Hybrid/Remote Utilization Review Pro - Compliance Focus
Diversified Treatment Alternative Centers
- Remote job
Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented Utilization Review Specialist to ensure authorization accuracy and regulatory compliance for our behavioral health programs. This role collaborates with Clinical, Admissions, and Revenue Cycle teams to minimize denials and support timely reimbursement. The position offers flexible hybrid or remote options, with a focus on maintaining medical necessity, efficient authorizations, and thorough documentation across EHR and #J-18808-Ljbffr Diversified Treatment Alternative Centers
- ...Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information... ...related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA compliance. The ideal candidate has 3-5 years of...Remote jobWork at officeWork from home
$20 per hour
...nationwide leader of affordable housing compliance. Since 1994, property managers,... ...Zeffert for accuracy and speed on utility allowances, tenant file reviews, building accessibility, and... ...Thinking: 2 years (Required) Work Location: Hybrid remote in St. Louis, MO 63141...Remote workFull timeWork experience placementLocal areaMonday to FridayFlexible hours- ...Job Summary The Utilization Management Clinical Analyst... ...conducts prospective reviews of authorization... ...clinical quality and compliance. Monitor and analyze... ...needs a primary focus of one’s actions; developing... ...environment. Hybrid (onsite/remote) work schedule available...Remote workWork at office
- ...support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely... ...Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client service. Key Responsibilities...Remote workFull timeWork at office
- ...Centene Corporation is seeking a Behavioral Health Utilization Review clinician to evaluate and authorize BH services, ensure appropriate... ...role emphasizes quality improvement, case presentations, and compliance with regulatory guidelines. Qualified candidates will have nursing...Remote work
- ...seeking a Senior Utility Management... ...metro-area) with a focus on water, wastewater... ...be provided in compliance with the... ...quality assurance reviews of deliverables... ...ArcGIS ArcMap and/or Pro and various extensions... ...job. This is a hybrid position (in office/remote). We offer a...Remote workFor contractorsWork at officeLocal areaWork from homeWork visa1 day per week
- ...Centers (DTAC) is seeking a detail-oriented Utilization Review (UR) Specialist to support our behavioral health programs in a hybrid/remote setup in Chadds Ford, PA. You will... ...reimbursement while maintaining regulatory compliance. #J-18808-Ljbffr Diversified Treatment...Remote job
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
- ...Massachusetts workers’ compensation claims by reviewing medical treatment requests, evaluating records,... ...This role offers a more predictable schedule and hybrid work arrangement in Manchester, NH. You will conduct utilization reviews, review treatment plans, apply state...Remote job
- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...Remote workFull time
- ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization review... ...patient status determinations and compliance with regulatory requirements while working remotely. Key responsibilities: Conduct...Remote workFull time
$114.3k - $127k
...not be considered.HYBRID SCHEDULE: Eversource... ...approved for remote work and are subject... ...execution, control, compliance and close-out... ...functional groups utilizing the Risk and EVM processes... ...procedures. Review and update the... ...engaged workforce Focus on the customer...Remote workFull timeContract workFor contractorsH1bWork at officeShift work- Montefiore WeCARE is seeking a Review Physician to support the Medical Director... ...to ensure NYC HRA contractual compliance. The role involves performing medical... ...WeCARE staff. The position offers a hybrid schedule with 1-2 days remote, Monday-Friday, and comprehensive benefits...Remote workMonday to Friday
$82.8k - $92k
...balance by offering hybrid schedules for... ...roles approved for remote work and are subject... ...Engineer, Reliability Compliance to support... ...preparation, and review of NPCC regulatory... ...Skill: Familiar with utility industry, especially... ...workforce Focus on the customer Take...Remote workFor contractorsH1bWork at office- .... The position is hybrid, with 3 days required... ...and approved remote/telework locations... ...priorities at Sprint Reviews, Monthly Status... ...trends, capacity utilization metrics, change success... ...improved, with a focus on increasing... ...\n \n\nSecurity & Compliance:\n\n \n Ensure all...Remote workFor contractorsWork experience placementShift workNight shift
- ...Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of... ...real-time queue. This full-time role emphasizes accuracy, compliance, and evidence-based decision making. Qualifications include...Remote jobFull time
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
- ...Job Description Job Description The utilization review and management (UM) component program... ...of care, while supporting regulatory compliance and organizational risk management. The... ...for lunch This is an in-office, no remote work capability position Travel ~...Remote workWork at office
$145.09k - $161.21k
...stakeholders support. Reviews informational responses... ...relationships across the utility and energy industry.... ...analytics and the ability to focus on the broader... ...commitments and results. HYBRID WORK POLICY: Eversource... ...to roles approved for remote work and are subject to...Remote workFor contractorsH1bWork at office- ...Location: Florida - Remote WHY JOIN FCS... ...in our network. Utilizing innovative... ...License Required Hybrid Position Supports... ...services team where our focus is to deliver best... ...monitoring and compliance. Provides support... ...Pharmacoinformatics Reviews drug utilization...Remote workPrivate practiceWork at officeLocal areaWork from home
- ...health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability,... ...are classified as hybrid, onsite or remote. While the majority of our employees are... ...State of Arizona. PURPOSE OF THE JOB The Utilization Review Supervisor coordinates the activities...Remote workFull timeWork experience placement2 days per week1 day per week
- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance Location: Burbank, CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-Time... ...staff, managing daily tasks, performance reviews, and any necessary disciplinary actions...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...Hybrid Litigation Paralegal We are seeking a dynamic... ...will allow you to utilize your extensive knowledge... ...large-scale document reviews, and guiding cases... ...responsible for ensuring legal compliance, managing case files... ...disability Hybrid remote/onsite work flexibility...Remote workPermanent employmentTemporary workLocal area
- ...Registered Nurse: Review and EvaluationAre you a registered nurse ready... ...and step into a dynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion... ...medical recordsExperience in utilization review, case management, quality...Remote workWork from home
$204k - $242k
...Operations Director (Hybrid) Ceribell United... ...technology company focused on transforming the... ...ED penetration and utilization Create core sales... ...applicants, please review our Privacy Policy. Compliance Disclaimer If you believe... ...compliance. #J-18808-Ljbffr Remote GenieRemote workLocal areaFlexible hours$120k - $130k
...growing team. In this hybrid role, you’ll work 3 days in-office and 2 days remote, managing projects that... ...on role performing and reviewing heavy construction... ...start to finish, with a focus on heavy construction layout... ...work for accuracy. Utilize AutoCAD Civil 3D to...Remote workWork at office$1,966 per week
...personalized managed health care, focused on what's important to you—... ...Holidays Work-life balance. Remote/hybrid setting (once trained) ROLE... ...: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours- ...their resources, drive compliance, and focus on their core... ...that is eligible for a hybrid schedule (3 days required onsite/2 days remote) after the first 90 days... ...~ Drive efficient utilization of developer resources... ...hiring process, such as reviewing applications, analyzing...Remote workContract work
- ...analysts, the full-time Utilities Manager will oversee... ...operations, and ensure compliance across multiple communities while working remotely. Key responsibilities... ...and compliance, while reviewing their work for accuracy... ...experience with a focus on setting expectations...Remote workFull time
- ...complex business tax returns. The role focuses on Partnerships and S Corporations, with... ...personalized client support. You will work in a remote, customer-facing capacity, using video... ..., explain tax concepts, and ensure compliance during peak filing periods. #J-18808-Ljbffr...Remote jobSeasonal work
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