Remote LVN — Medical Management & Utilization Specialist
SCAN
- Remote job
SCAN is seeking a Medical Management Specialist-LVN to support care quality and cost-effectiveness for members. The role requires managing utilization processes and working closely with the Clinical Supervisor. This position allows for remote work, ensuring timely and effective healthcare delivery. The ideal candidate will have 3+ years in medical-surgical nursing and a current California LVN license. Join us at SCAN and contribute to improving care for older adults while enjoying a range of benefits. #J-18808-Ljbffr SCAN
$35.62 - $52.99 per hour
...Responsibilities As our Utilization Review LVN, your focus will be to provide... ...to achieve maximum medical improvement while receiving... ...Medical Group in effective management of the managed care patient... ...operational flow. As a remote employee, we will provide you...Remote workContract work- SHPCA SCAN Health Plan is seeking a Medical Management Specialist‑LVN to promote the quality and effectiveness... ...regulatory guidelines. This role is remote and requires a California Licensed... ...in medical/surgical nursing and utilization management, with proficiency in maintaining...Remote job
$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States NeueHealth is a value-driven healthcare... ...– Centrum Health and Premier Medical – as well as unique partnerships with... ...Corporate office preferred / remote may be considered Collaborative environment...Remote workHourly payWork at office- ...remote position in any state except, NY, CA, HI, or AK max bill... ...Effectiveness And Quality Of Medical/Surgical Services And Serving... ...And Medical And Network Management Divisions. Review Service Requests... ...Information Regarding Utilization Management Requirements And Operational...Remote workContract work
$50k
Employer Industry: Behavioral Healthcare Management Why consider this job opportunity... ...authorizations, concurrent reviews, and internal utilization review assessments Consult with the... ...appeals Staff individual cases with medical doctors as required Maintain...Remote job- ...Behavioral Health Utilization Management Specialist We are seeking a detail-oriented and clinically skilled... ...health services to ensure medical necessity, regulatory compliance, and... ...ability to work independently in a remote environment. Key Responsibilities...Remote workFlexible hours
$41.6k - $47k
...Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG,... ...prior authorization requests within Medical Management. This role is responsible for ensuring... ...stay organized and productive in a remote, independent work environment...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work- ...from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements,... ...experience in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including...Remote jobContract workWork from home
- ...telehealth platform, the full-time Senior Utilization Review Specialist will manage the utilization review process, ensuring medical necessity and appropriate levels of care while... ...companies and clinical staff in a remote work environment. Key responsibilities Oversee...Remote workFull time
- Cambia Health Solutions in Tacoma, WA is looking for a UM IP Clinical Specialist to support the Clinical Services team. In this role, you will research and manage inpatient utilization management cases, collaborating with clinical professionals. Candidates must possess...Remote jobWork from homeFlexible hours
- Cambia Health Solutions is seeking a UM IP Clinical Specialist to support Inpatient Utilization Management cases. In this role, you will work from home and leverage your clinical knowledge to manage requests and collaborate with healthcare professionals. The ideal candidate...Remote jobWork at officeWork from home
- ...Harbor Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN supports prior authorization... ...clinical information, support medical necessity determinations, and maintain... ...Business Hours This position is fully remote Monday-Friday 8am - 5pm with the...Remote workLocal areaMonday to FridayShift work
$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... ...Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour...Remote workHourly payContract work- An established industry player in health care is seeking a Utilization Review Nurse to join their dedicated team. In this vital role, you will evaluate medical records and apply clinical expertise to ensure the delivery of necessary health services. Your contributions...
- ...2 days ago Requisition ID: 9252 UR Specialist – Join Camber and Make an Impact At... ...difference every day. Job Summary The Utilization Review department manages all aspects of a patient’s stay... ...schedule of 2 days in office and 3 days remote after successfully completing their...Remote workFull timeWork at officeMonday to Friday
- ...Metered Utilities Specialist Are you someone who enjoys research and has... ...those trends? Do you enjoy managing projects and building relationships... ...~ Life insurance ~ Paid medical leave/disability insurance... ...available; 50% in the office, 50% remote About LCS London...Remote workLive inWork at officeRelocationWork visa
$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions... ...team of revenue cycle management professionals... ...documentation, treatment plans, and medical records to optimize...Remote workWork at officeFlexible hours- Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
- Case Management Society of America (CMSA) ® is seeking a Behavioral Health Utilization Manager in Houston, Texas. The role involves performing concurrent and discharge reviews... .... Competency in MS Office is required, and a remote work schedule is available. #J-18808-Ljbffr...Remote job
- ...Utilization Management Specialist Our client, a health insurance company, is looking for a Utilization Management Specialist for their remote location. Responsibilities: ~50% Clinical Review... ...retrospective) to determine medical necessity, clinical appropriateness...Remote workWork at officeImmediate start
- ...Alternative Centers is looking for a Utilization Review Specialist in Chadds Ford, PA. This... ..., ensuring services are medically necessary and compliant... ...utilization review or case management. This position offers flexible hybrid or remote work options and a comprehensive...Remote jobFlexible hours
- Direct Jobs is hiring a Behavioral Health Utilization Manager based in Houston, Texas. The role... ...reviews on patients, ensuring adherence to medical necessity criteria, and collaborating... ...review in a managed care environment. Remote work is available for this position. #J...Remote job
- A healthcare services company seeks a Utilization Management Representative I, offering remote work with in-person training. Responsibilities include managing... ...GED, with preferred experience in call centers and medical terminology. Strong communication and problem-solving...Remote jobContract workFlexible hours
- ...IHMS USA, Inc. provides medical services to some of... ...accredited and compliant management systems that help... ...Electronic Medical Record Specialist is responsible for the... ...: Utilize and support an Office... ...Record system provides remote access, required accounts...Remote workMinimum wageFull timeContract workWork at officeLocal area
- Utilities Specialist I - Hybrid - 3 days on site, 2 days WFH Full time; Non-Exempt; 40 hours/week;... ...customer service experience. Benefits Medical, Dental, Vision, Wellness, Flexible... ...and/or move about the organization or remote office. The employee is frequently required...Remote workFull timeTemporary workWork at officeWork from homeFlexible hours
- System One is hiring a Permitting Specialist to manage the permitting process for telecommunications projects while working remotely. You will be responsible for coordinating with utilities and municipalities to secure necessary approvals. The ideal candidate has over 2...Remote jobWork at office
- ...Alignment Healthcare LLC is seeking a Lead Utilization Management Nurse, responsible for reviewing inpatient... ...leading a team of UM Nurses. This fully remote position demands strong communication skills and a valid California LVN or RN license. The role includes mentoring...Remote work
- SCAN Group in California seeks a Medical Management Specialist-LVN to ensure quality care for members. The... ...complex medical cases and applying utilization management principles to support care... ...and strong communication skills. This remote position provides competitive salary...Remote job
- ...electrical make ready design, and utility standards• Review and approve... ...designers, technicians, and specialists• Mentor team members (10-15... ...teams• Partner with project managers and leadership on workload... ...This role is designated as remote, giving you the flexibility to...Remote workWork at officeWork from home
- ...industry-leading revenue cycle management services for healthcare... ...are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The... ...environment. This is a fully remote or office/home hybrid... ...clinical information to ensure medical necessity and compliance...Remote workWork at officeFlexible hours
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