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
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...experience in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including...Remote workContract workWork from home
$90.9k - $129.9k
...patient interactions for this role, rather you will provide utilization review and quality assurance.Your role in our missionReview and evaluate... ...and proceduresWhat you should expect in this role100% Remote home office.Full-time position.Applications will be accepted...Remote workFull timeHome officeFlexible hours$55k - $70k
...support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000 - $70,000 a... ...position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be...Remote workFull timeWork at officeLocal area- ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services,... ...while collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform...Remote workPart time
- ...To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client...Remote workFull timeWork at office
- ...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 workWork at officeFlexible hours
$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- ...leadership programs... and more! Description The Utilization Review (UR) Specialist is a Registered Nurse responsible for conducting thorough... ...time may be required. Work Type: This position is a remote position outside traditional office, often from home or another...Remote workWork at office
- ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing... ...is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and...Remote workFull timeWork at office
$80 per hour
...healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization... ...healthcare operations.This role supports current and upcoming remote consulting opportunities focused on AI-assisted prior...Remote workHourly payPart timeFor contractorsWork at officeFlexible hours$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal area$16.74 - $26.92 per hour
...Utilization Review (UR) Intake SpecialistThe Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling... ...department, and of CorVel.This is a remote position.ESSENTIAL FUNCTIONS & RESPONSIBILITIES...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours$35 - $40 per hour
...Job Title: Utilization Review Specialist Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 2009 as Ashwood Outpatient and officially launched the Northpoint platform in 2015. Now celebrating...Remote workFull timeTemporary workWork at officeMonday to Friday- ...Responsible completion of assigned tasks related to preadmission reviews, continued stay reviews, medical necessity requests, and chart... ...appropriate services, in the least restrictive environment, utilizing proven clinical interventions will lead to the provision of safe...Remote workWork at office
- FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance....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
- ...Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...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- ...Who We're Looking For We are seeking an experienced specialist who is passionate about making a difference in the lives of... ...Health or related field required preferred. ~2-3 years of utilization review experience in behavioral health, addiction treatment, or managed...Remote jobDaily paidFull time
$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...Remote workHourly pay$16.74 - $26.92 per hour
...of a partner company, who manages all applications and next steps. Our partner is looking for a Utilization Review Intake Specialist based in United States. This remote role provides essential administrative and intake support within a utilization review and case management...Remote jobHourly payFull timeWork at officeFlexible 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
- ...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
$13 - $14 per hour
...0 per hour Job Type: Contract Location: Remote Schedule and Shift: Monday-Thursday from... ...contracted health plans requirements related to Utilization Management and authorizations Acts as a... ...Management process and requirements Reviews benefit language and medical records to...Remote workHourly payContract workWork at officeShift work- ...Remote OASIS Reviewer Join Custom Home Health's Quality team as a contingent OASIS Review Specialist! We're looking for detail-oriented clinicians with experience in OASIS review... ...patient diagnoses and comorbidities Utilize OASIS validation and alert reports to...Remote workFull timeFlexible hours
- ...Case Review Specialist- RN reqd Full-time and per diem available Position Purpose As the... ...cases, perform case review utilizing InterQual criteria and clinical knowledge... ..., no weekends or holidays Per diem: remote, up to 20 hrs. per week Qualifications...Remote workDaily paidFull timeContract workFor contractorsWork at office
$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$52.06k
...HVAC units. Control HVAC systems with remote fan coil units - chilled/tempered water.... ...Must be computer literate with ability to utilize Microsoft Office at an intermediate level... ...Special Instructions to Applicants: A review of applications will be ongoing until the...Remote workOngoing contractPermanent employmentWork at office- Utilities Specialist I - Hybrid - 3 days on site, 2 days WFH Full time; Non-Exempt; 40 hours/week;... ...obtain account status and current billing. Review loan documentation to determine utility... ...and/or move about the organization or remote office. The employee is frequently...Remote workFull timeTemporary workWork at officeWork from homeFlexible hours
$58.47k
...$58,473.00 Annually Location: Primarily Remote (Michigan-based) Schedule: Full-Time | Option... ...and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ensure...Remote workFull timeFlexible hours
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