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
- ...Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health...Remote workFull time
- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
$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- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with...Remote work
- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of...Remote work
- ...At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and...Remote workPart 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- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
- ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...healthcare practice, the contract-to-hire BCBA Licensed Utilization Review Specialist will perform prospective, concurrent, and retrospective reviews... ...medical necessity and appropriateness while working remotely. Key responsibilities Perform reviews to determine authorization...Remote workContract work
$29.62 - $45.31 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...requests, customer service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for candidates...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals and service authorization needs to ensure medical necessity aligns with CMS standards and organizational determinations. The role requires...Remote work
$60k - $62k
...Job Description Job Description Title : Utilization Review Specialist/Behavioral Health Substance Abuse (Remote) Reports to : UR Manager FLSA Classification : Exempt Full-Time or Part-Time : Full-Time Salary Range : $60,000 to $62,000 Starting...Remote jobFull timePart timeFlexible hours- ...an Appeals and Grievances Clinical Specialist to manage member complaints and... ...case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities... ...practice and knowledge of Utilization Review Guidelines. The position offers a...Remote work
- ...Job Description Job Description Salary: Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking...Remote workFull timeMonday to FridayFlexible hours
$16.74 - $26.92 per hour
...Job Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence... ...an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible 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 medical...Remote workHourly pay$41.6k - $47k
...Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 EMPLOYMENT TYPE- Full-Time, Exempt... ...skills with the ability to stay organized and productive in a remote, independent work environment Proactive communication...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work$26.35 - $39.53 per hour
...NeueHealth is seeking a Concurrent Utilization Review Nurse responsible for real-time clinical reviews to ensure the medical necessity of healthcare services. The role includes conducting assessments, coordinating with providers, and collaborating with the Medical Director...Remote workHourly pay- ...Metered Utilities Specialist Are you someone who enjoys research and has a keen eye for detail?... ...to manage customer utilities and rate reviews. Essential Functions Core functional... ...available; 50% in the office, 50% remote About LCS London Computer Systems...Remote workLive inWork at officeRelocationWork visa
$51 per hour
...Utilization Management Specialist (UM / Utilization Review Nurse) — Remote Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx... .... Required qualifications ~ Active RN or LPN license (RN preferred) — Maryland compact/...Remote workFull timeContract workWork at officeLocal areaFlexible hours$51.46k - $60k
...through Friday from 9:00 AM-5:30 PM (2-days remote, 3-days in office) Responsibilities... ...services from insurance and government payors Reviewing clinical records and determining the... ...summary reports and presentations on utilization management data Other duties as assigned...Remote workFull timeTemporary workWork at officeMonday to FridayFlexible hoursShift work- ...Full-Time Position Summary The Utilization Specialist uses strong independent... ...processes. Conduct utilization reviews to ensure services meet... ...services preferred. Active LPN, RN, MSW, CSW, LPC, or another... ...working on a computer. Hybrid or remote work may be available based...Remote workFull timeWork at officeFlexible hours
- ...Position: Case Review Specialist – Phone Intake & Documentation Location: Remote Remote Status: Remote Job Id: 1678 # of Openings: 1 About OncoHealth OncoHealth... ...2 years of experience in healthcare operations, utilization management, case management, intake, call center...Remote workWork at officeLocal areaMonday to FridayShift work
$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to... ...Corporate office preferred / remote may be considered Collaborative...Remote workHourly payWork at office$27.07 - $33.37 per hour
...exceptional leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length...Daily paidFull timeTemporary workPart timeWork experience placement- ...Medical Center Health System in Odessa, TX seeks a detail‑oriented support clerk to assist the Utilization Management department with utilization reviews, data collection, and care coordination activities. The position requires a high school diploma, at least one year...
$13 - $14 per hour
...hour Job Type: Contract Location: Remote Schedule and Shift: Monday-Thursday from... ...health plans requirements related to Utilization Management and authorizations Acts as... ...Management process and requirements Reviews benefit language and medical records to...Remote workHourly payContract workWork at officeShift work$20 - $30 per hour
...A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...- ...Utilization Review Specialist Position Summary: Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources... .... License Requirements: Licensed Practical Nurse (LPN) license with State Nursing Board and/or possess multistate...
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