Remote LPN Utilization Review Specialist
Mass Digital Health
- Remote job
Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements, requiring clinical expertise and knowledge of Medicaid guidelines. Candidates must have an active LPN license, at least one year of experience in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical, dental, and 401(k) plans. #J-18808-Ljbffr Mass Digital Health
$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 perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote workHourly payContract work- ...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
- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of...Remote work
- ...At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and...Remote workPart time
- 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 job
$50k
...lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent reviews...Remote job- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
$29.62 - $45.31 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...requests, customer service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for candidates...Remote workMinimum wageFull timeWork experience placementLocal areaShift work$27.07 - $33.37 per hour
...thinking, exceptional leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length...- ...and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workFull timeWork at officeFlexible hours
$60k - $62k
...Job Description Job Description Title : Utilization Review Specialist/Behavioral Health Substance Abuse (Remote) Reports to : UR Manager FLSA Classification : Exempt Full-Time or Part-Time : Full-Time Salary Range : $60,000 to $62,000 Starting...Remote jobFull timePart timeFlexible hours- ...Job Description Job Description Utilization Review Specialist – Behavioral Health Facility We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing clinical documentation, ensuring...Remote jobFlexible hours
$16.74 - $26.92 per hour
...Job Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence... ...an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...Job Description Job Description Salary: Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking...Remote workFull timeMonday to FridayFlexible hours
- ...an Appeals and Grievances Clinical Specialist to manage member complaints and... ...case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities... ...practice and knowledge of Utilization Review Guidelines. The position offers a...Remote work
$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly pay- ...Metered Utilities Specialist Are you someone who enjoys research and has a keen eye for detail?... ...to manage customer utilities and rate reviews. Essential Functions Core functional... ...available; 50% in the office, 50% remote About LCS London Computer Systems...Remote workLive inWork at officeRelocationWork visa
$51 per hour
...Utilization Management Specialist (UM / Utilization Review Nurse) — Remote Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx... .... Required qualifications ~ Active RN or LPN license (RN preferred) — Maryland compact/...Remote workFull timeContract workWork at officeLocal areaFlexible hours$51.46k - $60k
...through Friday from 9:00 AM-5:30 PM (2-days remote, 3-days in office) Responsibilities... ...services from insurance and government payors Reviewing clinical records and determining the... ...summary reports and presentations on utilization management data Other duties as assigned...Remote workFull timeTemporary workWork at officeMonday to FridayFlexible hoursShift work- ...Full-Time Position Summary The Utilization Specialist uses strong independent... ...processes. Conduct utilization reviews to ensure services meet... ...services preferred. Active LPN, RN, MSW, CSW, LPC, or another... ...working on a computer. Hybrid or remote work may be available based...Remote workFull timeWork at officeFlexible hours
- ...Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required...Remote workContract workWork at office
$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to... ...Corporate office preferred / remote may be considered Collaborative...Remote workHourly payWork at office$13 - $14 per hour
...hour Job Type: Contract Location: Remote Schedule and Shift: Monday-Thursday from... ...health plans requirements related to Utilization Management and authorizations Acts as... ...Management process and requirements Reviews benefit language and medical records to...Remote workHourly payContract workWork at officeShift work- ...Centinela Hospital Medical Center in Inglewood, CA seeks a skilled Utilization Review Tech to support denial management efforts and coordinate data with insurers. You will manage communications and data entry across multiple health plans, ensuring accurate tracking of...
- ...Utilization Review Specialist Position Summary: Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources... .... License Requirements: Licensed Practical Nurse (LPN) license with State Nursing Board and/or possess multistate...
- ...Utilization Review Specialist The Utilization Review Specialist (URS) exercises independent judgment and professional discretion in the practice of case management to a select group of patients. The URS collaborates with physicians to ensure that patients are at the...Shift work
$17.44 per hour
...Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E. Integrity, Compassion, Accountability, Respect, and Excellence. Our mission is to promote healthy communities and provide the highest quality care to enhance the well-being...Hourly payFull timeWork at officeFlexible hoursWeekend work- ...Utilization Review Specialist At Sycamore Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that...Full timeLocal area
- ...Botox Utilization Review Specialist This position plays a vital role in ensuring patients receive timely access to medically necessary therapeutic Botox treatments. The role offers a consistent weekday schedule and the opportunity to work closely with clinical teams...Work at officeWeekday work
$26.35 - $39.53 per hour
...experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting... ...Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California... ...discharges. Corporate office preferred / remote may be considered. Collaborative...Remote workHourly payWork at office
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