Remote Utilization Management Specialist
Cedars-Sinai
Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for UR Nurses, ensuring timely, accurate, and compliant utilization reviews. The role handles authorization workflows from submission to final determination and collaborates with UR Nurses, Case Management, Revenue Cycle, and payers to maintain documentation integrity. The ideal candidate will have at least 2 years in hospital authorization management and acute care experience, with strong #J-18808-Ljbffr
- ...CVS Health is seeking a Behavioral Health Utilization Management Clinician to join the remote Utilization Management team. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services...Remote work
- ...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 work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for the UR team. You will manage an assigned portfolio of cases, assemble and review documentation, and coordinate payer submissions to ensure timely and compliant authorizations...Remote work
- ...Cambia Health Solutions seeks a UM IP Clinical Specialist to support inpatient utilization management by researching requests, coordinating with licensed clinicians, and ensuring accurate case documentation and timely actions.The role emphasizes collaboration with clinical...Remote work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced support for the utilization review process. You will manage an assigned portfolio, assemble documentation for payer submissions, and ensure timely determinations while maintaining compliance...Remote work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for UR Nurses and ensure timely, compliant authorization workflows. You will manage case portfolios, coordinate documentation, and interact with payers to prevent denials...Remote work
- ...Providing advanced operational support, the remote California Utilization Management Specialist will manage authorization workflows, ensure compliance with regulatory standards, and facilitate communication with payers while collaborating with UR Nurses and other departments...Remote work
- ...Providence California Regional Services is seeking a Senior Utilization Management Assistant for a REMOTE, per diem role with 8-hour variable shifts. Reporting to the Regional Director of Care Management, you will support the care management team in coordinating patient...Remote workDaily paidShift work
- ...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...Remote workPart timeAfternoon shift
- ...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 work
- ...Trillium Health Resources is seeking an Utilization Management Specialist III - MH/SU to perform comprehensive clinical review of service requests... ...Carolina licensure; travel within the NC catchment is expected. Remote work options are available for many roles. #J-18808-...Remote work
$80k - $150k
...Asset Management SpecialistOrbital Engineering, Inc. is currently seeking an Asset Management Specialist with experience in CASCADE and ELECTRIC UTILITIES for a REMOTE WORK role for our Utility Services team to support the implementation of DNV Cascade 4 utility asset...Remote workTemporary workWork at officeWork from home- ...Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization... ...information is current and complete. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia,...Remote work
- ...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...Remote workWork from home
- ...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
$37.5 - $54.25 per hour
...Clinical Expertise to Logan Health’s Utilization Management Team! Our Mission: Quality, compassionate... ...for a Utilization Management Specialist to join our dedicated team! Our Utilization... ...compassion and person-centered care! Fully remote opportunity - Must currently reside in...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift- ...CVS Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United States. Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state...Remote work
- ...Logan Health Medical Center is seeking a Utilization Management Specialist to review admissions across the system and determine appropriate status.... ..., case management and insurers. The position is fully remote for Montana residents and offers a four-day work week with...Remote work
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation... ...communication and EMR proficiency, with a four-day work week and remote options for Montana residents. #J-18808-LjbffrRemote work
$114k - $161k
...Principal Consultant – Utility Return on Equity & Cost of Capital... ...Hybrid – 3 days in office, 2 remote days per week2025 Salary Range... ...is an employee-owned leading management consulting and financial advisory... ...on Equity & Cost of Capital Specialist serves a critical role...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
- ...The UM Administration Coordinator at Humana supports utilization management administration and provides non-clinical support to ensure appropriate... ..., with some discretion under defined policies. Remote position; 40 hours/week, Mon-Fri with Central Time alignment...Remote work
$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- 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
- 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
- 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
- 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...Remote job
$45.76k - $73.22k
...Job Description We’re hiring a Utilization Management Specialist to join the Commercial Pharmacy Phone & UMS Team! The Utilization Management Specialist... ...with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a...Remote workFull timeWork at officeLocal areaFlexible hours2 days per week- ...Cedars-Sinai is seeking a dedicated Utilization Management Specialist to support UR Nurses and ensure timely, compliant approval workflows using EPIC/CS-Link. You will coordinate payer submissions, maintain documentation integrity, and monitor authorizations across an...Remote work
- ...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
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