Remote Utilization Management Reviewer Care Coordination
Capital District Physicians Health Plan Inc
- Remote job
Capital District Physicians Health Plan Inc is seeking a dedicated professional for a utilization management position in Albany, NY. The role involves coordinating and monitoring behavioral health services, ensuring compliance with standards set by regulatory bodies. Ideal candidates should hold an Associate's degree with an active NYS RN license, have at least three years of clinical experience, and demonstrate strong communication skills. Opportunity for remote work available on a case-by-case basis. #J-18808-Ljbffr Capital District Physicians Health Plan Inc
- ...is responsible for coordinating, integrating, and monitoring the utilization of behavioral... ...Medical Director for review. Refer to and work... ...closely with Case Management to address member... ...benefits, and efficient care delivery processes... ...opportunity for remote work within all...Remote workContract workWork at office
$71.1k - $97.8k
...healthcare organization is seeking a Utilization Management Registered Nurse to support the coordination and documentation of medical services. This remote position requires a valid RN license... ...and ensuring appropriate care delivery. The role offers a pay range...Remote work$71.1k - $97.8k
...in the United States is seeking a Utilization Management Registered Nurse to utilize clinical skills in coordinating medical services and ensure appropriate care levels for members. This role... ...experience. The position offers a remote work option and includes a comprehensive...Remote work$71.1k - $97.8k
...healthcare solutions company is looking for a Utilization Management Registered Nurse to interpret and coordinate medical services. This fully remote position requires a Compact RN license... ...criteria and collaborating with care providers. The position offers a competitive...Remote work- ...A healthcare organization is looking for a Utilization Management Registered Nurse to work remotely in Cheyenne, Wyoming. You will utilize your clinical nursing skills to coordinate medical services and ensure appropriate care levels. The ideal candidate will hold a Compact...Remote work
- ...Humana is seeking a Utilization Management Administration Coordinator to provide non-clinical support for optimal treatment and care of members. This role works fully remote within the Home Solutions organization... ...tasks including chart reviews and authorizations. The ideal...Remote workWork at office
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for... ...professional judgment, the Clinical Care Reviewer assesses the... ...services, identifies care coordination opportunities, and ensures... ...work solutions include remote options, hybrid work...Remote workMonday to FridayFlexible hoursWeekend work
$71.1k - $97.8k
A healthcare company based in Arizona seeks a Utilization Management Registered Nurse to interpret and support the coordination of medical services. Responsibilities include making benefit determinations based on clinical criteria and communicating with providers and members...Remote job- ...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual... ...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...their care team, which may require coordination with internal and external parties...Remote workFull time
- ...accountable specialty care management organization focused... ...editing, tracking, and coordination of clinical patient... ...standards. This is a remote position with hours generally... ...and FirstScript. Utilize the EDDG workflow and... ...Conduct critical reviews for spelling, grammar...Remote workFull timeContract workPart timeFor contractorsLive inLocal areaMonday to FridayFlexible hours
$20 - $30 per hour
...delivering exceptional care, utilizing state-of-the-art facilities... ...of Revenue Cycle Management Department/Location: Remote FLSA Status: Exempt Travel... ...Responsibilities Utilization Review on Behalf of the Clinics... ...treating clinicians. Coordinate Peer-to-Peer (P2P) Review...Remote work$19 per hour
...The UM Coordinator assists and supports the clinical... ...related to processing Utilization Management prior authorization and... ...UM authorizations review requests in UM platform... ...Coordinator in a managed care payer environment... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area$7.5k
...LPN Licensed Practical Nurse - Utilization Mgmt Reviewer - Case Management - Full Time Cortland, NY, United States Job Description This position is... ...Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices,...Full timeWork at officeRelocation packageShift work$40k - $52.3k
...Become a part of our caring community The UM Administration Coordinator (UMAC) provides non-clinical... .... Reporting to the Manager of Utilization Management, you will work fully remote. You are part of the Home... ...manage NLP's for chart reviews for the nursing team You...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$26.92 - $33.65 per hour
Position Title: Utilization Management Coordinator II Location: Montebello, CA 90640 Remote Type: Hybrid Description: Grow Healthy If you are as passionate about helping... ..., we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional...Remote workHourly payLocal areaFlexible hours- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board... ...cases while ensuring high standards of patient care. Responsibilities include collaborating with management...Remote workFull timeWork from home
- ...Humana is seeking a Utilization Management Administration Coordinator to provide non-clinical support in a fully remote position. In this role, you will... ...Responsibilities include managing chart reviews, authorizations, and... ...commitment to supporting member care. #J-18808-Ljbffr...Remote workWork from home
- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines and support high-quality patient outcomes. The role requires current...Remote work
- ...details. Office Location: Remote Option Available; Flexible for any of... ...position is responsible for facilitating the review of service plans and service... ...appropriate services at a given time. The IDD Utilization Management Reviewer screens authorization...Remote workWork at officeFlexible hours
- A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities include determining service eligibility and facilitating care. This remote role requires an RN license and clinical experience...Remote jobWork from home
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- Moda Health in Portland, Oregon, is hiring a Care Coordinator to manage treatment plans and ensure timely care delivery. This is a full-time work... ...The role involves interacting with members and providers, utilizing internal systems to assess eligibility, and maintaining a...Remote jobFull timeWork from home
- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical... ...collaborating to ensure quality care for members. Candidates must be board...Remote work
- ...Service Corp. is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team, focused on ensuring high-... ...judgment and experience in sub-acute care settings. The position offers competitive compensation, remote work, and the opportunity to champion...Remote work
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
$58.66k - $79.82k
...Job Title: Care Coordinator Responsibilities The Care Coordinator is an... ...Sinai Health Partners Care Management and is responsible for coordinating... ...to care plans. They utilize a variety of behavioral change... ...visits and accompaniment and remote work. Location for on‑site work...Remote workTraineeshipWork from home$71.1k - $97.8k
Humana Inc is seeking a Utilization Management Nurse to leverage clinical expertise for optimal treatment and care for members. This role includes coordination and communication with healthcare providers and patients in a hybrid home/office work model. The ideal candidate...Remote jobWork at officeWork from homeHome office- ...A healthcare management company is seeking an experienced Licensed Practical Nurse... ...(LPN) to facilitate value-based care for patients. This fully remote position offers the chance to work... ...conducting health assessments, coordinating resources, and assisting with medication...Remote workWork from home
- ...specialize in healthcare management technology and offer our clients a suite of utilization management software... ...improving the quality of care and expediting the... ...is a hybrid in-office/remote position. Responsibilities... ...Serve as the resource/reviewer for coworkers on...Remote workWork at officeFlexible hours
- ...The Clinical Care Coordinator is a licensed healthcare professional and... ...- and family-centered care management services. This role supports... ...Monitor ongoing services, utilization, and cost-effectiveness; recommend... ...on-site visits and virtual/remote engagements Maintain...Remote workWork at officeWork from homeHome office
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