Remote Manager, Clinical Review & Utilization Management
Premera
Seattle, WA
- Remote job
Premera seeks a Manager Clinical Review for the Federal Employee Program to lead UM operations. You will guide clinical review strategy, oversee multidisciplinary teams, and drive quality and member experience while aligning with regulations and accreditation standards. Responsibilities include budgeting, cross-functional collaboration, data analysis, and continuous improvement to support Premera’s clinical review goals and service levels. #J-18808-Ljbffr Premera
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Manager, Clinical Review & Utilization Management in Seattle, WA vacancy
- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-... ...staff, managing daily tasks, performance reviews, and any necessary disciplinary...Remote workPermanent employmentFull timeTemporary workFlexible hours
- Centene Management Company LLC is seeking a senior leader to supervise Utilization Management teams, overseeing prior authorization, concurrent, and retrospective reviews. The role drives quality, compliance, and... ...policies and practices. Remote eligibility is available,...Remote job
- ...The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization... ...and Utilization Management. HeC-JG Education and Clinical Documentation Improvement: Supports education and clinical...SuggestedFull timeWork experience placement
$248.5k - $373k
...together. The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some...Remote jobMinimum wageWork experience placementLocal area$248.5k - $373k
...Job category: Medical & Clinical Operations WellMed, part... ...medicine physician to join our Utilization Management team. Optum is a clinician-... ...the flexibility to work remotely * from anywhere within the... ...processes Participates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeUnitedHealth Group
Austin, TX5 days ago- ...Supervisor Of Behavioral Health Utilization Review Saint Luke's Crittenton... ...Review Department, Case Management and Reception teams of a 24/... ...Friday, dayshift, 9am -5pm. Remote work not preferred, but occasional... ...care provider. ~ Review clinical charts in order to file...Remote workMonday to FridayDay shift
$133.7k - $247.4k
...28 million members as a clinical professional on our Medical Management/Health Services team. Centene... ...Purpose Directs the utilization management team to... ...Assurance (NCQA) standards Reviews, analyzes, and reports on... ...flexible approach to work with remote, hybrid, field or office...Remote workFull timePart timeWork at officeFlexible hours- ...is seeking a high-performing Physician Reviewer for their Group Health division. This full... ...vision coverage, involves performing utilization reviews across various case types such as... ...systems and working independently in a remote environment. #J-18808-Ljbffr Dane StreetRemote jobFull time
$45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves... ...nursing license and have at least 2 years of clinical nursing experience, along with strong communication and...Remote workDane Street
New York, NY1 day ago- ...healthcare provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license... ...This position offers the flexibility of remote work while supporting professional growth...Remote work
Guidehealth
Chicago, IL3 days ago - ...Manager, Utilization Management Medical Director Medical Mutual employees must... ...MySource. This is a hybrid-remote role based out of the Brooklyn... ...Medical Directors while remaining clinically engaged through utilization management reviews and strategic quality...Remote workCasual workWork at office
$130 - $145 per hour
...We're hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance... ...and pharmacy services by reviewing clinical information and applying evidence-... .... Work Location: This is a remote position, open to candidates who reside...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY6 hours ago- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing... ...This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
IntePros
New York, NY6 hours ago - ...Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage... ...utilization management decisions based on clinical judgment. Candidates must have a... ...practice in the US. This position offers remote work options and competitive...Remote workFull time
Hispanic Alliance for Career Enhancement
Springfield, IL2 days ago $1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...in Utilization Management, Utilization Review, or Case Management ~• Preferred...Remote workContract workImmediate startMonday to FridayVarite
Aurora, CO5 days ago- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
Solving IT
New York, NY5 hours ago - ...Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical... ...team focused on member care within a managed care framework. The position requires... ...experience, including acute care and utilization management experience. #J-18808-...Remote job
$236.5k
...Medical Director by directing medical management and quality improvement initiatives... ...The role emphasizes leadership in utilization management, ensuring compliance... ...dedicated team, you'll conduct medical reviews, collaborate with clinical staff, and actively participate in...Remote job- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical... ...and a minimum of two years of clinical experience. The position offers a competitive salary range, remote work options, and a...Remote work
Dane Street
Washington DC3 days ago $45k - $70k
A healthcare management firm is seeking a Utilization Management Nurse Reviewer to ensure efficient use of medical services. The role involves reviewing medical records... ...nursing license and have at least two years of clinical experience, with one year in utilization...Remote job$170k - $352.5k
...health organization in Denver seeks a physician for utilization management. Responsibilities include reviewing escalated cases and participating in case... ...will hold an MD or DO and have at least 5 years of clinical experience. Strong skills in critical thinking and...- New England Life Care, Inc. is seeking a full-time Licensed Clinical Review Specialist to work remotely. The role involves conducting utilization management reviews and providing clinical information to ensure patient coverage while delivering high-quality, cost-effective...Remote jobFull time
$65k - $75k
Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to make high-quality care...Remote job$70k - $75k
Guidehealth seeks an experienced Utilization Management Registered Nurse to perform UR activities and document cases per federal, state,... ...directors and providers while ensuring timely, compliant reviews. Remote work option; salary range $70,000-$75,000 annually. Benefits...Remote job- Molina Healthcare seeks a Telephonic Care Review Clinician (RN) to support Medicare inpatient utilization management. You will verify medical necessity, review admissions and ongoing services against guidelines, and partner with providers, case management, and care coordination...Remote jobMonday to FridayFlexible hours
- BHPS, a remote Utilization Management provider, seeks an experienced UM Nurse (LPN) to review medical necessity and benefits according to national standards and policies. The role requires collaboration with healthcare partners, presenting cases to the Medical Director,...Remote job
- Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves... ...medical necessity criteria to reviews, documenting findings, and interfacing... ...license active and 3+ years clinical experience preferred....Remote jobFull time
- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements... ...(combination of in person and remote considered) General Summary The... ...issues on a case-by-case basis with clinical staff. Demonstrates working knowledge...Remote workFull timeShift work
Gibson Area Hospital
Gibson City, IL1 day ago $90.82k - $145.31k
...Medical Case Manager, BHI Utilization Management - Covered California Join... ...difference, we encourage you to review and apply today and help us... ...from health professionals, clinical facilities and ancillary... ...the 500, 505 Building or a remote work location: Work is typically...Remote workTemporary workWork at officeLocal areaImmediate startFlexible hoursWeekend workAfternoon shift2 days per week- Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Manager, Clinical Review & Utilization Management. Be the first to apply!
Related searches
- public health project manager Seattle, WA
- clinic supervisor Seattle, WA
- clinical data manager remote Seattle, WA
- medical device manager Seattle, WA
- clinical research manager remote Seattle, WA
- director sr. director clinical operations Seattle, WA
- health services manager Seattle, WA
- entry level healthcare project manager Seattle, WA
- medical sales manager Seattle, WA
- behavioral health supervisor Seattle, WA