Remote Utilization Management Specialist Payer Authorization
Cedars-Sinai Medical Center
Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for utilization review processes. You will work with UR Nurses and other teams to ensure timely, accurate, and compliant authorization workflows using EPIC/CS-Link and payer portals.
Responsibilities include preparing documentation, tracking submissions, and communicating determinations within regulatory timeframes to support revenue integrity and prevent denials.
#J-18808-Ljbffr- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for the UR team. You... ...and review documentation, and coordinate payer submissions to ensure timely and compliant authorizations. The role requires collaboration with UR...Remote work
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for... ...Nurses and ensure timely, compliant authorization workflows. You will manage case... ...coordinate documentation, and interact with payers to prevent denials while...Remote work
- ...Cedars-Sinai is seeking a dedicated Utilization Management Specialist to support UR Nurses and ensure timely, compliant... ...EPIC/CS-Link. You will coordinate payer submissions, maintain documentation integrity, and monitor authorizations across an assigned case portfolio....Remote work
- Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support to UR Nurses, ensuring... ..., and compliant utilization review with payer submission and documentation. You will manage the authorization lifecycle, track payer responses, and...Remote job
- ...Cedars-Sinai is seeking an Utilization Management Specialist to support the UR team in a fast-paced, hospital setting... ...You will help ensure timely, accurate authorization workflows and regulatory compliance using EPIC/CS-Link and payer portals. Responsibilities include...Remote work
- Cedars-Sinai is seeking a skilled Utilization Management Specialist to support UR Nurses in timely, compliant utilization review processes. You will manage case portfolios, assemble documentation for payer submissions, and monitor payer timelines to prevent delays. In collaboration...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
- Randstad USA is seeking an experienced Prior Authorization Specialist to join our national Utilization Management team. 100% remote role with a Monday-Friday schedule, 8:00 AM - 5:00 PM CST. You will manage authorization queues, verify eligibility, gather medical documentation...Remote jobMonday to Friday
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for... ...utilization reviews. The role handles authorization workflows from submission to final... ...Management, Revenue Cycle, and payers to maintain documentation integrity...Remote 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
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for... ...ensuring timely, accurate, and compliant authorization processes. You will manage case portfolios, prepare documentation for payer submissions, and coordinate with...Remote work
- ...You Will Do in This Role: The Utilization Management Specialist provides advanced operational... ...functions that directly support payer communication, authorization coordination, documentation integrity... ...and complete. *Approved Remote States: Arizona, California, Colorado...Remote work
$37.5 - $54.25 per hour
...Expertise to Logan Health’s Utilization Management Team! Our Mission:... ...Management Specialist to join our dedicated... ...centered care! Fully remote opportunity - Must currently... ...to facilitate authorizations and medical... ...activities, and responds to payer inquiries in a professional...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift$19 - $20 per hour
## Grant Specialist, Authorization ManagementApply: In Person: Amber... ...Specialist Authorization Management Specialist**... ...and co-pay cards are utilized, and exploring financial... ...patient chart notes and payer requirements to... ...conferences, meetings, and remote events.* Constantly...Remote workHourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday- ...leading revenue cycle management services for... ...We are seeking a ABA Utilization Review Specialist The ABA Utilization... ...initial and continuing authorizations for ABA and related... ...environment. This is a fully remote or office/home... ...clients in understanding payer requirements for...Remote workWork at officeFlexible hours
- ...and a strong background in prior authorizations? We are seeking a highly... ...detail-oriented Prior Authorization Specialist to join our national Utilization Management team. In this role, you will serve... ...Position Type: Full-Time | 100% Remote Schedule: Monday – Friday, 8:...Remote workFull timeLive inWork from homeMonday to Friday
- Duly Health and Care seeks a qualified Utilization Management Specialist to manage referrals, authorizations, and benefit determinations across capitated and value-based populations. The role emphasizes payer requirements, clinical guidelines, and timely access to care...
- ...Elevance Health is seeking an Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role is remote with occasional in-person training sessions and flexible scheduling to support work-life balance. You will manage...Remote workFlexible hours
- ...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 work
- ...Supporting the prior authorization request process, the full-time Authorization Specialist II will assist the utilization management team in documenting requests and ensuring timely processing... ...of healthcare services while working remotely from Missouri. Key responsibilities...Remote workFull time
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing... ..., case management and insurers to authorize care and ensure medical necessity.... ...proficiency, with a four-day work week and remote options for Montana residents. #J-...Remote work
$50k - $55k
Alliance Health System seeks an Authorization Specialist to obtain prior authorizations for treatments across commercial, automobile, and workers' compensation payers. The role can be remote or hybrid, supporting the Matawan-based headquarters. Salary ranges from $50,0...Remote job$68.89k - $92.14k
Pay Plan Title: Utilization Management Specialist III Working Title: Utilization Management Specialist III... ...$68,890- $92,138 Office Location: Remote within North Carolina POSTING... ...of care needed and making service authorization decisions regarding individual service...Remote workWork at officeLocal areaImmediate startWork from homeFlexible hours- Principles Recovery Center is seeking a remote Utilization Review Specialist to manage insurance authorizations for adolescent and adult behavioral health, PHP, and IOP... ...continuity of care. Proficiency with EMR/EHR and payer communication is essential. #J-18808-Ljbffr...Remote job
- ...Miami Health System seeks a Full-time, remote Utilization Case Manager to conduct ongoing reviews for... ...utilization and determine continued authorization. The role coordinates with the Nurse... ...clinical team and patient, and adheres to payer guidelines and internal policies....Remote workFull time
$45.76k - $73.22k
...Job Description We’re hiring a Utilization Management Specialist to join the Commercial Pharmacy Phone... ...Medical Director. Conducts reviews of authorizations entered to ensure accuracy to avoid... ...– giving you flexibility to work remotely with intentional in-person...Remote workFull timeWork at officeLocal areaFlexible hours2 days per week$17.84 - $28.02 per hour
...as a resource and supports the prior authorization request process to ensure that all authorization... ...the contractual timeline. Supports utilization management team to document authorization... ...and a flexible approach to work with remote, hybrid, field or office work...Remote workHourly payFull timePart timeH1bLive inWork at officeFlexible hours- ...care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through accurate... ...to independently complete clinical review to obtain payor authorization. Demonstrates mastery in InterQual Level of Care Criteria...Remote workTemporary workWork experience placementLive outFlexible hours
- ...seeking a skilled RN to support vendor-related authorizations and ensure effective collaboration between the Utilization Management (UM) department and vendors. The position requires on-call availability monthly and a remote work setup with occasional onsite meetings in...Remote jobMonday to Friday
- McLaren Health Care is seeking a Registered Nurse to join the Utilization Management team. The role focuses on determining appropriate patient... ...necessity, and documenting care for insurance and government payers within an acute care hospital context. You will collaborate...Remote job
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