Remote Medicaid Ops Specialist III-Epic Utilization Review

$30 - $45 per hour

Pyramid 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

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Remote Medicaid Ops Specialist III-Epic Utilization Review in Long Beach, CA vacancy

Operations Specialist III - Medicaid / Medi-Cal (Epic + Utilization Review
$30 - $45 per hour
...Immediate need for a talented Operations Specialist III – Medicaid / Medi-Cal (Epic + Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Long Beach , CA(Remote). Please review the job description below and contact...
Remote work
Epic
Contract work
Local area
Immediate start
Pyramid Consulting
Long Beach, CA
2 days ago
Coding Specialist III
...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 work
Epic
Contract work
Local area
Parkland Health
United States
1 day ago
Health Informatics Specialist III
$45 - $50 per hour
...Talent Acquisition Specialist Ritika Sharma at... ...Duration : 6 months/ Remote Pay range : $... ...Specialist III is an experienced... ...operational projects. Utilizing process improvement... ...implementation for developing, reviewing, approving and... ...optimization Epic experience...
Remote work
Epic
Hourly pay
Permanent employment
Contract work
Immediate start
Shift work
Generis Tek Inc
Philadelphia, PA
2 days ago
AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote
$28.72 - $36.92 per hour
...available. AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote The 61st Street Service... ...advanced coding review to appropriate CPCs or... ...HMOs, PPOs, Medicare, Medicaid and compliance program... ...mail, etc.) Experience in Epic and or other electronic...
Remote job
Epic
Hourly pay
Full time
Work at office
Local area
61st Street Service Corporation
New York, NY
3 days ago
Travel RN - Case Management/Utilization Review - Utilization Review
$2,147 per week
...Travel RN - Case Management/Utilization Review American Traveler Somerville... ...Traveler is hiring a remote RN for Utilization Management... ...utilization review decisions Epic EMR preferred... ...required ~ Experience with Medicaid, Medicare, and Commercial lines...
Remote work
Epic
Weekly pay
Local area
Monday to Friday
Shift work
American Traveler
Somerville, MA
5 days ago
Utilization Review Specialist
$60k - $75k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US 14 days ago... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization... ...with commercial insurance, Medicare, Medicaid, Managed Medicaid, TRICARE, Veterans...
Remote work
Full time
Part time
Work at office
Bradford Health Services
Birmingham, AL
3 days ago
RN Virtual Health Services I
...Registered Nurse – Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review RN role supporting multiple service... ...without this will not be considered. Proficient in Epic, with recent use within the last 6–12 months. Experience...
Remote work
Epic
3B Healthcare, Inc.
Torrance, CA
1 day ago
Coding Specialist III
...Coding Specialist III With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern... .... Exercises independent judgment in the review of encounters characterized by high... ...encounter documentation within Epic to ensure accurate and compliant documentation...
Remote work
Epic
Full time
Live in
Work at office
Work from home
Monday to Friday
Flexible hours
Shift work
UT Southwestern Medical Center
United States
4 days ago
Access Specialist I- OB/GYN
...Access Specialist I- OB/GYN Work Arrangement... ...(On-Site and Remote mix) Location: Durham... ...conflict, utilizing emotional intelligence... ...not limited to: EPIC, Cadence, Op-time, Template changes... ...or Out-of-County Medicaid, Veterans... ...for a financial review and trace the progress...
Remote work
Epic
Duke University
Durham, NC
1 day ago
Remote Utilization Review RN - Hospital Admissions
...BJC HealthCare seeks a PRN Utilization Review RN to support hospital resource utilization from a remote location within one hour of St. Louis, MO. You will review admissions... ...and an active MO/IL RN license are required; EPIC experience preferred. Orientation for full-time...
Remote work
Epic
Full time
Relief
Shift work
BJC HealthCare
Brentwood, MO
2 days ago
Healthcare Nurse - Remote
...Job Title In this remote role, you will perform utilization reviews, ensuring compliance with clinical guidelines and patient care standards. Collaborate... ...determination and familiarity with charting systems like Epic will be essential. This position offers flexibility...
Remote work
Epic
Weekly pay
Slate Healthcare
United States
4 days ago
Revenue Cycle Specialist III (Gastroenterology)
...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 work
Epic
Cedars-Sinai
Los Angeles, CA
1 day ago
Healthcare RN (Weekend Shift)
...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 work
Epic
Shift work
Weekend work
AMN Healthcare
United States
5 days ago
Urgent!! REMOTE Registered Nurse (RN)
$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:... ...campuses Scrub Color: Any (no reddish orange permitted) Charting: EPIC Parking Cost: Facility Paid
Remote work
Epic
Local area
Immediate start
Monday to Friday
Shift work
Weekend work
Pacer Group
Everett, WA
1 day ago
Utilization Review Specialist
...Job Description: The Utilization Review Specialist nurse (UR RN) is responsible for monitoring adherence to the Utilization Review Plan (UR Plan... ...On-site required Must be proficient in in both EPIC and InterQual programs Position Urgency: Normal...
Epic
Contract work
Monday to Friday
Flexible hours
Shift work
Weekend work
Varite
Moses Lake, WA
3 days ago
Remote Utilization Review Specialist - Behavioral Health
...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and appeals...
Remote work
Northpoint-Recovery-Holdings,-LL
United States
1 day ago
Remote Utilization Review Specialist - Behavioral Health
...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....
Remote work
Part time
Weekend work
Recovery Unplugged
United States
3 days ago
Behavioral Health Utilization Review Specialist
...and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support medical necessity criteria while working remotely. Key responsibilities Verify insurance benefits, eligibility,...
Remote work
Full time
Virtual Vocations Inc
United States
5 days ago
Utilization Review Specialist
...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...
Remote work
Full time
Virtual Vocations Inc
United States
1 day ago
ABA Utilization Review (UR) Specialist
...and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...
Remote work
Work at office
Flexible hours
Spectrum Billing Solutions
Skokie, IL
4 days ago
Utilization Review Specialist
$40k - $50k
...Job Type Full-time Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey...
Remote work
Full time
Part time
Work at office
Weekend work
The Joint Commission
Fort Lauderdale, FL
3 days ago
Remote ABA Utilization Review Specialist
Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...
Remote job
Work at office
Work from home
Spectrum Billing Solutions
Skokie, IL
3 days ago
Utilization Review Specialist
...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced...
Remote work
Full time
Monday to Friday
Flexible hours
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA
1 day ago
Remote LPN Utilization Review Specialist
...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The... ...requiring clinical expertise and knowledge of Medicaid guidelines. Candidates must have an... ...setting, and the ability to work in a remote environment. Comprehensive benefits are...
Remote work
Contract work
Work from home
Mass Digital Health
Quincy, MA
2 days ago
Utilization Review Specialist
$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $30-35/hour Northpoint Recovery Holdings, LLC... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...
Remote work
Full time
Temporary work
For contractors
Work at office
Monday to Friday
Northpoint-Recovery-Holdings,-LL
Meridian, ID
1 day ago
Surgery Scheduler - Surgical Specialist
$22.3 - $30.11 per hour
...$30.11 Surgical Specialists Clinic - Remote/Hybrid, Oregon ST... ...Varies DATE LAST REVIEWED: March 5, 2024 OUR... ...procedure schedule to EPIC procedure... ...and is proficient utilizing snap board, case... ...guidelines including CMS, Medicaid, COBRA, EMTALA,... ..., a trauma level III, type B rural...
Remote work
Epic
Monday to Friday
Shift work
Day shift
St. Charles Health System Inc.
Redmond, WA
2 days ago
Registered Nurse - Utilization Review
$45 - $51 per hour
...Position Details Position: RN Utilization Management / Utilization Review Setting: 100% Remote Schedule: 5x8-hour days Hours: 8:00... ...based Utilization Review experience required Epic experience required , with recent use within the...
Remote work
Epic
Hourly pay
Weekend work
Hanker Systems
California
2 days ago
Healthcare RN (Weekend Shift)
...Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review... ...hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT - 1... ...weekend rotation SYSTEMS - Epic, Dragonfly - DragonFly experience is required...
Remote work
Epic
Temporary work
Shift work
Weekend work
Trinity Clinics AMN
Fort Myers, FL
5 days ago
RN Day Shift REMOTE
$48 - $55 per hour
...Description Job Description Job Title: Registered Nurse – Utilization Review (Remote) Location: Fort Myers, FL (Remote) Job Type: Contract... ...experience. CCM or CMCN certification required. Epic experience required. DragonFly Utilization Management tool...
Remote work
Epic
Contract work
Local area
Monday to Friday
Shift work
Weekend work
Day shift
Compu-Vision - South
Houston, TX
7 days ago
RN Utilization Review
...RN Utilization Review Seven Healthcare are seeking a dedicated RN Utilization Review specialist for a travel assignment in Fort Myers, FL. This remote position requires expertise in utilization management... ...electronic medical records with Epic software Function as core...
Remote work
Epic
Weekly pay
Work experience placement
Flexible hours
Seven Healthcare
Fort Myers, FL
23 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medicaid Ops Specialist III-Epic Utilization Review. Be the first to apply!