Remote Utilization Case Manager — Authorization & Clinical Coordination
University of Miami
- Remote job
University of Miami Health System seeks a Full-time, remote Utilization Case Manager to conduct ongoing reviews for clinical utilization and determine continued authorization. The role coordinates with the Nurse Case Manager and healthcare team to support timely patient care and avoid delays. This position manages a designated caseload, communicates progress to the clinical team and patient, and adheres to payer guidelines and internal policies. #J-18808-Ljbffr University of Miami
$50k
...Case Manager / Patient Advocate (Non-Clinical) Valeris is a fully integrated life... ...investigations, prior authorizations / denial appeals,... ...and/or outcome Coordinates nurse teach with field... ...requirements Utilize Valeris' values as... ...English are a plus. Remote work eligibility is...Remote workTemporary workWork at officeImmediate startWork from homeMonday to FridayShift work- ...Location: United States (remote) We're hiring a full-time (W2) Care Coordination Case Manager. This is a US-based,... ...with therapists, clinical leads, and the care... ...records with proper authorization, and confirm the... ...discharge planning, utilization management, or referral...Remote workFull timeShift work
- ...Services Inc. is seeking a Telephonic Medical Case Manager, RN, to deliver comprehensive remote case management in Texas. You will drive... ...employees, providers and employers, and may include utilization review and care coordination. The role requires an active RN license, BSN...Remote job
- ...exciting opportunity for a full time Utilization Review Case Manager to work Remote. The incumbent conducts initial,... ...retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for...Remote workFull timeWork experience placement
- ...review this tip sheet .The purpose of the Utilization Case Manager (Remote) position is to complete ongoing reviews for clinical utilization and identifying the need for continued authorization. The Utilization Case Manager coordinates with the Nurse Case Manager as well as...Remote workTemporary workWorldwide
- The University of Miami is seeking a remote Utilization Case Manager to conduct ongoing reviews for continued authorization and coordinate with the healthcare team to ensure optimal patient outcomes. This is a full-time staff position with a focus on timely authorization...Remote jobFull time
- AllMed Medical Management is seeking a Clinical Quality Assurance Coordinator to support 100% remote utilization review services. The role focuses on applying evidence-based guidelines to determine medical necessity and ensure accuracy and regulatory compliance across reviews...Remote job
- ...supports the FACET Prior Authorization program across Canada. You... ...will work with a team of Clinical Pharmacists to manage high-cost specialty drug... ...nationwide. The role emphasizes coordination, clinical adjudication,... ...and French is an asset. Remote work is available after...Remote jobTrial period
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
$40 - $45 per hour
...Philadelphia, PA (Remote) As a... ...medical knowledge to cases utilizing specified resources... ...InterQual, Care Management Policy, Medical... ...Management and Coordination Manager when indicated... ...referral/authorization requests. Ensures... ...Health clinical experience in a...Remote workHourly payFull timeContract workTemporary workWork experience placementImmediate startWorldwideFlexible hours- ...Immediate Hire for Hospice RN Case Manager Immediate hire for... ...delivers care to patients utilizing the nursing process of assessment... ...professional nursing and clinical competency. Duties and responsibilities... ...patient/family change. Authorize, coordinate and supervise care, as...Remote workImmediate start
- The Case Management Coordinator is a work-at-home position, collaborating with contracted providers in Phoenix, Arizona, with 25% of time spent at provider offices. This role supports care coordination, education, and assessment to facilitate appropriate healthcare outcomes...Remote jobWork from home
- CVS Health in Phoenix, AZ is hiring a Case Management Coordinator to work from home with 25% office visits. You will coordinate care for members, evaluate needs, and collaborate with providers to support behavioral health goals. Requires 2+ years in behavioral health, a...Remote jobFull timeWork at officeWork from home
- AvonRisk is seeking a Medical Case Management nurse (RN) to ensure maximum medical and... ...improvement through early intervention and coordinated care for injured workers in... ...Responsibilities include triage, pre-authorization, utilization review, and ensuring timely...
- CVS Health Corporation seeks a Case Management Coordinator to support members by coordinating appointments, helping access benefits, and educating members through care management tools. The role requires 50-75% travel in Illinois and telework with standard business hours...Remote job
- CVS Health is seeking a Case Management Coordinator for a full-time remote role with travel 50-75% in the Cook County area, primarily Northwest Chicago. Standard... ...needs, coordinating care plans, and engaging with clinical teams to overcome barriers to optimal outcomes. #J-...Remote jobFull timeMonday to Friday
- ...RN Case Manager West Los Angeles County, CA Now Hiring... ...County, CA Remote position + local field... ...physician, and employer. Coordinate RTW with injured... ...direction or secure authorization for services.... ...with physicians. Utilizes clinical expertise and medical...Remote workWork at officeLocal areaImmediate start
$24 - $36 per hour
...primary purpose of the Care Coordinator for the Behavioral Authorization Team (BAT) is to... ...Care Coordinators, Care Managers, facilities and individual... ...ensure proper access and utilization of benefits. Must be available... ...management of customer cases including meaningful...Remote jobHourly payFull timeWork experience placementLocal areaWork from home- CVS Health Corporation is hiring a Case Management Coordinator to support members by coordinating appointments, benefits access and education through care management tools and resources. This full-time telework position requires 50-75% travel within DuPage, Kane, DeKalb...Remote jobFull time
$53.71k - $98.21k
...Now Hiring: RN Case Manager – Grand Rapids, MI Region Remote position + local field travel... ...physician, and employer. Coordinate RTW with injured... ...case direction or secure authorization for services. Maintains... ...with physicians. Utilizes clinical expertise and medical...Remote workFull timeWork at officeLocal areaImmediate start- ...are looking for a Case Manager Mental Health... ...treatment plans utilizing the IM+CANS to maximize... ...be performed remotely. Remote work... ...communications and coordination of services with... .... Complete authorizations, reauthorizations... ...Attend monthly clinical supervisions per...Remote workFull timeMonday to FridayFlexible hoursAfternoon shift
- AllMed is seeking a Clinical Quality Assurance Coordinator (RN) to lead quality utilization reviews and ensure medical necessity in... ...guidelines. The role is 100% remote, requiring a strong knowledge... ...document findings, and support management on compliance concerns while maintaining...Remote job
- Libertana is seeking a Registered Nurse Case Manager for a fully remote role in the United States. You will coordinate clinical care for patients in their homes, perform comprehensive assessments, administer medications as ordered, and monitor required services in partnership...Remote job
- CVS Health is seeking a Case Management Coordinator for a full-time remote role with 50-75% travel in Cook County, IL. You will support members by scheduling appointments, guiding benefit access, and educating members using care management tools. The role requires collaboration...Remote workFull time
$29 - $35 per hour
...Word Processing Coordinator II - Regulatory Document... ...Location: 100% remote. Candidates must... ...formatting and Clinical Study Report (CSR... ...Information Management Systems (RIMS).... ...with the document author. Process, proofread... ...Science, Power & Utilities, Constructions &...Remote workWork at officeWorldwideVisa sponsorshipWork visa- ...The Advocacy Clinical Review Coordinator investigates member... ...care, and expedite cases within... ...decisions while managing multiple regulatory... ...clinical resource with authority to review... ...year in quality/utilization review; or an LPN... ...opportunity for remote work within all...Remote work
- ...diverse place of employment. The Case Manager utilizes advanced nursing skills and knowledge... ...and fiscal responsibility to coordinate the clinical care for a designated patient population... ...-122801-Clinical Case Management Remote/Hybrid/Onsite Onsite On Call Required...Remote workFull timeImmediate startShift workDay shift
$59.12k - $88.68k
...Intake Coordinator The Intake Coordinator... ...include screening of clinical information on... ...to obtain initial authorizations and will maintain... ...assists Clinical Managers and Scheduling Coordinator... ...system utilizing e-fax. Ongoing... ...Nurse preferred Remote Type: On-site...Remote workWork at officeLocal areaFlexible hours$22 - $26 per hour
...message the job poster from Absolute Authorizations LLC Chief Executive Officer at... ...healthcare clinician for our Clinical Case Manager position. This is a fully remote position advocating patient... ...management coverage as needed 6.Coordinate and streamline communication between...Remote workFull timeTemporary work- ...job Internal Title: Clinical Lead Care Manager We are looking for... ...services to ensure coordinated, aligned, and comprehensive... ...CLCM manages client cases, coordinates health... ...(in-person and remote) care management duties... ...e.g. PCP, etc.) Utilize evidence-based practices...Remote workLocal areaImmediate startRelocation packageMonday to Friday
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