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
- ...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 workContract workWork from home
- ...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 workPart time
- 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 workFlexible hours
- ...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 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- ...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 workWork at officeFlexible hours
- ...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 workDaily paidFull time
- 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-ChildrenRemote jobWork at officeWork from home
- ...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
- ...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 workTemporary workSummer workFlexible hours
- 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
- 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
- ...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 workWork at office
- 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 jobWork at office
- ...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
$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- 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
- 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
$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- 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...
- ...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
$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 workFull timeLocal area$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- 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 jobWork at officeWork from home
$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 workHourly payContract workWork at officeLocal areaShift work- ...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 workFull timeFlexible hours
- ...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 workContract workFixed term contractWork at office
- 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
$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 workWork at officeImmediate startWork from homeFlexible hours
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