Remote IDD Utilization Review Clinician
Vaya Health
Vaya Health is seeking an IDD UM Clinician for a remote position based in North Carolina. The clinician will conduct service plan reviews, authorization of services, and facilitate provider network development. A Master's degree in a relevant field and two years of experience in Utilization Management in Behavioral Healthcare are required. The role demands strong interpersonal and problem-solving skills. #J-18808-Ljbffr
- ...Vaya Health is seeking an IDD UM Clinician for a remote position based in North Carolina. The role involves conducting utilization review tasks, collaborating with care coordinators, and ensuring quality service provision for individuals with intellectual and developmental...Remote work
- ...Job Title Provides support for clinical member services review assessment processes. Verifies that services are medically necessary... ...teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications...Remote workWork at office
$25.08 - $51.49 per hour
...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required...Remote jobHourly payWork experience placementWork at office- ...Utilization Review Clinician, Advocate, Remote We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status...Remote workDaily paid
$27.02 - $48.55 per hour
...flexibility. POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN... ...Purpose: Performs a clinical review and assesses care related to... ...improve quality and appropriate utilization of services Provides... ...degree for behavioral health clinicians required. Clinical knowledge...Remote workHourly payFull timePart timeWork at officeFlexible hours$34 - $40 per hour
...range $34.00/hr - $40.00/hr Remote (Compact Licensure Required)... ...Medix is seeking an experienced Utilization Review Nurse to support our mission... .... Provide feedback to clinicians on medical necessity, homebound... ...25 REMOTE Registered Nurse (IDD Assessments) North Carolina,...Remote workFull time$27.02 - $48.55 per hour
...workplace flexibility. This is a remote position. Hours are Monday... ...Position Purpose: Performs reviews of member's care and health... ...quality and appropriate utilization of services Interacts with... ...degree for behavioral health clinicians required. Behavioral health...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...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
- ...A leading healthcare solutions company seeks a skilled Utilization Review Nurse to conduct vital reviews for medical necessity and appropriateness. The ideal candidate will have an active RN license, 3+ years of inpatient clinical experience, and strong written communication...Remote workWork from homeFlexible hours
- ...is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant...Remote workWork from home
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour... ...Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license. Member assessments...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...principles placing our clients’ and clinicians’ best interests first with our commitment...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- 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 jobFull timeWork at officeWork from home
- 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
$45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote work$35 - $45.94 per hour
...Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About The Role You will perform frequent case... ...the Supervisor, Utilization Review. Work Location This is a remote position, open to candidates who reside in: Arizona; Florida;...Remote workHourly payFull timeWork from homeHome office- ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
- ...Inc. is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals and validating... ...of clinical nursing experience, including utilization review, and a valid RN license in Florida or...Remote workFull time
- ...a full-time RN UR Specialist in Albany, GA. Responsibilities include managing insurance notifications and certifications for Utilization Review, ensuring compliance with regulations while supporting patient care. Candidates should possess an Associate Degree in Nursing...Remote workFull time
- ...A leading healthcare organization is seeking a remote RN to ensure appropriate administration of hospital resources and quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations. The ideal candidate...Remote work
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
$45k - $70k
...A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote work- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
$260k - $275k
...Medix™ is seeking a Board-Certified Physician for a fully remote, non-clinical role in Utilization Management. The position involves reviewing clinical documentation to determine the appropriateness of inpatient, outpatient, and pharmacy services. Ideal candidates will...Remote work$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time- ...COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workFull time
- ...Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and... ...collaborating with providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive...Remote work
- ...Providence Health & Services is seeking an RN Utilization Review for a part-time remote position. This role focuses on conducting clinical reviews and utilization reviews across Southern California ministries, requiring effective problem-solving and decision-making skills...Remote workPart time
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