Remote LVN Utilization Review Specialist: Prior Auth
Crains Cleveland
Kelsey-Seybold Clinic is seeking a Utilization Review Specialist (LVN) to conduct medical reviews and assess medical necessity for services requiring prior authorization. This role involves liaising with providers and completing denial letters in accordance with guidelines. Ideal candidates should possess a Licensed Vocational Nurse certification and extensive experience in utilization review. Flexibility for remote work is provided for Texas residents. Competitive hourly pay and benefits are offered. #J-18808-Ljbffr
$20.38 - $36.44 per hour
...Psychiatric Association Inc seeks a Utilization Review Specialist (LVN) who will conduct medical reviews and... ...medical necessity for services requiring prior authorization and serving as a... ...license. The position offers flexible remote work options adhering to company policies...Remote workHourly payFlexible hours- Ensemble Health Partners is seeking Senior Virtual Utilization Review Specialists to join their remote team in the United States. This role involves conducting medical necessity reviews, managing denial processes, and collaborating with healthcare professionals. Candidates...Remote job
$32.65 - $53 per hour
...currently looking for a Sr. Virtual Utilization Review Specialist in United States. This role plays... ...level of care at the right time. Working remotely, the role collaborates closely with... ...an acute care setting preferred. Prior experience in utilization review, discharge...Remote jobFull timeFlexible hours- ...Working remotely in a full-time capacity, the State Licensed Utilization Review Specialist will manage the review, investigation, and resolution of member and provider appeals... ...utilization management, or case management Prior experience in Appeals & Grievances or Managed...Remote workFull time
$60k - $75k
...behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $60,000 - $75... .... This is an in-office position and must have prior UR & clinical experience. Remote hires and applicants without prior experience...Remote workFull timeWork at office$20.38 - $36.44 per hour
...Utilization Review Specialist (LVN) Explore opportunities with Kelsey-Seybold Clinic, part of the Optum... ...care services requiring authorization prior to rendering services to members.... ...you will have the flexibility to work remotely as you take on some tough challenges...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaFlexible hours- Utilization Review (UR) Specialist Position Title: Utilization Review Specialist Department: Clinical / Billing... ...required deadlines. Submit Medicaid prior authorization (PA) packets including... ...behavioral health environment. Remote flexibility depending on needs of department...Remote workFull time
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
- ...callers through the criteria based prior authorization process.... ...and accurate documentation of reviews. Transfers all clinical questions... ...reviewing and processing Prior Auth's received via fax and ePA,... ...Responsibilities: Utilizing multiple software systems to complete...Remote work
$29.62 - $45.31 per hour
...Responsibilities Be responsible for all core functions in the Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the... ...service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for...Remote workMinimum wageFull timeWork experience placementLocal areaShift work$30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ...along with experience in Epic EHR and Utilization Review. The selected candidate will perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote workHourly payContract work- ...caseload of 50-75 patients, the full-time Florida Licensed Utilization Review Specialist will conduct pre-authorization and concurrent reviews,... ...to ensure compliance and support discharge planning in a remote setting. Key responsibilities Authorize 15-25 cases daily...Remote workFull time
- ...TryApplyNow is seeking a Licensed Vocational Nurse (LVN) for a full-time remote position in Utilization Review within San Diego County. This role involves reviewing and managing cases to determine medical necessity and eligibility for services provided to Scripps Clinic...Remote workFull time
$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$22 per hour
...A recruiting firm seeks a remote Pharmacy Technician I to provide assistance through the prior authorization process. The role involves answering calls, documenting reviews, and collaborating with a pharmacist team. The ideal candidate should have 0-3 years of customer...Remote workHourly payContract work- United Cerebral Palsy of Georgia is hiring a Utilization Management Specialist in Miami, Florida. The role requires collaboration with Medical Directors to review healthcare services and authorize necessary services. Strong analytical skills are essential. This position...Remote jobLocal area
- Dove Recovery is seeking a Utilization Review Specialist responsible for managing authorization and review activities for clients. The position requires... ...MCO processes. This full-time position offers potential remote flexibility and requires attention to detail. #J-18808-...Remote jobFull time
- ...Providence Health Plan Group is seeking an RN Utilization Review for a remote, per diem position in Los Angeles. You will be responsible for conducting utilization reviews across Southern California ministries and require a strong clinical background. Ideal candidates...Remote workDaily paid
- ...Providence is seeking an experienced RN for Utilization Review to provide essential patient care while working remotely in Irvine, California. This role involves conducting clinical reviews and managing utilization efficiently in a dynamic regulatory environment. The...Remote workDaily paid
- ...Providence Health & Services is seeking an RN Utilization Review for a part-time remote position. This role focuses on conducting clinical reviews and utilization reviews across Southern California ministries, requiring effective problem-solving and decision-making skills...Remote workPart time
$57.28 - $88.92 per hour
...Providence Health Plan Group is seeking an RN for Utilization Review, working full-time in a remote position. The role involves conducting clinical reviews and managing utilization reviews across various health plans in Southern California. Required qualifications include...Remote workHourly payFull time- Overview Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote About Exact Billing Solutions Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hours
- We are seeking Senior Virtual Utilization Review Specialists to work in Pacific Time and Mountain Time zones. The role is remote with a weekday schedule of three 12‑hour shifts per week, rotating weekends and holidays. Role Overview The Senior VUR Specialist performs resource...Remote workWork at officeRotating shiftWeekday work
$55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hours$34 - $47 per hour
Astrana Health is seeking a CA-licensed Utilization Review Nurse for remote work. This role involves using clinical judgment to approve or deny outpatient medical services based on Medical Necessity Criteria. Candidates must have at least one year of outpatient UM experience...Remote jobHourly payShift work$75k
...for a Registered Nurse (RN) to perform concurrent inpatient utilization reviews. The role requires a BSN and current nursing license, with preference... ...with health, dental, and vision benefits. The position is remote with a standard Monday-Friday schedule and a supportive work...Remote jobMonday to Friday$34 - $47 per hour
Astrana Health, Inc. seeks a CA-licensed UM Review Nurse to work remotely, approving or denying outpatient services based on medical necessity. Candidates... ...overtime required. Responsibilities include conducting prior authorization reviews and maintaining regulatory knowledge...Remote jobHourly payFull timeFlexible hours$30 - $34 per hour
...A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...Remote workHourly pay- ...Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and... ...through the continuum appropriately. Medical necessity reviews for designated services are completed for all Priority Health...Remote workFull timeMonday to FridayShift workWeekend work
- A healthcare facility in Sidney, Nebraska, seeks a full-time Clinic Utilization Review Specialist. This role focuses on ensuring timely authorization requests, analyzing medical justifications, and collaborating with medical staff to enhance patient care. Ideal candidates...Full time
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