Utilization Review Clinician (Remote)
Elevance Health
- Remote job
Elevance Health is seeking a Medical Management Clinician Associate for a virtual, full-time role with in-person training sessions when indicated. The role ensures appropriate administration of plan benefits by reviewing clinical information and assessing medical necessity under guidelines and policies. Requirements include a current RN/LPN license, at least 2 years of clinical or utilization review experience, and ability to work within licensure in applicable states. #J-18808-Ljbffr Elevance Health
- ...Health in Tampa, FL is seeking a Medical Management Clinician Associate. The role is primarily virtual with... ...including weekends or holidays. The role involves reviewing medical necessity, precertifications, and utilization reviews within the scope of licensure, supporting...Remote jobMonday to Friday
$27.02 - $48.55 per hour
...Purpose Performs a clinical review and assesses care related to... ...improve quality and appropriate utilization of services Provides... ...degree for behavioral health clinicians required. Clinical knowledge... ...flexible approach to work with remote, hybrid, field or office work...Remote workHourly payFull timeContract workPart timeWork at officeFlexible hours- ...Job Title Provides support for clinical member services review assessment processes. Responsible for verifying that services are... ...multidisciplinary teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required...Remote job
- ...Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical... ...duties as required. This position is full-time, fully remote (work from home) and requires some weekend, evening,...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
$45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote work- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of Assignment: 13 weeks Shift / Hours...Remote workShift workWeekend work
- ...Registered Nurse - Utilization Review About Company Bestica We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
- (CHR) Community Health Resources, Inc. is seeking a Utilization Review Therapist to manage authorization activities pertaining to IOP and Residential programs. This full-time, remote role requires a Master’s degree in behavioral health and relevant experience in treatment...Remote workFull time
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
$45k - $70k
...A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote work$46 per hour
...Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role As a Utilization Review Registered... ...policies. Job details $46.00 / hour Remote, California New Profession: Registered Nurse...Remote work- ...Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and... ...collaborating with providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive...Remote work
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson... ...No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~... ...in Utilization Management, Utilization Review, or Case Management ~• Preferred Certifications...Remote workContract workImmediate startMonday to Friday- ...Preferred Skills & Certifications: Experience in Utilization Review or case management roles. Specialty certifications relevant... ...transportation. Strong ability to work independently in remote settings. Must be able to handle fast-paced and complex...Remote workFlexible hours
$45k - $70k
...A leading healthcare company in the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical services and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for candidates having...Remote work- ...years of relevant experience. This position will primarily be remote, with requirements to work at an Elevance Health location at least... ...week. Candidates will be responsible for conducting treatment reviews and collaborating with healthcare providers to ensure...Remote job1 day per week
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews, assisting...Remote work
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work- ...seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference... ...in NC, five years of clinical experience, including acute care and utilization management experience. #J-18808-Ljbffr Vaya HealthRemote job
- Johns Hopkins Health Plans is seeking an experienced Utilization Review Registered Nurse. The role focuses on evaluating care, authorizing services, and coordinating discharge planning for plan members. You will work within a managed care framework and communicate decisions...Remote job
- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
- ...assess care related to mental health and substance abuse. This role involves evaluating treatment needs, performing authorization reviews, and improving service quality. Ideal candidates should have strong behavior health experience and a relevant license. This position...Remote jobFlexible hours
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
$65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30... ...? No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient... .... The position offers a competitive salary range, remote work options, and a comprehensive benefits package...Remote work
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
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