Remote Utilization Management Rep I
Elevance Health, Inc.
Elevance Health, Inc. is seeking a Utilization Management Representative I (US) to coordinate precertification and prior authorization reviews. The role supports remote work with required in-person training sessions and occasional office presence as needed. You will handle calls, check eligibility, and authorize services while collaborating with nurses and other teams. The ideal candidate has a HS diploma or GED and at least 1 year in customer service or a call-center environment, with strong #J-18808-Ljbffr
Vacancy posted 23 hours ago
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Atlanta, GA2 days ago - ...Elevance Health seeks an Utilization Management Representative I to support precertification and prior authorization reviews. The role offers flexible virtual work with required in-person training and occasional office presence, located in Columbus, OH. Key duties include...Remote workWork at officeFlexible hours
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Pueblo, CO2 days ago- ...Description Summary This position supports the Utilization Management (UM) workflows by providing... ...coaching, and training to UM Services Reps. Collaborates with other key departments... ...Please note: There may be opportunity for remote work within all jobs posted by the CDPHP...Remote workContract workWork at officeWork from homeHome office
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Buffalo, NY2 days ago - ...Excellus BCBS is seeking an UM Services Representative to support Utilization Management workflows with administrative and customer service duties. You will handle inbound/outbound calls, process authorizations via phone, fax, and provider tools, and ensure timely, accurate...Remote work
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Utica, NY2 days ago - ...seeking an Inside Sales Support professional for a remote US position. You will handle order entry, tracking, and order management with local units and ABB groups, while... ...technical customer support experience in industrial/utility contexts, with knowledge of power...Remote workLocal area
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Lansing, MI3 days ago - ...an Inside Sales Support professional to manage daily order entry, tracking, and order management... ...business units and agent accounts. This remote US role requires coordinating across ABB... ...customer support within industrial/utility fields, strong database skills, and B2B experience...Remote workLocal area
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Montgomery, AL2 days ago - ...professional located in the United States to manage order entry, tracking, and order... ...technical customer support within industrial/utility fields, plus familiarity with product configuration tools and B2B processes. Remote work option with domestic travel possible....Remote workLocal area
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United States2 days ago - ...CVS Health is seeking a Registered Nurse to join our Utilization Management team in a work-from-home weekend position. You will assess, plan, and coordinate care, applying clinical criteria to determine appropriate benefits and services for members. The role requires...Remote workWork from homeWeekend work
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United States23 hours ago - ...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 certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
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New York, NY3 days ago - ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate care for members. The role requires a registered nurse with at least 3 years of experience and an active license in the resident state.The position operates...Remote workWork from home
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United States2 days ago - ...Sentara Health Plans is seeking an RN Clinician for a remote role focused on utilization management and claim review. The position requires an active RN license (VA or Compact) and a BSN, with at least 3 years of acute care experience, including utilization review or post...Remote work
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United States23 hours ago - ...Job Description\n Utilization Management Medical Director Oncology\n\n\n \n \n Work Location: REMOTE (work from home)\n \n \n The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology care with...Remote workWork from home
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CVS Health
Virginia Beach, VA3 days ago $35 - $40 per hour
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United States4 days ago$75k - $90k
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United States23 hours ago- ...CVS Health is hiring a Medicare Precertification Utilization Management Nurse Consultant. The role involves assessing care options, applying clinical criteria, and coordinating with providers to ensure appropriate services are delivered. Requires RN licensure and 3+ years...Remote workFull timeWork from homeMonday to Friday
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Coraopolis, PA3 days ago - ...Health Solutions is hiring a Clinical Specialist to work from home across Idaho, Oregon, Utah, and Washington. You will help manage utilization and ensure high-quality, timely case handling while supporting providers and members. Ideal candidates have a high school...Remote workWork from home
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United States1 day ago - ...Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will apply UM criteria and clinical judgment to determine coverage for inpatient and outpatient services, coordinating with care teams to ensure appropriate...Remote workFull time
Oak Street Health, part of CVS Health
United States1 day ago
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