Remote Utilization Management Specialist (UR/Payer Ops)
Cedars-Sinai
- Remote job
Cedars-Sinai is seeking a skilled Utilization Management Specialist to support UR Nurses in timely, compliant utilization review processes. You will manage case portfolios, assemble documentation for payer submissions, and monitor payer timelines to prevent delays. In collaboration with Case Management and Revenue Cycle, you will ensure accurate data entry in EPIC/CS-Link and payer portals, with a focus on compliance and revenue integrity within CMS and payer requirements. #J-18808-Ljbffr Cedars-Sinai
- Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support to UR Nurses, ensuring timely, accurate, and compliant utilization review with payer submission and documentation. You will manage the authorization lifecycle, track payer...Remote job
- ...Will Do in This Role: The Utilization Management Specialist provides advanced operational... ...to Utilization Review (UR) Nurses to ensure timely, accurate... ...that directly support payer communication, authorization... ...current and complete. *Approved Remote States: Arizona, California...Remote job
- ...leading revenue cycle management services for... ...We are seeking a ABA Utilization Review Specialist The ABA Utilization Review... ...environment. This is a fully remote or office/home hybrid... ...in understanding payer requirements for... ...Management Specialist | UR Specialist | Revenue...Remote workWork at officeFlexible hours
- Principles Recovery Center is seeking a remote Utilization Review Specialist to manage insurance authorizations for... ...programs. The role requires 2+ years of UR experience and fluency with ASAM,... ...care. Proficiency with EMR/EHR and payer communication is essential. #J-188...Remote job
$37.5 - $54.25 per hour
...Expertise to Logan Health’s Utilization Management Team! Our Mission :... ...for a Utilization Management Specialist to join our dedicated team!... ...person-centered care! Fully remote opportunity - Must... ...activities, and responds to payer inquiries in a professional...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift- Cedars-Sinai is seeking an Utilization Management Specialist to support the UR team in a fast-paced, hospital setting. You will help ensure timely, accurate authorization... ...and regulatory compliance using EPIC/CS-Link and payer portals. Responsibilities include assembling review...Remote job
- ...Job Description Job Description Utility Vegetation Management Specialist Who are we? We’re dedicated to the growth of our employees. We... ...vehicle operation and foot patrol of utility power lines; remote locations as well as urban, city environment; physical...Remote workFull time
- ...Managing insurance authorizations for mental health and substance... ...-time Behavioral Health Utilization Review Specialist will verify benefits,... ...necessity criteria while working remotely. Key responsibilities... ...communicating with insurance payers and managed care...Remote workFull time
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA... ...Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time... ...authorized, and compliant with payer, state, and regulatory... ...Review Specialist manages the full lifecycle of authorizations...Remote workFull timeMonday to FridayFlexible hours
- ...seeking an experienced specialist who is passionate... ...ll Do Responsible for managing all clinical authorization... ...communication with insurance payers. This role supports... ...payer guidelines. The UR Specialist helps... ...preferred. 2-3 years of utilization review experience in behavioral...Remote workDaily paidFull time
$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... ...Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour...Remote workHourly payContract work$24 - $26 per hour
...Utilization Review Specialist - Behavioral Health (Remote) PHP/IOP | Full-Time | Monday-Friday, 9 AM-5 PM ET | $24-$2... ...hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent... ...(SCAs) with out-of-network payers. Submit denial appeals and...Remote workFull timeMonday to Friday$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-... ...Northpoint team, the Utilization Review Specialist is a licensed professional... ...discharge. The UR Specialist takes the... ...knowledgeable liaison between payers and the clinical care... ...care team and management staff when patient no...Remote workFull timeTemporary workFor contractorsWork at officeMonday to Friday$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- ...Providence California Regional Services is seeking a Senior Utilization Management Assistant for a remote Per Diem role. The 8-hour day shifts provide support within the Care Management team to coordinate patient care. You will work under the supervision of the Regional...Remote jobDaily paidDay shift
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
$114k - $161k
...Job Title: Principal Consultant Utility Return on Equity & Cost of Capital Specialist Job Location : Marlborough... ...: Hybrid 3 days in office, 2 remote days per week 2025... ...Concentric") is an employee-owned leading management consulting and financial advisory...Remote workWork at officeWork from homeFlexible hours2 days per week- Trillium Health Resources in North Carolina is seeking a Utilization Management Specialist III - MH/SU to join our team. You will perform comprehensive... ...support providers with guidance and documentation. This remote role offers standard work hours, strong benefits, and the...Remote job
- Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will receive, research, and act on documentation and requests from diverse sources, collaborating with licensed clinicians to guide appropriate actions and...Remote job
- Trillium Health Resources is seeking an Utilization Management Specialist III - MH/SU to perform comprehensive clinical review of service requests for... ...licensure; travel within the NC catchment is expected. Remote work options are available for many roles. #J-18808-Ljbffr...Remote job
- Solventum is seeking an Infection Prevention Specialist, Peri-op, to lead infection prevention... ...drive growth through strategic account management, and leverage data-driven planning to... ...clinical insight and sales acumen, with remote work and up to 20% travel. A relevant...Remote jobWork at office
- Providence California Regional Services is seeking a Senior Utilization Management Assistant for a remote, per diem role. You will support the Care Management team in coordinating patient care, performing clerical duties, and contributing to efficient care workflows from...Remote jobDaily paid
- Elevance Health is seeking a detail-oriented Utilization Management Representative II to manage inbound calls, determine eligibility, and authorize care. The role supports virtual work with required in-person training sessions and may require commuting within a reasonable...Remote job
- Providence California Regional Services seeks a Senior Utilization Management Assistant to support the Care Management team. This REMOTE, part-time role offers 8-hour Evening shifts under the supervision of the Regional Director of Care Management. You will perform complex...Remote jobPart timeAfternoon shift
- Elevance Health is seeking an Utilization Management Representative II in Florida. The role involves handling incoming calls, triaging cases, authorizing inpatient and outpatient services, and gathering demographic information. The position supports a hybrid/virtual work...Remote job
- 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
- Randstad USA is seeking an experienced Prior Authorization Specialist to join our national Utilization Management team. 100% remote role with a Monday-Friday schedule, 8:00 AM - 5:00 PM CST. You will manage authorization queues, verify eligibility, gather medical documentation...Remote jobMonday to Friday
$68.89k - $92.14k
Pay Plan Title: Utilization Management Specialist III Working Title: Utilization Management Specialist III MH/SUFLSA Status: Exempt Posting Salary Range: $68,890- $92,138 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources...Remote workWork at officeLocal areaImmediate startWork from homeFlexible hours- Elevance Health is seeking an Utilization Management Representative II in Florida. The role involves managing inbound calls, triage, case openings, and authorizations for inpatient and outpatient services. Candidates must reside in Lake Mary, Tampa, or Miami, FL and be...Remote jobWeekend work
- Minnesota Adult & Teen Challenge is seeking an Utilization Review Coordinator to manage insurance authorizations for treatment services. This role collaborates with admissions, counselors, and payers to ensure timely authorizations and compliance with payer and regulatory...Remote job
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