Remote LVN: Utilization Review & Prior Authorization
$20.38 - $36.44 per hourWisconsin Psychiatric Association
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
- ...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 workHourly 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- ...TryApplyNow is seeking a Licensed Vocational Nurse (LVN) for a full-time remote position in Utilization Review within San Diego County. This role involves reviewing and managing cases to determine medical necessity and eligibility for services provided to Scripps Clinic...Remote workFull time
$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- ...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 workLocal areaMonday to FridayShift work
$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 workHourly payMinimum wageFull timeWork experience placementLocal areaFlexible hours$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$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$34 - $47 per hour
Astrana Health Management is seeking a Utilization Review Nurse (LVN) to work remotely in California. You will utilize your clinical judgment to approve or deny outpatient medical services. Candidates must have a CA LVN license and at least one year of outpatient UM experience...Remote jobHourly payFull timeShift 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 workHourly pay$65k - $78k
...values work-life balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services,...Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...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 work
$85.99k - $105.34k
...community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams....Remote workFull time- ...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 work
$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 work- ...Health Coordinated Care Organization is hiring a part-time remote Utilization Review Nurse. The ideal candidate will be a licensed RN with... ...utilization review. Responsibilities include reviewing prior authorizations, ensuring quality care, and applying medical necessity...Remote workPart time
- ...Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective Review* Admission Criteria... .../National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote work
- ...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 workFlexible hours
$1,949.74 per month
...Registered Nurse Specialty Utilization Review Job ID 17979666 Job... ...Week(s) Job Description Remote Utilization Review RN responsible for... ..., medical necessity determinations, prior authorizations, continued stay reviews, and utilization...Remote workWeekly payShift work- ...support for clinical member services review assessment processes. Verifies that... ...procedures. Conducts reviews to determine prior authorization/financial responsibility for Molina... ...the Molina care model. Adheres to utilization management (UM) policies and...Remote workWork at office
- 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
- ...Resources Management Location: 100% Remote Schedule: M-F 9:00am to 5:30... ...and eligibility Process prior authorization determinations within... ...teams Summary Works with the Utilization Management team primarily responsible... ...necessity/utilization review and other utilization...Remote workContract work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
$25.08 - $51.49 per hour
...support for clinical member services review assessment processes. Responsible for... ...procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina... ...the Molina care model. • Adheres to utilization management (UM) policies and...Remote jobHourly payWork experience placementWork at office- 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
- 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
$35.29 - $47.37 per hour
...individual and their work-life balance Remote work options and Flexible scheduling... ...currently hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed nurse with... ...utilization management. Reviews prior authorization requests for appropriate care and setting...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours- ...recommendations to meet QM objectives Responsibilities: Reviews documentation and evaluates Potential Quality of Care... ...~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience with Medcompass Skills:...Remote work
$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in... ...Responsibilities Review and process prior authorizations and reauthorization requests in... ...nursing license (RN, LPN, or LVN) in good standing with the...Remote workContract workFlexible hoursWeekend work
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