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
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity, coordinate with physician advisors, and... ...of resources. Must hold an unrestricted RN or LPN license and have 3+ years of acute care nursing experience...Remote job
- ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a liaison between clinical operations...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
$70k - $100k
...of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position is ideal... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two...Remote workContract work2 days per week- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
- ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle... ...to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities...Remote workWork at officeFlexible hours
- ...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
- Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
$39.4 - $53 per hour
...39.40 - $53/hr based on experience LPN pay scale $32.65 - $46.90/hr based on... ...other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job... ...and Abilities Required: This is a remote role which requires access to high speed...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend work$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 jobHourly payContract work$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- ...assigned tasks related to preadmission reviews, continued stay reviews, medical necessity... ..., in the least restrictive environment, utilizing proven clinical interventions will lead... .... Seeks guidance from appropriate leadership when facility #J-18808-Ljbffr Remote JobsRemote workWork at office
$41.6k - $47k
...Utilization Review Specialist At Umpqua Health, we're more than a healthcare organization we're a community-driven Coordinated Care Organization... ...with the ability to stay organized and productive in a remote, independent work environment Proactive communication with...Remote workWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work- 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 a detail-oriented and experienced Utilization Review (UR)...Remote workFull timeMonday to FridayFlexible hours
- Diversified Treatment Alternative Centers is looking for a Utilization Review Specialist in Chadds Ford, PA. This role supports behavioral health... ...case management. This position offers flexible hybrid or remote work options and a comprehensive benefits package. #J-188...Remote jobFlexible hours
$55k - $70k
Utilization Review Specialist ? Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are? Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental...Remote workFlexible hours- 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 job
- HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role... ...and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr...Remote job
- Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit...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, assisting...Remote job
$65k - $85k
...Job Description Job Description Utilization Review Specialist (RN) – Remote $65K–$85K | OASIS & Coding Certified | Florida RN License Required Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home...Remote workMonday to FridayWeekday work$51 per hour
...Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote – offsite) Type: Contract To Hire Compensation: $51/hr (W2) Work Model: 100% Remote Must be Licensed in one of the 3 states: MD, VA or Washington D.C. Overview...Remote workContract workTemporary workWork at officeLocal areaWork from home$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...Daily paidFull timeTemporary workPart timeWork experience placement- An established industry player in health care is seeking a Utilization Review Nurse to join their dedicated team. In this vital role, you will evaluate medical records and apply clinical expertise to ensure the delivery of necessary health services. Your contributions...
- ...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
- Molina Healthcare is seeking a Remote Medical Review Nurse (LVN/LPN) for PST schedule in the United States. The role involves reviewing documentation to ensure medical necessity and appropriate level of care, with focus on coding accuracy and reimbursement. The candidate...Remote jobShift work
- ...is seeking a Pharmacy Coordinator – Fraud, Waste, and Abuse (FWA) to support the Medical Management/Health Services team remotely. You will review FWA referrals, assist with regulatory requests, and help analyze and document investigations. The role requires 3+ years of...Remote work
- ...coordination. Staggered Remote Position This position... ...: Clinical Triage Specialist must be able to demonstrate... ...in the EMR. Review patient data for relevant... ...history of present illness. Utilize MD approved guidelines... ...Certification Association Active LPN license in state of...Remote jobPart timeWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote LPN Utilization Review Specialist. Be the first to apply!


