Remote Inpatient Utilization Clinical Specialist
Cambia Health Solutions
- Remote job
Cambia Health Solutions is seeking an experienced Utilization Management Inpatient Clinical Specialist to support IP UM reviews from a home office across Washington, Oregon, Idaho, and Utah. The role partners with licensed clinicians to verify information, respond to requests, and ensure timely case handling. Ideal candidates bring clinical expertise, strong communication skills, and proficiency with EMR and billing systems while thriving in a fast-paced environment. #J-18808-Ljbffr Cambia Health Solutions
- ...Clinical Specialist Utilization Management Under the general supervision of the Director of Utilization... ...provider network for psychiatric inpatient, detox, residential authorizations and... ...of Michigan. This position can work remotely with supervisory approval....Remote workTemporary workWork at office
- 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... ...case handling across multiple locations through a remote work setup. The role emphasizes independent work...Remote job
- Cambia Health Solutions is seeking an UM IP Clinical Specialist to review inpatient utilization management requests, collaborate with licensed clinicians, and ensure accurate documentation. You will work in a fast-paced environment, independently handling a high-volume...Remote job
$28.2 - $38.2 per hour
...economically sustainable health care system. Who We Are Looking For Every day, Cambia’s dedicated team of Utilization Management Inpatient (UM IP) Clinical Specialist are living our mission to make health care easier and lives better. As a member of the Clinical Services...SuggestedWork at officeImmediate startWork from homeFlexible hours- Cambia Health Solutions seeks an UM IP Clinical Specialist to review inpatient utilization requests, research information, and coordinate with clinicians to support efficient reviews. The role emphasizes accuracy, timeliness, and adherence to regulatory standards. Work-...Remote jobWork from home
- 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
- ...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...Remote workWork experience placementRelief
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient’s PCP, facility case manager, discharge planner, and contracted providers to ensure appropriate, cost-effective levels of care...Remote work
- ...care. We are currently looking for a UM Clinical Support Specialist to join our growing team! The UM... ...in supporting the leadership of the Utilization Management team by collecting, analyzing... ...Street, Suite 140 Phoenix, AZ 85020 Remote Essential Functions Works independently...Remote jobFull timeWork at officeLocal areaWork from home
- ...Coding department, the Senior Clinical Coding Specialist plays a critical role in... ...Specialist reviews complex inpatient medical records, assigns appropriate... ...annually Work Location: Remote (within Texas only) -Must... ...hospital records • Utilize 3M software, Epic, and coding...Remote workFull timeApprenticeshipWork experience placementWork at officeLocal areaRelocation package
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatients and collaborate with physicians, case managers and facilities to ensure the most appropriate, cost-effective care level. Qualified candidates...Remote work
- ...Humana Inc is seeking a Medical Director to lead inpatient medical necessity reviews and utilization management with a focus on quality and physician collaboration... ...cases and support Humana’s care standards. This remote position requires MD or DO, board certification, and...Remote work
- Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will receive, research, and act on documentation and requests from diverse sources, collaborating with licensed clinicians to guide appropriate actions and...Remote job
$71.39k - $132.79k
...partner is looking for a Clinical Denials Management Specialist based in the United States. In this fully remote role, you will leverage your... ...closely with nursing, utilization management, revenue integrity... ...necessity, clinical validation, inpatient versus observation status,...Remote workFull timeHome office- Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will guide patients through the continuum of care, coordinating with physicians, case managers and service providers to ensure safe, cost-effective care aligned with...Remote job
$92k - $128k
...to be a part of ZOLL!Job Type: Remote Job SummaryThe Clinical Implementation Specialist (CIS) will coordinate post-sale... ...relationships to encourage ongoing utilization of ZOLL hospital products and... ...patient outcomes in an inpatient hospital setting.Required/Preferred...Remote workMinimum wageOngoing contractFull timeLocal areaWorldwide- Alignment Health is seeking an experienced inpatient review nurse to join the remote utilization management team. You will review inpatients with complex medical needs and coordinate care across physicians, facilities, and community providers, ensuring appropriate and cost...Remote job
- Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance, auditing DRG classifications...Remote jobContract work
$20.1 - $26.13 per hour
...for administrative management, tracking, and coordination of inpatient clinical denials, including patient status determinations, medical... ...Experience: Three years’ hospital billing, denials management, utilization review support, or related revenue cycle experience....Full timeTemporary workPart timeWork at officeFlexible hours- ...hospitalizations nationwide. The role emphasizes using clinical expertise to determine admission status and provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
$75k - $82k
...looking for an experienced Clinical Risk Specialist to join our Clinical Quality... ...healthcare. *This is a remote position with a typical schedule... ...Technology & Innovation Utilize technology systems and... ....g., emergency department, inpatient, mobile crisis, IOP, PHP, residential...Remote workLocal areaMonday to FridayFlexible hours- ...Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across... ...license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
- ...Remote Clinical Review Specialist New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and... ...The Clinical Review Specialist will conduct regular utilization management reviews and provide clinical information as required...Remote workTemporary workLive inLocal areaMonday to Friday
$128k
...professional to join our team. While this is a remote position not located at a physical... ...for this role.The Surgical Robotics Utilization Team manages all aspects of system... ...Primary Responsibilities:As a Robotics Clinical Specialist you will be responsible for the successful...Remote workFull timeH1bWork at officeLocal areaImmediate startRelocationFlexible hoursShift work- ...Clinical Denials Specialist Role: Clinical Denial Specialist Schedule: M - F 8 AM - 4:30 PM EST GENERAL SUMMARY: The goal of the Clinical... ...management review and identifies trends. Reviews and understands utilization review and coverage guidelines for multiple payers...Remote workContract workLocal area
$185k
...professional to join our team. While this is a remote position not located at a physical... ...is essential for this role. The Clinical Specialist serves as the primary technical and clinical... ...leadership regarding implantation and utilization of Medtronic Surgical Based Therapy...Remote workFull timeH1bWork at officeLocal areaImmediate startFlexible hoursWeekend workAfternoon shift$76k
...Position Summary The Clinical Reviewer Specialist is responsible for performing clinical and... ...required benefits. Position is fully remote only in the state of Florida. Must... ...of experience in appeals processing, utilization management, case management, or clinical...Remote workPermanent employmentTemporary workLive inImmediate startRelocationFlexible hours- ...Clinical Imaging Specialist As a Clinical Imaging Specialist, you will utilize your clinical expertise to support the market leader in surgical C-arms. You will collaborate closely with healthcare professionals to showcase product features, capabilities, and benefits...Remote workRelocation package
- CVS Health Corporation is seeking a Concurrent Review Nurse (RN) for a 100% remote role. The position involves reviewing inpatient stays, collaborating with care teams, and ensuring appropriate care levels in a remote setting. Requires 5+ years inpatient nursing, strong...Remote job
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