Remote OT Clinical Reviewer - Utilization Review
Cohere Health
- Remote job
Cohere Health is seeking a licensed Occupational Therapist to deliver on Cohere’s therapy programs by reviewing medical information and applying evidence-based guidelines. This remote role supports a fast-paced review team and requires clinical acumen and effective communication. You’ll perform timely medical reviews, document decisions clearly, and participate in peer-to-peer discussions with treating providers. #J-18808-Ljbffr Cohere Health
$64.48k - $108.16k
...Utilization Management Clinical Reviewer (California) - Remote Must currently reside and be a licensed RN in California Hours: Monday-Friday. Must be able to work an 8-hour shift between 8:00 a.m.-5:00 p.m. PST. In this role, you will manage an active caseload,...Remote workHourly payFull timeTemporary workLocal areaWork from homeMonday to FridayShift work$88k - $93k
Profile Remote work opportunities are available in the following states: AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD... ...family members are encouraged to apply. Job Summary The Utilization Management Clinical Review nurse reviews and makes decisions about the...Remote workContract workTemporary workInterim roleWork at officeLocal areaShift work- Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective...Remote jobFull timeContract work
$45 - $50 per hour
Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a competitive pay of $45 - $50...Remote jobHourly pay- ...Carolina subsidiary, seeks a Medical Reviewer II (RN) to perform medical... ...decisions and supports utilization review across multiple services. The position is remote, full-time, with standard hours... ...associate degree, and 2+ years of clinical RN experience required. #J-18...Remote jobFull time
- Comagine Health is seeking remote Clinical Reviewers licensed as Physical Therapists or Occupational Therapists in Washington state to support workers' compensation therapy reviews. This full-time role involves evaluating medical records, applying clinical criteria, and...Remote jobFull time
- ...Clinical Reviewer Position Are you passionate about using your clinical expertise to support... ...We're recruiting for five full-time remote/hybrid Clinical Reviewer positions. This... ...Clinical Reviewer position supports utilization management activities by assessing the...Remote workFull timeWork from homeMonday to Friday
- ...Behavioral Health Services Reviewer Are you passionate about improving... ...? Do you enjoy using your clinical expertise to evaluate needs,... ...evidence-based criteria to utilization management reviews; document... ...success on this team. This is a remote position based in Oregon and...Remote workFull timeContract workWork from home
- ...LOCATION: Remote - This is a home based, virtual position that operates... ...audits of DRG coding and clinical documentation. The ideal... ...quality recoverable claims by reviewing medical records and other documentation... ...-10 PCS codes and MS-DRGs. Utilizing evidence-based criteria...Remote workLive inWork from homeMonday to Friday
- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged... ...improve care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role in our...Remote workFull timeContract work
- ...Clinical Quality Reviewer Ensures compliance with the contract, and program requirements for Clinical Quality Management (CQM) within West... ...records retrospectively for potential quality, safety, and utilization issues by using organizational, national, and URAC standards...Remote workContract workInterim role
- ..., our scalable solutions and clinical expertise help solve programmatic... ...Member. This position is REMOTE within US Only - Equipment... ...West Coast) The Clinical Reviewer supports the WISeR Prior Authorization... ...judgment within regulated utilization management or prior...Remote workWork at officeImmediate startMonday to FridayFlexible hoursAfternoon shift
$185 per hour
...compliant AI platform that unifies intake, clinical documentation, coding, and quality... ...Experience: ~3+ years in home-health QA/OASIS review, utilization review, or clinical documentation QA.... ...a fast-moving startup environment and remote collaboration tools. Reliability...Remote workContract workReliefShift workWeekend work- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration:... ...Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $...Remote workContract work
- ...JOB SUMMARY Reports to Team Lead, Clinical Quality and Record Review. Works independently and with other... ...RESPONSIBILITIES Clinical Review Utilizes clinical expertise to conduct... ...PROTECTED BY LAW. Mondays & Fridays Remote Tuesday through Thursday In...Remote workWork at officeImmediate startMonday to Friday
$28.37 - $39.19 per hour
...outcomes through technology, services, and clinical expertise. Our mission is to innovate... ...Acentra Health is looking for a Clinical Reviewer (SCA) to join our growing team. Job... ...Summary: The purpose of this position is to utilize clinical expertise during beneficiary...Remote jobContract workWork at officeLocal areaFlexible hours$77k - $80k
...Job Description Job Description Remote role but must be willing to work 8:30-5 Eastern... ...opening for a Full Time, Quality Reviewer with OASIS certification to work remotely... ...and OASIS assessments. This role ensures clinical accuracy, regulatory compliance with Medicare...Remote workFull timeWork at officeLocal areaImmediate start- 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
- ...R1 RCM is seeking an experienced Utilization Review Author (RN) for our Physician Advisory Team. The role involves first-level admission and continued stay reviews using InterQual/MCG criteria and requires hospital-based UR or Case Management experience. The position...Remote workFlexible hours
- ...Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote work
- ...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, ensuring services meet clinical guidelines and are provided in the least restrictive setting...Remote workFull time
$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer in the Town of Florida, NY, to consult on medical necessity within utilization management. This vital role involves reviewing authorization requests and ensuring compliance with Healthfirst's regulations. The ideal candidate...$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer to consult on medical necessity in utilization management and ensure compliance with internal and external regulations... ...collaborating with various departments to manage clinical judgements efficiently. The position requires a...- Blue Cross Blue Shield of Massachusetts, a leading not-for-profit health plan, seeks a Clinical Utilization Reviewer to facilitate care for members with complex needs and to authorize services at the right level of care. The role emphasizes independent work, collaboration...
- A leading medical review organization is seeking Board-Certified physicians... ...for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per... ...Gastroenterology, and 5 years of clinical experience. Adherence to HIPAA...Remote workFlexible hours
$135.2k - $141.44k
...and requirements are subject to change. Position: Clinical Pharmacist Reviewer Location: Remote Status: Part-time About J29 J29 is... ...Evaluate medical necessity, formulary requirements, utilization management criteria, and benefit coverage...Remote workHourly payContract workPart timeFor contractorsWork at office- ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of... ...payer authorization while collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform concurrent...Remote workPart time
$32 - $33 per hour
...situation fit into our culture. We have an opening for a: RN - Clinical Field Reviewer (Remote in Montana) The RN Clinical Field Reviewer is a remote... ..., practice cultural humility with each client, and utilize evidence-based practice as a foundation for our interventions...Remote workFull timeTemporary workLocal area- ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs.... ...2+ years in utilization review or case management, strong clinical knowledge, and proficiency with Microsoft Office and healthcare...Remote workWork at office
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