Utilization Management Specialist II Remote
Elevance Health
Elevance Health is seeking a detail-oriented Utilization Management Representative II to manage inbound calls, determine eligibility, and authorize care. The role supports virtual work with required in-person training sessions and may require commuting within a reasonable distance to posting locations in Florida. You will collect patient demographics, perform clinical screening, and liaise with medical management and other departments to ensure timely and accurate authorizations and referrals. #J-18808-Ljbffr
- Elevance Health is seeking a detail-oriented Utilization Management Representative II to manage inbound calls, determine eligibility, and authorize care. The role supports virtual work with required in-person training sessions and may require commuting within a reasonable...Remote job
- Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance...Remote jobHourly payFull time
- ...direction of the Assigned Management, upon successful... ...regulations the Enrollment Specialist performs enrollment... ...all member enrollments utilizing multiple Health Plan... ...management. Level II - in addition to Level... ...may be opportunity for remote work within all jobs posted...Remote workWork experience placementWork at officeWork from homeHome office
- ...AI-enabled solutions that span practice management to electronic medical records and e-... ...quality care to their clients. As an RCM Specialist II, you will serve as a trusted partner to... ...operational efficiency and customer outcomes. Utilize technology and available tools to...Remote workWork at office
$65k - $85k
...geologists, and technical specialists, embedded in a people-... ...Project Controls Specialist II, as a support role to the Project Manager. This opportunity is... ...Project Management software utilizing Gantt charts. The role... .... This position is remote. As a Project Controls...Remote workFull timeTemporary workFlexible hours- ...DescriptionProSidian is a Management and Operations Consulting... ...Seeks a Subject Matter Expert II - Subject Matter Specialist (NSS010) headquartered near CONUS - Washington, DC (Remote) to support requirements... ...| Oil & Gas | Power & Utilities | Distribution Engineering...Remote workFull timeTemporary workFor contractorsWork at officeFlexible hours
$27.07 - $38.08 per hour
...We are seeking a Program Specialist II who will support the administration... ...Doing Assist Program Managers in developing, implementing,... ...through electric and gas utility-offered programs and directly... ...offers role-dependent options for remote, hybrid, and in-office work....Remote workHourly payFull timeTemporary workWork experience placementFlexible hours- ...Utilization Management Team Member We are seeking dedicated remote professionals residing in Florida to join our utilization management team. In this work-from-home role, you will play a critical part in connecting members with the care they need by processing member...Remote workWork from homeMonday to Friday
- ...Cambia Health Solutions seeks a UM IP Clinical Specialist to support inpatient utilization management by researching requests, coordinating with licensed clinicians, and ensuring accurate case documentation and timely actions.The role emphasizes collaboration with clinical...Remote work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for the UR team. You will manage an assigned portfolio of cases, assemble and review documentation, and coordinate payer submissions to ensure timely and compliant authorizations...Remote work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for UR Nurses and ensure timely, compliant authorization workflows. You will manage case portfolios, coordinate documentation, and interact with payers to prevent denials...Remote work
- ...Providence California Regional Services is seeking a Senior Utilization Management Assistant for a REMOTE, per diem role with 8-hour variable shifts. Reporting to the Regional Director of Care Management, you will support the care management team in coordinating patient...Remote workDaily paidShift work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced support for the utilization review process. You will manage an assigned portfolio, assemble documentation for payer submissions, and ensure timely determinations while maintaining compliance...Remote work
$75k - $90k
...Specialist II, Neurosurgery Company: AESCULAP INC. Job Posting Location:... ...Functional Area: Sales Working Model: Remote Days of Work: Wednesday,... ...a leader in infusion therapy and pain management, develops, manufactures, and markets innovative...Remote workSeasonal workRelocationShift work- ...Providing advanced operational support, the remote California Utilization Management Specialist will manage authorization workflows, ensure compliance with regulatory standards, and facilitate communication with payers while collaborating with UR Nurses and other departments...Remote work
$80k - $150k
...Asset Management SpecialistOrbital Engineering, Inc. is currently seeking an Asset Management Specialist with experience in CASCADE and ELECTRIC UTILITIES for a REMOTE WORK role for our Utility Services team to support the implementation of DNV Cascade 4 utility asset...Remote workTemporary workWork at officeWork from home- Specialist II, Education & Knowledge Technical TrainingPOSITION PROFILEDirectly supports the... ...Works with Services Training and field management to deliver training and knowledge that... ...noise levelRequires periodic travel to remote officesMay require overnight travel 20-...Remote workWork at officeLocal areaWorldwideFlexible hoursNight shift
$63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt Unit : UAW Department/Location : Utilization Management Compensation: $63,102.73-$83,647.81 The Final... ...position. While the position is remote, the individual in this...Remote workFull timeTemporary workMonday to Friday- ...Trillium Health Resources is seeking an Utilization Management Specialist III - MH/SU to perform comprehensive clinical review of service requests... ...Carolina licensure; travel within the NC catchment is expected. Remote work options are available for many roles. #J-18808-...Remote work
- ...Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization... ...information is current and complete. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia,...Remote work
- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
$17.84 - $28.02 per hour
...are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate... ...time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be...Remote workHourly payFull timePart timeH1bLive inWork at officeFlexible hours- ...Proposal Specialist IIAECOM is seeking a Proposal Specialist II to support our Program Management marketing team on pursuits, including partnering in the preparation of formal... ...hybrid position including a combination of both remote and in-office work schedules, that can be...Remote workDaily paidWork at officeRelocation package
$22.22 - $31.71 per hour
...to ensure proper reimbursement and minimize claim denials. Utilize coding software, encoders, and electronic health record systems... ...fast-paced environment. Additional Job Details Remote Type: Remote Work Location: 399 Revolution Drive Scheduled...Remote workHourly payShift work- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
- The University of Texas Southwestern Medical Center is seeking a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers. The role emphasizes follow-up and resolution of denied claims, with no direct billing...Remote job
- ...Akron Children's Hospital is seeking a Coding Specialist II for a remote, full-time role. The position emphasizes training, mentoring, and leadership of Coding Specialist I, with responsibility for accurate CPT/HCPCS/ICD coding prior to charge entry. You will review EPIC...Remote workFull time
$68.89k - $92.14k
Pay Plan Title: Utilization Management Specialist III Working Title: Utilization Management Specialist III MH/SUFLSA Status: Exempt Posting Salary Range: $68,890- $92,138 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources...Remote workWork at officeLocal areaImmediate startWork from homeFlexible hours- Providence California Regional Services is seeking a Senior Utilization Management Assistant for a remote, per diem role. You will support the Care Management team in coordinating patient care, performing clerical duties, and contributing to efficient care workflows from...Remote jobDaily paid
- UT Southwestern Medical Center in Dallas seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals within the Revenue Cycle Department. The role emphasizes follow-up and resolution of denied claims and does not involve...Remote job
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