Remote Clinical Utilization Reviewer
Genex Services, LLC
Enlyte is seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers’ compensation related prospective, concurrent, and retrospective treatment referrals. The role requires clinical judgment to ensure medical necessity, collaboration with providers and claims adjusters, and staying current with industry regulations and best practices to improve review quality. #J-18808-Ljbffr
Vacancy posted 11 hours ago
Similar jobs that could be interesting for youBased on the Remote Clinical Utilization Reviewer in New York, NY vacancy
- ...improve care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role in our... ...And much more! Position Overview We are seeking a Clinical Utilization Review Nurse (RN) to assess the medical necessity and quality of...Remote workFull timeContract workWork at officeWork from home
Comagine
United States3 days ago - ...Performing clinical claim reviews, the part-time Massachusetts Licensed Clinical Review RN will... ...and federal guidelines while working remotely. Key responsibilities: Conduct clinical... ...setting 1+ years of experience in Utilization Management, claim review, or medical...Remote workPart timeWork at office
Virtual Vocations Inc
United States1 day ago - ...Clinical Reviewer Position Are you passionate about using your clinical expertise to support... ...We're recruiting for five full-time remote/hybrid Clinical Reviewer positions. This... ...Clinical Reviewer position supports utilization management activities by assessing the...Remote workFull timeWork from homeMonday to Friday
- ...Clinical Reviewer The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements. Position is remote however candidates must reside in California and they need to have an...Remote workContract workFlexible hours
$68k - $71.03k
...Claims Clinical Documentation Reviewer Job No: 541748 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Research, Social... .... Monitor over and under service utilization, conduct prepayment claims reviews, provide...Remote workFull timePart timeInternshipWork at officeWork from homeLong distanceFlexible hoursArizona Department of Administration
United States1 day ago$28.37 - $39.19 per hour
...outcomes through technology, services, and clinical expertise. Our mission is to innovate... ...Acentra Health is looking for a Clinical Reviewer (SCA) to join our growing team. Job... ...Summary: The purpose of this position is to utilize clinical expertise during beneficiary...Remote workContract workWork at officeLocal areaFlexible hoursAcentra Health
McLean, VA22 hours ago- ...accelerator is seeking a medical professional to utilize their expertise in internal or emergency medicine by designing advanced clinical scenarios and evaluating AI-generated responses for accuracy. This fully remote contractor position requires an MD or equivalent and...Remote jobFor contractors
$85k - $92k
...Hourly Equivalent: ~$41 –$44/hr Location: Remote Schedule: Must work AZ hours (... ...unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or... ...(HIGHLY DESIRED) Clinical Quality / Utilization Review / Case Review experience Experience...Remote workHourly payDay shiftTEEMA Solutions Group
Phoenix, AZ4 days ago- ...federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing... ...with experience in clinical review, utilization management, or healthcare quality within... ...driven environment Other Information Remote or onsite depending on business needs...Remote workWork at officeHome office
TEEMA Solutions Group
Phoenix, AZ3 days ago $122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer in the Town of Florida, NY, to consult on medical necessity within utilization management. This vital role involves reviewing authorization requests and ensuring compliance with Healthfirst's regulations. The ideal candidate...Health First
Florida, NY11 hours ago$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer to consult on medical necessity in utilization management and ensure compliance with internal and external regulations... ...collaborating with various departments to manage clinical judgements efficiently. The position requires a...Health First
Nashville, TN11 hours ago$50k - $65k
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend Availability as Needed) Banyan Treatment Centers... ...authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund...Remote workFull timeTemporary workWeekend workWeekday work- Job Description: Job Title: Clinical Quality Reviewer RN (Quality of Care Review) Duration: 9+... ...Extension and Conversion to FTE) Location: Remote - CA Work Schedule: Monday -... ...Quality Review experience Utilization Management (UM) experience Case...Remote workWork experience placementWork at officeMonday to Friday
Pacer Group
United States3 days ago - ...ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers, apply payer rules for authorizations, and collaborate with clinicians to optimize resource use and care quality. Qualifications...Remote workPart timeWork from home
Santa Barbara Cottage Hospital
New York, NY1 day ago - ...improvement, and better health outcomes. Our remote workforce collaborates across the... ...Medicaid Prior Authorization (PA) program reviewing ABA therapy services. In this role,... ...ABA treatment review, Medicaid policy, or utilization management preferred Equal...Remote workRelief
Comagine Health
El Paso, TX3 days ago - Location: Remote - Texas Work Schedule: Dallas, TX (Onsite) 4... ...). Primary Purpose The Clinical Documentation Integrity Specialist... ...) performs patient record reviews to establish complete,... ...extender, nurse, case manager/utilization reviewer and HIM coder to identify...Remote workFull timeTemporary workWork from homeMonday to FridayFlexible hours
Parkland Health and Hospital System
Dallas, TX2 hours ago $122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, 100% work-from-home role available to candidates in the EST Zone. You will review medical necessity, coordinate care, and document UM processes to ensure safe, cost-effective care...Remote workWork from home
4062 Aetna Resources, LLC
New York, NY11 hours ago - ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote work
Santa Barbara Cottage Hospital
New York, NY1 day ago - ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
Virtual Vocations Inc
United States1 day ago - ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting... ...coordinating authorizations, and serving as a liaison between clinical operations and managed care organizations. Key...Remote workFull time
Virtual Vocations Inc
United States2 days ago - ...Working remotely on a part-time basis, the National Clinical Mental Health Counseling Exam Question Reviewer will leverage their expertise to review and enhance exam questions, ensuring accuracy and alignment with official exam standards. Key responsibilities Review...Remote workPart time
Virtual Vocations Inc
United States1 day ago $70k - $120k
...Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement... .... Perform concurrent and retrospective reviews of medical records to ensure accurate... ...and complete clinical documentation. Utilize clinical knowledge and expertise to...Remote workLocal areaMonday to FridayActalent
Middletown, CT3 days ago$74.48k - $111.74k
...Clinical Documentation Specialist It's more than a career, it's a calling IL-REMOTE STL PLAN Worker Type: Regular Job Highlights:... ...Excel. Prior experience reviewing PSI (patient safety indicator... ...and resolves mismatches utilizing the escalation policy....Remote workAya Healthcare
Saint Louis, MO3 days ago- ...Supporting BlueCare Plus Clinical Review Managers, the full-time remote Clinical Assistant will manage provider inquiries, assist with authorization requests... ...and direct incoming calls and faxes related to Utilization Management and Care Management Investigate and...Remote workFull timeWork at officeRotating shift
Virtual Vocations Inc
United States2 days ago - A healthcare technology company seeks a Clinical Reviewer to train AI models and evaluate their performance. This remote position allows flexibility and offers an hourly wage of $50-$60, with bonuses for high-quality work. The ideal candidate must be fluent in English...Remote workHourly pay
DataAnnotation
El Paso, TX1 day ago $96k - $132k
...pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best... ...(CDI) Specialist is responsible for reviewing inpatient medical records to ensure accurate... ...organizational skills Work location: Remote-United States Travel: May include up to...Remote workFull timeH1bWork at officeRelocation packageFlexible hours$50 - $60 per hour
A leading AI training company is seeking a Clinical Reviewer. This remote role involves evaluating the outputs of AI chatbots dealing with complex healthcare problems. Candidates should have a medical degree and fluency in English. The position allows for flexible scheduling...Remote workContract workFlexible hoursDataAnnotation
Nevada, IA1 day ago- ...appeals and dispute cases, the full-time Licensed Medicare Appeals Reviewer will independently review clinical documentation, interpret federal regulations, and issue determinations while working remotely from the United States. Key responsibilities Review medical...Remote workFull time
Virtual Vocations Inc
United States1 day ago $35 per hour
A mobile app evaluation company is seeking a Remote Newsletter Writer to explore and test new mobile games. This entry-level role involves providing feedback about app performance and user experience, requiring no prior experience. The position offers flexibility to work...Remote workHourly payReview Pays
New York, NY1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Utilization Reviewer. Be the first to apply!
Related searches
- medical records clerk New York, NY
- medical reviewer New York, NY
- remote clinical documentation specialist New York, NY
- medical records reviewer remote New York, NY
- medical records reviewer New York, NY
- medical records administrator New York, NY
- clinical documentation specialist New York, NY
- medical record assistant New York, NY
- medical records clerk part time New York, NY
- clinical reviewer New York, NY