Remote LPN Utilization Review Specialist
Mass Digital Health
Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements, requiring clinical expertise and knowledge of Medicaid guidelines. Candidates must have an active LPN license, at least one year of experience in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical, dental, and 401(k) plans.
#J-18808-Ljbffr- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Remote workPart timeWeekend work
- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and appeals...Remote work
- ...and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support medical necessity criteria while working remotely. Key responsibilities Verify insurance benefits, eligibility,...Remote workFull time
- ...treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews,... ...diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) preferred Minimum of three years' experience...Remote workFull time
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced...Remote workFull timeMonday to FridayFlexible hours
$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- ...and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for... ...and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter. #J-18808-Ljbffr...Remote work
- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically... ...RN license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate degree...Remote workWork from homeMonday to FridayWeekend work
- ...Utilization Review Specialist – Join a Top 1% Workplace Are you looking for a fast-paced clinical role where your contributions are truly valued... .... 2 days in office at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary point of contact...Remote workWork at office
$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for...Remote workFull timeMonday to Friday- ...Bradford Health Services seeks an experienced Utilization Review Specialist to join our Birmingham-based team. You will evaluate patient records, treatment plans, and clinical data to determine medical necessity and appropriate level of care while ensuring regulatory compliance...Remote work
$40k - $50k
...Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply. Job Details...Remote workFull timePart timeWork at officeWeekend work- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
$60k - $70k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range: $... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization... ...relevant certification, such as RN, LPN/LVN, LMSW, LPC, CADC, LADAC, CCM, or...Remote workFull timePart timeWork at office$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $30-35/hour Northpoint Recovery Holdings, LLC... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...Remote workFull timeTemporary workFor contractorsWork at officeMonday to Friday- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Remote workWork at office
- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials... ...appropriate levels of care and timely approvals. This remote role requires PA RN licensure (or multi-state eNLC), a care-management...Remote work
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Remote workWork at office
- To support a growing behavioral healthcare team, the remote Licensed Utilization Review Specialist will ensure clinically appropriate care and cost-effective utilization of services, managing the review process from patient admission through discharge while collaborating...Remote work
- ...Corporation is seeking a licensed clinician to review ABA services and health status across... ...reviews, data analysis to improve utilization, and collaboration with BH providers. Time... ...MST, or CST is required, with flexible remote/hybrid options. #J-18808-Ljbffr Centene...Remote workFlexible hours
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday work- Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented Utilization Review (UR) Specialist to support our behavioral health programs in a hybrid/remote setup in Chadds Ford, PA. You will manage authorizations and eligibility verification across clinical...Remote job
- Minnesota Adult & Teen Challenge is seeking an Utilization Review Coordinator to manage insurance authorizations for treatment services. This role collaborates with admissions, counselors, and payers to ensure timely authorizations and compliance with payer and regulatory...Remote job
- Optum is seeking a Behavioral Health Utilization Review Specialist to support case management and care coordination remotely. You will review cases, determine levels of care, and coordinate transitions between inpatient and outpatient settings. You will collaborate with...Remote jobMonday to Friday
- .... Who We're Looking For We are seeking an experienced specialist who is passionate about making a difference in the lives of... ...Health or related field required preferred. ~2-3 years of utilization review experience in behavioral health, addiction treatment, or managed...Remote workDaily paidFull time
- HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and others from admission onward...Remote job
$28 per hour
LPN Utilization Management Nurse Reviewer Miami, FL (Work from Home position for FL residents only) Currently seeking an LPN FL licensed Utilization Management... ...clear and active for the state of FL (Required) Work Location: Remote #J-18808-Ljbffr Coastal Care Services, Inc.Remote workHourly payFull timeWork at officeLocal areaWork from homeRelocationHome officeWeekday work
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