (DMC-ODS), including review of medical records to ensure proper utilization of treatment resources... ...health treatment. UR Specialists also interpret, advise... ...The option for hybrid remote work may be available based... ...pertaining to managed care; laws and regulations...Remote workContract workLocal areaTrial periodFlexible hours
$62.4k - $72.8k
...Job Title: Utilization Review Specialist Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation... ...with clinical care team and management staff when patient no longer meets... ...Refer to management staff any case that surpasses expected LOS, expected...Remote workFull timeTemporary workWork at officeMonday to Friday- The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions... ...the Case Management department and of CorVel. This is a remote position ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours
- Jobgether is seeking a Case Manager - Utilization Review Specialist for a remote US-based position. You will oversee admission and concurrent reviews, analyze medical records for medical necessity, and coordinate first-, second-, and third-level appeals with physician advisors...Remote job
- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
- Coronis Health is seeking a qualified Utilization Review Specialist to manage authorization of treatment with insurance and managed care companies from a remote Jackson, MI area. You will provide information to payers about medical necessity and perform pre-certification...Remote job
- Principles Recovery Center in Florida is seeking a remote Utilization Review Specialist to manage insurance authorizations for adolescent and adult behavioral health, substance use, and co-occurring treatment in a PHP/IOP setting. You will verify benefits, complete prior...Remote job
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