Utilization Review Clinician Associate - Remote/Hybrid
Elevance Health
- Remote job
Elevance Health in Tampa, FL is seeking a Medical Management Clinician Associate. The role is primarily virtual with mandatory in-person training sessions, located in Tampa, Miami, or Lake Mary. The schedule is Monday–Friday, 8:00 am–5:00 pm (EDT), with potential extra hours including weekends or holidays. The role involves reviewing medical necessity, precertifications, and utilization reviews within the scope of licensure, supporting complex decisions, and escalating when needed. #J-18808-Ljbffr Elevance Health
$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. License to practice... ...flexible approach to work with remote, hybrid, field or office work...Remote workHourly payFull timePart timeWork at officeFlexible hoursShift work- ...Edison (SCE) is hiring a Design/Drafting, Associate Specialist to create CAD-based designs for utility distribution. This role directly impacts... ...ensure compliance with standards. This hybrid position involves both on-site and remote work as needed. Join SCE and make a...Remote work
$23.76 - $51.49 per hour
...seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...offers a competitive hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly pay- ...A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity... ...at least five years of relevant experience. This full-time hybrid position emphasizes attention to detail and critical thinking...SuggestedFull time
- ...Centene Corp. is seeking an Utilization Review Clinician in Behavioral Health to perform clinical reviews and determine the medical necessity of BH services. The role supports Oklahoma Complete Health – Behavioral Health Utilization Management, with a schedule that includes...Remote workEarly shift
$2,210 per week
...trained? Check out Hines & Associates! ABOUT US: Hines is a nationwide... ...Holidays Work-life balance. Remote/hybrid setting (once trained) ROLE... ...: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours$29.62 - $45.31 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...requests, customer service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for candidates...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
- Elevance Health is seeking a Medical Management Clinician Senior to advance utilization review decisions, collaborate with physicians and leadership, and mentor junior staff. This role is virtual full-time with occasional in-person training and requires licensure and solid...Remote jobFull time
- ...Family Services, Inc. in Westlake Village is seeking an Associate Therapist to join our growing multidisciplinary private... ...with children, teens, adults and couples, with flexible hybrid schedules offering remote and in‑person therapy, supervision from our Clinical Director...Remote workPrivate practiceFlexible hours
- ...Standards & Practices Associate Duration: 6+ Months... ...& Practices Associates review high profile national advertising... ...obtained and utilized in the clearance process... ..., or communications Hybrid role; In-Office days Mon.-Thurs.; Fri. Remote US Tech Solutions is...Remote workContract workFixed term contractWork at office
- ...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
- ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Responsibilities Review patient admission and...Remote workWork at officeFlexible hours
- ...Oversight) Location: On-site/Hybrid - Chicago, IL Contract Duration... ...and annual onsite/remote audits of delegated vendors,... ...Monitor delegate performance, review compliance reports, and ensure... ...clinical, behavioral health, utilization management, quality improvement...Remote workContract workFor subcontractorWork at officeMonday to FridayNight shift
- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
$50.9k - $68.7k
...fill current and future Associate Eligibility Specialist... ...-time, non-exempt, hybrid position. Pay & Benefits... ...may have hybrid remote opportunities after the... ...Eligibility Specialist. Review applications to determine... ...support to staff utilizing various formats of technology...Remote workFull timeSecond jobWork at officeMonday to FridayFlexible hours$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 60936... ...REQUIREMENTS: Full time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY... ...to deal with high stress level associated with working with acutely ill patients...Remote workHourly payFull timeWork at officeRelocation packageShift work- ...decisions. At AZ Blue, we have a hybrid workforce strategy, called... ...as hybrid, onsite or remote. While the majority of our employees... .... PURPOSE OF THE JOB The Utilization Review Supervisor coordinates the... ...review Required Education Associate’s Degree in general field of...Remote workFull timeWork experience placement2 days per week1 day per week
$61k - $86k
Underwriting Associate - Technology (Hybrid or Remote in the West Coast) Job Category : Specialty - Underwriting... ...documenting eligible renewals by utilizing guidelines with minimal to no underwriting... .... For further information, please review the Know Your Rights notice from...Remote jobFull timeWork at office$60k - $70k
...based solutions for our utility, government, and... ...seeking a full-time Solar Associate, Application Processing... ...is responsible for reviewing applications for accuracy... ...required to work in a hybrid work environment... ...Office Locations and a Remote Workforce Energy Solutions...Remote workFull timeFor contractorsWork at office1 day per week- ...meaningful difference every day. Job Summary The Utilization Review department manages all aspects of a patient’s stay... ...8:00 AM – 5:00 PM Candidates may elect to work a hybrid schedule of 2 days in office and 3 days remote after successfully completing their first 90 days...Remote workFull timeWork at officeMonday to Friday
$60k - $70k
Solar Programs Associate - Strategy and Outreach (Hybrid - Chicago, IL) Interested in joining... ...‑based solutions for our utility, government, and... ...accordance with documented SOPs Review, validate, and process applications... ...Office Locations and a Remote Workforce Energy...Remote workFor contractorsWork at office$75k
...Santa Barbara Cottage Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical necessity reviews and collaborating with clinical teams to make informed decisions. Candidates must hold an...Remote work$120k - $135k
...Transaction Management Associate to support the end-to-end... ...position follows a hybrid work model, with working... ..., NJ office and 2 days remote. What you can expect Manage... ...trailing documents. Review and validate trade... ...portfolio visibility. Utilize Microsoft 365 (Excel, SharePoint...Remote workInterim roleWork at office- ...Michigan-Flint currently utilizes Interfolio for all... ...Modes of Work Hybrid The work requirements... ...for hybrid or mobile/remote work mode are at the discretion... .... Work agreements are reviewed annually at a minimum... ...Title Adjunct/Associate/Professor of Practice...Remote workFull timeTemporary workPart time
- Utilization Review Analyst Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews of service authorizations... ...events which may occur outside of standard office hours. Hybrid (onsite/remote) work schedule available. The ideal candidate must be...Remote workWork at office
- ...Utilization Review Nurse Position at Vassar Brothers Medical Center... ...documentation quality. 5. Hybrid Work Standards and Accountability... ...outlined in the Nuvance Health Remote Work Program Policy when... ...Education Skills Experience: Associate's degree in nursing 3...Remote workNight shift
$71.61k - $79.57k
...life balance by offering hybrid schedules for certain... ...to roles approved for remote work and are subject to... ...Eversource is looking for an Associate Analyst, Transmission... ...in the planning and/or review of regulatory filings... ...Familiarity with the utility industry preferred. Database...Remote workFor contractorsH1bWork at office- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels... .... Strong knowledge of Medicare regulations and associated utilization management processes, including: Condition...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 workContract work
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