Remote RN Reviewer for Workers' Comp Utilization
ADP, Inc.
- Remote job
iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring medical necessity and standard of care, supporting care quality and professional integrity. Active RN license required; NY license preferred. Minimum three years in workers' comp or utilization review, with strong assessment, documentation, and HIPAA #J-18808-Ljbffr ADP, Inc.
- ...integrating, and monitoring the utilization of behavioral health (BH) or... ...cases to the Medical Director for review. Refer to and work closely... ...Associates degree and active NYS RN license required. Bachelors... ...There may be opportunity for remote work within all jobs posted by...Remote workContract workWork at office
- A leading Workers' Compensation service provider is seeking a Quality Analyst to manage the medical file review process, ensuring accuracy and adherence to standards. The position requires exceptional communication skills and business experience, preferably in a healthcare...Remote job
- Acrisure is hiring a Telephonic Nurse Case Manager. This fully remote role involves managing workers' compensation claims through clinical case management and... ...hands-on experience in this domain, alongside an active RN license and relevant certifications. Successful...Remote job
- Acrisure is seeking a Telephonic Nurse Case Manager to manage workers' compensation claims. This role is fully remote and focuses on coordinating care and facilitating treatment plans. Candidates must have an active RN license and experience in case management practices....Remote job
$150k - $220k
...Job Description Job Description Workers’ Comp Attorney (Flexible/Remote) Celebrating 30 years in business, Michael Sullivan & Associates LLP... ...companies, employers, and third-party administrators. Utilize Attorney-led technology built for WC cases, including...Remote workTemporary workWork at officeLocal areaFlexible hours- ...Centene is seeking a Utilization Review Clinician to assess mental health and substance use care across the continuum. Two schedules are available... ...Eastern Time Zones. Start times: 8:00 or 9:00 AM ET. Requires RN or Master’s in Behavioral Health, 2–4 years of related...Remote workShift work
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...Ability to obtain additional RN licensure across the enterprise including... ...Package Flexible work solutions include remote options, hybrid work schedules,...Remote workMonday to FridayFlexible hoursWeekend work
$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access to a reliable high-... ...Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for... ...active and unencumbered Registered Nurse (RN) license in the District of Columbia required...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work- Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental health and substance use services. This remote role may require on-site travel to Roseburg, OR as needed and offers a full-time exempt schedule. The URC collaborates with care...Remote jobFull time
- Comagine Health is seeking a Clinical Reviewer to work remotely from Oregon with travel across the Eugene and surrounding areas. You will review... ..., 3 years of direct patient care in behavioral health, and familiarity with utilization review. #J-18808-Ljbffr Comagine HealthRemote job
$219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around... ..., Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United States...Remote workFull timeLocal areaWork from homeHome officeWeekend work- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote workFor contractorsMonday to FridayFlexible hours
- ...Job Description Job Description Remote but must be able to get to Newark, Nj to pick up and drop off equipment This position... ...end reports. Responsibilities: 1. Conducts on-site/virtual reviews at participating provider offices to assess environment, quality...Remote work
- A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote jobFull timeWork from home
- ...Worker Utility Production Cement We're looking for a hardworking and adaptable Production Utility Worker to support plant operations. In... ...required to be performed in person at the assigned worksite. Remote work is not available for this role. At Cemex, we're committed...Remote workShift workNight shiftWeekend workEarly shift
$105k - $135k
...CopperPoint has an exciting opportunity for a fully remote Supervisor Workers Comp Claims. In this role, you will lead a dynamic team of workers... ...claim data. Conducts and/or evaluates Quality Assurance Reviews - provides kudos and coaching as needed based on results...Remote workHourly payTemporary workWork experience placementCasual workLocal areaFlexible hours- ...Dane Street, a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...Remote work
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with...Remote jobWork from home$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient... ...at a time. Company: Oak Street Health Location: Remote/ Treehouse Role Description: This full-time role...Remote workHourly payFull time- Pollart Miller LLC is seeking a knowledgeable Work Comp Defense Paralegal with 2-3 years of workers’ compensation defense experience. The ideal candidate will... ...hearings and IMEs. The firm offers a full remote work environment and a comprehensive benefits package...Remote job
- ...identification and collection of avoidable days Coordinates with the CM RN and/or CMA to identify and complete the process for CMS required patient notices. Completes and documents utilization reviews, physician advisor referrals and other communications related to...Full time
- CopperPoint Insurance Companies is seeking a Supervisor Workers’ Comp Claims to oversee a team of claims professionals across experience levels, driving performance and quality service for a broad multistate jurisdiction including AZ, CO, UT, NV, NM, TX, OK, MO, KS, FL,...Remote job
- ...Orthopedic Surgeon Utilization Reviewer Dane Street, a nationally recognized Independent Review... ...an active New York medical license and Workers' Compensation Board Certification to conduct... ...Reviews. This is a fully remote, non-clinical role offering supplemental...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires... ..., and 2+ years in hospital medicine, with utilization review experience preferred. You will coordinate with PCP/SNF meetings...Remote job
- ...Sullivan & Associates LLP is seeking a full-time Legal Assistant with workers' compensation experience to join our team in Orange County. The... ...industry. We publish the highly respected Sullivan on Comp legal treatise and conduct live training seminars and webinars....Remote workFull timeCasual workWork at officeLocal area
- 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 job
- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure...Remote jobFull time
- ## Workers Comp Collections ManagerApplylocations: Tyvantime type: Full timeposted on: Posted... ...ManagerMust live in the Greater Houston area / Remote (potential after 30 business days and... ...filing and prompt payment.* Actively review billing/collection policy changes for...Remote workLive inWork from home
- ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality...Remote job
- A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote jobFull timeCasual workMonday to Friday
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