Remote LVN: Utilization Review & Prior Authorization
$20.38 - $36.44 per hourWisconsin Psychiatric Association Inc
- Remote job
Wisconsin Psychiatric Association Inc seeks a Utilization Review Specialist (LVN) who will conduct medical reviews and verify benefits. The role involves determining medical necessity for services requiring prior authorization and serving as a liaison for surgery requests while communicating with providers for timely decisions. Candidates should have 5+ years of utilization review experience and an active RN license. The position offers flexible remote work options adhering to company policies, along with a competitive hourly pay ranging from $20.38 to $36.44. #J-18808-Ljbffr Wisconsin Psychiatric Association Inc
- Kelsey-Seybold Clinic is seeking a Utilization Review Specialist (LVN) to conduct medical reviews and... ...necessity for services requiring prior authorization. This role involves liaising with... ...utilization review. Flexibility for remote work is provided for Texas residents...Remote jobHourly pay
$34 - $47 per hour
Astrana Health, Inc. seeks a CA-licensed UM Review Nurse to work remotely, approving or denying outpatient services based on medical necessity... ...overtime required. Responsibilities include conducting prior authorization reviews and maintaining regulatory knowledge....Remote jobHourly payFull timeFlexible hours$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States NeueHealth is... ...The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with... ...authorization. Responsibilities include reviewing prior authorizations for...Remote workHourly payFull timeContract workWork at officeWork from home$18 - $20 per hour
...so, keep reading! Title of Job: Remote Utilization Management LPN/LVN Location: REMOTE (anywhere in... ...for ensuring timely and accurate review of authorizations, helping maintain compliance with... ...Duties: Evaluate and manage prior authorization requests, including...Remote workHourly payWeekly payFull timeTemporary workLive inImmediate startHome officeMonday to Friday$20.38 - $36.44 per hour
...Utilization Review Specialist (LVN) Explore opportunities with Kelsey-Seybold Clinic, part of the Optum... ...health care services requiring authorization prior to rendering services to members.... ...will have the flexibility to work remotely as you take on some tough challenges...Remote jobHourly payMinimum wageFull timeWork experience placementLocal areaFlexible hours$34 - $47 per hour
Astrana Health is seeking a CA-licensed Utilization Review Nurse for remote work. This role involves using clinical judgment to approve or deny outpatient medical services based on Medical Necessity Criteria. Candidates must have at least one year of outpatient UM experience...Remote jobHourly payShift work- ...Texas. Harbor Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN supports prior authorization and utilization review activities to ensure timely and... ...and Business Hours This position is fully remote Monday-Friday 8am - 5pm with the exception...Remote jobLocal areaMonday to FridayShift work
$34 - $47 per hour
...looking for a CA-licensed Utilization Review Nurse to assist our Health... ...shifts per week. This is a remote position for CA-licensed nurses... ...What You'll Do Complete prior authorization/retrospective review of elective... ...Active and unrestricted LVN license in CA. 1+ years of...Remote workHourly payLive inWork at officeMonday to FridayShift work$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...Remote jobHourly pay$85.7k - $128.54k
...opportunities for growth and innovation. Utilization Management Nurse Lead Responsibilities Reviews reporting to assign tasks to UM... ...in concurrent review and/or prior authorization at a managed care organization.... ..., valid, and unrestricted LVN or RN license in California (...Remote jobImmediate start- ...Technician to support retail pharmacy operations remotely. This role involves processing prescriptions, performing prior authorization reviews, and coordinating care for patients.... ...pharmacy, ideally with experience in utilization review. A strong knowledge of insurance processes...Remote job
- Martin's Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong background in clinical... ...medical outcomes. Responsibilities include reviewing prior authorization requests, collaborating with healthcare providers, and participating...Remote job
- ...nationally recognized Independent Review Organization (IRO) and leading provider of Utilization Review (UR) services, is... ...Utilization Reviews on a flexible, remote basis. This is a non-... ...treatments or procedures Review prior authorizations and appealed cases using evidence...Remote workExtra incomeContract workFor contractorsFlexible hours
- TurningPoint Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be a Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking skills and attention to detail. The...Remote job
- Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience...Remote job
- Ensemble Health Partners is seeking Senior Virtual Utilization Review Specialists to join their remote team in the United States. This role involves conducting medical necessity reviews, managing denial processes, and collaborating with healthcare professionals. Candidates...Remote job
$49.34 - $76.59 per hour
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote job- A health insurance startup is looking for an experienced Medical Director to oversee utilization reviews and prior authorizations. This remote position demands a strong clinical background with a doctorate in medicine and board certification. The ideal candidate will have...Remote jobFlexible hours
$90k - $125k
...Utilization Review (MDS) RN/LPN Location: Valley Stream, New York Job Type: Full-Time Schedule: Hybrid (Onsite Required 4 Days per... ...changes, and discharge planning activities. Coordinate prior authorizations, clinical updates, denials, reconsiderations, and appeals...Full time- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential for Extension... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
$7.5k
...LPN Utilization Management Reviewer This position is eligible for up to $15,000.00 Sign on Bonus for those that are eligible. ($7,500.00... ...Utilization Management (UM) processes and requirements of prior authorization/certification for reimbursement of patient care...Full timeWork at officeRelocation packageShift work- ...since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt... ...enrollees with a need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific inpatient...Remote workWork at office
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor... ...One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient... ...Active and unrestricted LVN license in California MUST have experience...Remote jobHourly payMonday to Friday$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical... ...Essential Functions Process patient prior authorization and reauthorization requests in accordance... ...nursing program (RN, LPN, or LVN). Minimum of two years of general nursing...Remote workContract workWeekend work- Utilization Review (UR) Specialist Position Title: Utilization Review Specialist... ...for managing all aspects of authorization, continued stay requests,... ...deadlines. Submit Medicaid prior authorization (PA) packets... ...behavioral health environment. Remote flexibility depending on...Remote workFull time
$45.9 - $71.4 per hour
Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development...Remote jobHourly payLocal area- ...Description: Manager of Clinical Utilization Management - Denial... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... .... Minimum of five years in prior-authorization, appeals & grievance, or health...Remote workPermanent employmentFull timeTemporary workFlexible hours
$27.02 - $48.55 per hour
...flexibility. This is a remote position. Hours are Monday... ...Position Purpose: Performs reviews of member's care and health... ...clinical standards Performs prior authorization reviews related to BH to... ...improve quality and appropriate utilization of services Interacts...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...role will be responsible for overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations. The... ...through effective peer-to-peer discussions. This is a remote position requiring a "roll up your sleeves" attitude...Remote workFull timeFlexible hours
$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations... ...evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday
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