Remote Medicaid Ops Specialist III-Epic Utilization Review
$30 - $45 per hourPyramid Consulting, Inc.
A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various employee benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr
$80 per hour
...experienced in prior authorization, utilization management, clinical review, medical necessity... ...current and upcoming remote consulting opportunities focused... ..., Medicare Advantage, Medicaid, and other payer authorization... ...and EHR platforms such as Epic, Cerner, or similar...Remote workEpicHourly payPart timeFor contractorsWork at officeFlexible hours- ...Description - Coding Specialist III (250000US) UT Southwestern... ...Experience — Epic electronic health record... ...Performs accurate and timely review of complex coding and... ...of UTSW accounts utilizing ICD-10-CM, HCPCS, and... ...procedures to include the Remote Coding Agreement where...Remote workEpicFull timeLive inWork from homeMonday to FridayFlexible hoursShift work
- ...Experience Required - Remote work for TX, AR, WI and... ...purpose of the Coding Specialist III is to code and verify... ...reimbursement (Medicare and Medicaid) principles. •... ...CAC). •Knowledge of Epic EHR and 3M 360 coding... ...% accuracy on quality reviews and meet assigned productivity...Remote workEpicContract workLocal area
$28.72 - $36.92 per hour
...position is primarily remote, candidates must reside... ...: The AR Follow-Up Specialist III, Coding and Complex... ...requiring advanced coding review to appropriate CPCs or... ...HMOs, PPOs, Medicare, Medicaid and compliance program... ...etc.) Experience in Epic and or other...Remote jobEpicHourly payFull timeWork at officeLocal area- ...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... ...provider collaboration, and adherence to Medicaid contracts. Qualifications include a Bachelor...Remote workFull time
- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines....Remote work
- ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities...Remote workPart time
$1,900 - $2,000 per week
...Registered Nurse (RN) | Utilization Review Location: Cape Coral, FL Agency: Lifelink Healthtech... ...: 9/14/2026 About the Position REMOTE POSITION Utilization Management: Shift:... ...Dragon Fly. CCM/CMCN required. EMR: Epic experience required & UM tool is...Remote workEpicFull timeContract workMonday to FridayShift workWeekend work- ...Utilization Review Nurse We are seeking a detail-oriented and experienced... ...with CMS, Medicare, Medicaid, Joint Commission, and other... ...payer audits. Familiarity with Epic, Cerner, Meditech, or other... ...utilization management department. Remote, hybrid, or on-site...Remote workEpicWork at office
$1,900 - $2,000 per week
...Registered Nurse (RN) | Utilization Review Location: Cape Coral, FL Agency: Lifelink Healthtech... ...RN in Cape Coral, Florida, 33904! REMOTE POSITION Utilization Management: Shift:... ...Dragon Fly. CCM/CMCN required. EMR: Epic experience required & UM tool is...Remote workEpicFull timeContract workMonday to FridayFlexible hoursShift workWeekend work- ...Coding Specialist III WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort... .... Exercises independent judgment in the review of encounters characterized by high documentation... ...encounter documentation within Epic to ensure accurate and compliant documentation...Remote workEpicFull timeLive inWork at officeWork from homeMonday to FridayFlexible hoursShift work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels... ...candidates without this will not be considered. Proficient in Epic, with recent use within the last 6–12 months. Experience...Remote workEpic
- ...this role? The Revenue Cycle Specialist III works under general supervision... ...assessment of charge review. Inputs specialty or cosmetic... ...documentation of appeal activity in Epic, ensuring compliance with... ...audit readiness. *Approved Remote States: Arizona, California,...Remote workEpic
- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical... ...hospital-based) ~ Skilled experience with remote work Length of assignment: 13... ...fifth weekend rotation Systems: Epic, Dragonfly - DragonFly experience is required...Remote workEpicShift workWeekend work
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day... ...campuses Scrub Color: Any (no reddish orange permitted) Charting: EPIC Parking Cost: Facility Paid...Remote workEpicLocal areaImmediate startMonday to FridayShift workWeekend work- ...In this role, you will manage utilization review processes, ensuring quality patient care... ...and utilizing EMR systems, specifically Epic and Dragonfly, for documentation and analysis... ...contributing to a collaborative and supportive remote work environment. Benefits...Remote workEpicWeekly payMonday to FridayWeekend work
- ...Compass Health Center is seeking a Remote Utilization Review Specialist to obtain insurance authorization for patients receiving Behavioral Health treatment at high levels of care. The UR Specialist serves as a liaison between the clinical team and insurers, helping patients...Remote work
$50k
...the 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...Remote work- ...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
- ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services,... ...while collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform...Remote workPart time
$24.65 - $30.03 per hour
...corporate team! Responsibilities The Utilization review tech essentially works to... ...CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific...Remote workFull timeWork at officeLocal areaShift work- A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...Remote workFlexible hours
- Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and... .... After a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide-ChildrenRemote jobWork at officeWork from home
- ...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
$45k - $55k
...below to learn more. If you are a current employee wanting to apply for a different position, clickhere . Back to jobs Utilization Review Specialist Remote Weekly outpatient therapy isn't always enough, and a trip to the ER isn't the only answer. Patients and their...Remote workWork at office$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 workPermanent employment2 days per week- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing...Remote workTemporary work
- ...to help improve the health of individuals and the quality of life in our community. New Horizons is seeking an Utilization Review Specialist , who will be responsible for following up on patient accounts when authorization for stay is required, initiate pre-...Remote workLocal area
$32.65 - $43.9 per hour
...including weekends as needed. We are seeking Virtual Utilization Review Specialists to join our team. Essential job function include:... ...Knowledge, Skills, and Abilities Required: This is a remote role which requires access to high speed internet Excellent...Remote workTemporary workWork at officeLocal area- ...excellence.Who We're Looking ForWe are seeking an experienced specialist who is passionate about making a difference in the lives of... ...Health or related field required preferred.2-3 years of utilization review experience in behavioral health, addiction treatment, or managed...Remote workDaily paidFull time
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