Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote LPN Utilization Review Specialist in Quincy, MA vacancy
  • 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

    Ampcus Inc

    Owings Mills, MD
    4 days ago
  •  ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical...  ...experience in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including... 
    Remote work
    Contract work
    Work from home

    Mass Digital Health

    United States
    2 days ago
  •  ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services,...  ...while collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform... 
    Remote work
    Part time

    Virtual Vocations Inc

    United States
    2 days ago
  • A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have... 
    Remote work
    Flexible hours

    Medical Review Institute

    United States
    2 days ago
  •  ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting.... 
    Remote work
    Full time

    Alliance Health in

    Morrisville, NC
    3 days ago
  • $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 work
    Hourly pay
    Contract work

    Pyramid Consulting

    Long Beach, CA
    4 days ago
  •  ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle...  ...to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR...  ...rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities... 
    Remote work
    Work at office
    Flexible hours

    Spectrum Billing Solutions

    Skokie, IL
    1 day ago
  •  ...excellence.Who We're Looking ForWe 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 work
    Daily paid
    Full time

    The Florida House

    Deerfield Beach, FL
    3 days ago
  • Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and...  .... After a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide-Children
    Remote job
    Work at office
    Work from home

    Nationwide-Children

    Columbus, OH
    4 days ago
  •  ...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 work
    Part time

    ADDICTION AND MENTAL

    United States
    1 day ago
  •  ...Healthcare Utilization Review Specialist Join our team at Company and build a meaningful career in employee benefits solutions. As a Healthcare Utilization Review Specialist, you'll play a vital role in ensuring our clients and members receive the right care at the... 
    Remote work
    Temporary work
    Summer work
    Flexible hours

    Cobalt Benefits Group

    United States
    17 hours ago
  • Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant... 
    Remote job

    Spectrum Billing Solutions

    Skokie, IL
    1 day ago
  • FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance.... 
    Remote job

    Fherehab

    Deerfield Beach, FL
    3 days ago
  •  ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs. You will review cases, coordinate with providers, and ensure timely decisions in line with policy and regulatory requirements. Ideal... 
    Remote work
    Work at office

    HealthHelp

    Houston, TX
    4 days ago
  • CorVel Corporation is seeking an UR Intake Specialist to provide staff support such as typing reports, handling...  ...while answering incoming calls and supporting the Utilization Review/Case Management department. This remote role requires strong communication, multitasking,... 
    Remote job
    Work at office

    CorVel Corporation

    Folsom, CA
    4 days ago
  •  ...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

    TurningPoint Healthcare Solutions

    Florida, NY
    4 days ago
  • $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 work
    Hourly pay
    Minimum wage
    Full time
    Work at office
    Local area
    Flexible hours

    CorVel Healthcare Corporation

    Irving, TX
    7 days ago
  • Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary... 
    Remote job

    Ascension

    Milton, FL
    2 days ago
  • HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role...  ...and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr... 
    Remote job

    HonorHealth

    Phoenix, AZ
    1 day ago
  • $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 work
    Minimum wage
    Full time
    Work experience placement
    Local area
    Shift work

    Providence Health & Service

    Oregon, WI
    2 days ago
  • An established industry player in health care is seeking a Utilization Review Nurse to join their dedicated team. In this vital role, you will evaluate medical records and apply clinical expertise to ensure the delivery of necessary health services. Your contributions... 

    Emanate Health

    Covina, CA
    2 days ago
  •  ...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

    Health First

    United States
    4 days ago
  • $62k - $70k

     ...of this position is to ensure that the utilization process is thorough, organized and streamlined...  ...timely manner Completes peer to peer reviews with insurance MDs to advocate for...  ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available... 
    Remote work
    Full time
    Local area

    Charlie Health

    Nashville, TN
    19 days ago
  • $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 work
    Hourly pay

    Astrana Health

    United States
    4 days ago
  • Nationwide Children’s Hospital is seeking a Behavioral Health Utilization Review Specialist to review cases, determine medical necessity, and ensure compliance with guidelines. The role conducts pre-certifications, pre-authorizations, and retrospective reviews, collaborating... 
    Remote job
    Work at office
    Work from home

    Nationwide Children's Hospital

    Columbus, OH
    4 days ago
  • $13 - $14 per hour

     ...Type : Contract Location- Remote Schedule and Shift:...  ...plans requirements related to Utilization Management and authorizations...  ...process and requirements Reviews benefit language and medical...  ...direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred... 
    Remote work
    Hourly pay
    Contract work
    Work at office
    Local area
    Shift work

    Pride Global

    United States
    4 days ago
  •  ...Remote OASIS Reviewer Join Custom Home Health's Quality team as a contingent OASIS Review Specialist! We're looking for detail-oriented clinicians with experience in OASIS review...  ...patient diagnoses and comorbidities Utilize OASIS validation and alert reports to... 
    Remote work
    Full time
    Flexible hours

    Custom Home Health Inc

    Troy, MI
    2 days ago
  •  ...Services. Standards & Practices Associates review high profile national advertising...  ...support, and other documentation obtained and utilized in the clearance process is an integral...  ...Hybrid role; In-Office days Mon.-Thurs.; Fri. Remote US Tech Solutions is a global staff... 
    Remote work
    Contract work
    Fixed term contract
    Work at office

    US Tech Solutions

    New York, NY
    2 days ago
  • Trillium Health Resources is seeking a dedicated Utilization Management Specialist II to support clinical review by validating service authorization requests and...  ...determinations to ensure timely and accurate decisions. Remote within North Carolina with standard hours and... 
    Remote job

    Trillium-Health-Resources

    New York, NY
    3 days ago
  • $56.27k - $69.9k

     ...application process. Professionals Remote, Remote, US 2 Attachments 5 days ago...  ...Resources has a career opening for a Utilization Management Specialist II to join our team! The Utilization...  ...Management Specialist II supports clinical review by validating service authorization... 
    Remote work
    Work at office
    Immediate start
    Work from home
    Flexible hours

    Trillium-Health-Resources

    New York, NY
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote LPN Utilization Review Specialist. Be the first to apply!