Remote Clinical Specialist - Utilization Management
Cambia Health Solutions
Cambia Health Solutions is hiring a Clinical Specialist to work from home across Idaho, Oregon, Utah, and Washington. You will help manage utilization and ensure high-quality, timely case handling while supporting providers and members.
Ideal candidates have a high school diploma and 2 years of clinical or hospital experience, with strong organizational, data, and documentation skills to excel in a fast-paced environment.
#J-18808-LjbffrVacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical Specialist - Utilization Management in United States vacancy
- ...positions become available. The Clinical Specialist reports to the Medical Management Director and provides clinical decision... ...membership through effective utilization management strategies. The... ...planning and transitions in care. Remote work is required. Must provide sufficient...Remote workWork at officeLocal areaHome officeFlexible hours
- Cambia Health Solutions is seeking a Clinical Specialist to support utilization management processes from a home-based model across select western states. You will review requests, gather information, and prepare cases for clinical review while coordinating with providers...Remote jobWork from home
- Cambia Health Solutions seeks a Clinical Specialist to support utilization management and regulatory compliance from a remote home base across Idaho, Oregon, Utah, and Washington. The role emphasizes clinical insight, documentation, and collaboration with RNs to optimize...Remote jobWork from home
- ...Community Health Options is seeking a Clinical Specialist who provides clinical decision... ...resources to support medical management. This role analyzes... ...Director, and ensures efficient utilization management across the health continuum. Remote work is required, with secure...Remote workHome office
- ...Cambia Health Solutions, Inc. is seeking a Clinical Specialist to support utilization management by handling nonclinical tasks and coordinating case information... ...and teamwork within a fast-paced environment, with remote work options available across several states....Remote work
- ...leader in the home health management industry and is preparing... ...currently looking for a UM Clinical Support Specialist to join our growing team!... ...supporting the leadership of the Utilization Management team by... ...Suite 140 Phoenix, AZ 85020 Remote Essential Functions...Remote jobWork at officeLocal areaWork from home
- ...Cambia Health Solutions is seeking a Clinical Specialist to work from home within Idaho, Oregon, Utah, and Washington. Join our Clinical... ...hospital experience. You will use strong organizational and data-management skills, EMR familiarity, and the ability to mentor...Remote workWork from home
- ...infusion therapy company, the full-time Massachusetts Licensed Clinical Review Specialist will conduct utilization management reviews and provide clinical information to confirm patient coverage, working remotely with a schedule of Monday to Friday from 8:30 am to 5:00 pm....Remote workFull timeMonday to Friday
- ...Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will review IP UM requests, gather information, and coordinate with licensed clinicians to ensure accurate, compliant decisions. The role emphasizes timely...Remote work
- ...Job Summary The PRN Remote Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued stay...Remote workWork experience placementRelief
$72k - $90k
...Cardiac Rhythm Management Clinical SpecialistCareers that change lives start... ..., defibrillation, and remote monitoring solutions. CRM's... ...customer accounts. Clinical Specialists must be available to support... ...lead for extended periods, utilizing computers and mobile devices...Remote workWork experience placementH1bWork at officeLocal areaImmediate startFlexible hoursWeekend work$71.39k - $132.79k
...of a partner company, which manages all applications and next... ...Our partner is looking for a Clinical Denials Management Specialist based in the United States. In this fully remote role, you will leverage... ...Working closely with nursing, utilization management, revenue integrity...Remote workFull timeHome office$83.1k - $120.36k
...Grievances (A&G) unit manages Healthfirst member complaints... ...of or delivery of clinical and non-clinical... ...manner. The A&G Clinical Specialist is the subject matter... .... This is either a remote or on-site position located... ..., claims processing, utilization review or utilization...Remote workContract workTemporary workWork experience placementLocal area- ...Interventional Technologies seeks a TEG Clinical Specialist to drive utilization of the TEG product line at customer... .... You will support account management through clinical education and case... ...role requires up to 50% travel and is remote within the Minneapolis, MN area. Ideal...Remote work
- ...To support a growing healthcare team, the full-time Inpatient Clinical Specialist will work remotely from Washington, Oregon, Idaho, or Utah, focusing on researching and managing inpatient utilization management cases while collaborating with licensed health professionals...Remote workFull time
$28.2 - $38.2 per hour
...Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho or UtahPreference will be given to current employees... ...of Utilization Management Inpatient (UM IP) Clinical Specialist are living our mission to make health care easier and...Work at officeImmediate startWork from homeFlexible hours- ...days at home. About the job The Clinical Intake Specialist is an integral member of the Enhanced Care Management (ECM) team. In this role, the... ...personalized care planning Utilize evidence-based practices,... ...Individualized Care Plans, Healthcare, Remote Additional Information The...Remote workLocal areaMonday to FridayShift workWeekend workAfternoon shift
- ...America Location: Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe... ...00 locations in our network. Utilizing innovative clinical research, cutting-edge... ...medication monitoring, protocol management, medication information, education...Remote workPrivate practiceWork at officeLocal areaWork from home
$75k - $88k
...alternative application process. Clinical Reviewer RN - Alabama... ...outcomes. Our talented remote workforce spans the country... ...We are seeking Clinical Utilization Review Nurses (RN) based in... ...and retrospective utilization management reviews. This full-time, remote...Remote workFull timeContract work$120.3k - $192.4k
...Associate Director of Clinical Support and supports the Specimen Management business unit, Pacific... ...and expertise as product specialist for Specimen Management... ...optimal workflow and product utilization Facilitates project... ...and work-life balance. Remote or field-based...Remote workHourly payDaily paidTemporary workWork at officeFlexible hoursShift work$80k - $100k
...Dallas territory. The Associate Clinical Oncology Specialist (ACOS) is responsible for... ...provides to facilitate test order management Utilize and maintain internal reports of key... ...to cost of labor considerations. Remote USA $80,000-$100,000 USD OUR OPPORTUNITY...Remote workWork at officeImmediate startWorldwideFlexible hoursWeekend workAfternoon shift- ...Remote-Full Time-DaysScope of Work: Serves in the Lead capacity for Clinical Program Specialist. Responsibility for coordinating the services provided by multiple disciplines... ...Medical Affairs Admin, PH Pre-Service Utility Management Upon Hire Required Or LIC-License...Remote workFull time
- Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will research and act on IP UM requests, coordinate... ...handling across multiple locations through a remote work setup. The role emphasizes independent work...Remote job
- ...Clinical Operations Specialist This is a remote full-time hourly position. We are currently able to employ team members who live in the following... ...years of hands-on experience in prior authorization, utilization management, clinical care coordination, scribing, or other...Remote workHourly payFull timeLive inRelocation
- New England Life Care, Inc. is seeking a Remote Clinical Review Specialist to perform utilization management reviews and provide essential clinical information to confirm patient coverage. The role emphasizes regulatory compliance, complex specialty drug knowledge, and...Remote job
- tango in Phoenix, AZ seeks a UM Clinical Support Specialist to support Utilization Management through data collection, reporting, and administrative tasks. You will help maintain logs, develop reports, and assist reviewers with obtaining clinical information while supporting...Remote job
- Acadia Healthcare seeks a utilization management professional to proactively monitor service utilization and optimize reimbursement for the Georgia... ...between managed care organizations and the facility clinical staff, review plans for medical necessity, and coordinate communications...
$70k - $79k
...Cardiac Rhythm Management Clinical Specialist The Cardiac Rhythm Management (CRM) portfolio delivers... ...advanced pacing, defibrillation, and remote monitoring solutions. CRM's unique ability... ...9 lbs. of lead for extended periods, utilizing computers and mobile devices, and...Remote workWork experience placementH1bWork at officeLocal areaFlexible hoursWeekend work$127.99k - $162.32k
...Based out of (Burlington, MA.) Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in... ...comprehensive clinical and distributive medication management services and will utilize their advanced clinical skills in the provision of...Remote workWork experience placementWork at officeMonday to FridayDay shift- ...Humana is seeking a dedicated Utilization Management Registered Nurse to interpret and support clinical and administrative determinations for post-acute care services including SNF, Home Health, and DME. You will work from home or hybrid, reporting to the Manager of...Remote workWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Specialist - Utilization Management. Be the first to apply!
Related searches
- community health educator United States
- clinical intake specialist United States
- clinical specialist crm United States
- clinical nurse specialist United States
- clinical education specialist United States
- clinical nurse educator United States
- senior clinical specialist United States
- clinical operations specialist United States
- entry level public health educator United States
- clinical data specialist United States

