Remote Utilization Review RN Specialist
$69.39k - $88.61kCincinnati Children's
Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of related experience. The position is full-time with 0.8 FTE and a starting pay range of $69,388.80–$88,608.00, plus potential #J-18808-Ljbffr
- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials... ...appropriate levels of care and timely approvals. This remote role requires PA RN licensure (or multi-state eNLC), a care-...Remote work
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Remote workWork at office
- ...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
- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary... ...license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday work- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- ...Cohere Health seeks an experienced RN Reviewer to perform prospective, concurrent, and retrospective reviews ensuring medical necessity... ...Commercial, Medicare, and Medicaid lines. The role is fully remote, requires strong communication, and entails 40 hours per week...Remote workFlexible hours
- ...seeking experienced nursing professionals to review medical records and ensure appropriate... .... Candidates must have a valid California RN license and at least two years of clinical... ...degree in a related field. The position offers remote work with emphasis on critical thinking...Remote work
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and appeals...Remote work
- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Remote workPart timeWeekend work
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented...Remote workFull timeMonday to FridayFlexible hours
$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 perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...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–$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...Remote workFull timeMonday to Friday- ...Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for... ...and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter. #J-18808-Ljbffr...Remote work
- ...Utilization Review Specialist – Join a Top 1% Workplace Are you looking for a fast-paced clinical role where your contributions are truly valued... .... 2 days in office at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary point of contact...Remote workWork at office
- ...Bradford Health Services seeks an experienced Utilization Review Specialist to join our Birmingham-based team. You will evaluate patient records, treatment plans, and clinical data to determine medical necessity and appropriate level of care while ensuring regulatory compliance...Remote work
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
$60k - $70k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range: $... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization... ...or relevant certification, such as RN, LPN/LVN, LMSW, LPC, CADC, LADAC, CCM,...Remote workFull timePart timeWork at office$40k - $50k
...Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply. Job Details...Remote workFull timePart timeWork at officeWeekend work$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $30-35/hour Northpoint Recovery Holdings, LLC... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...Remote workFull timeTemporary workFor contractorsWork at officeMonday to Friday- Kingman Healthcare Incorporated (KHI) seeks an experienced Utilization Review Nurse to support case management in Arizona. You will conduct medical... .... Ideal candidates hold a BSN (MSN preferred), have 3+ years RN hospital experience, and UR or CM exposure. #J-18808-Ljbffr
- ...advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement... ...is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review...Remote jobTemporary workWork experience placementLive outFlexible hours
- ...Job Summary We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play... ...ensure appropriate reimbursement. Qualifications Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact...Work experience placement
- ...treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews,... ...School diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) preferred Minimum of three years'...Remote workFull time
- Cincinnati Children's is seeking a Utilization Review professional to perform admission and continued stay reviews... ...certification for inpatient stays. The role requires RN licensure with relevant experience and works remotely in the United States. The position includes...Remote job
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist. The role supports review of clinical data to determine medical necessity... ...for ABA and related services. It is a fully remote or office/home hybrid position with a collaborative, detail...Remote jobWork at office
- ...Corporation is seeking a licensed clinician to review ABA services and health status across... ...reviews, data analysis to improve utilization, and collaboration with BH providers. Time... ...MST, or CST is required, with flexible remote/hybrid options. #J-18808-Ljbffr Centene...Remote workFlexible hours
- 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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