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
$50k
...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- ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities...Remote workWork at officeFlexible hours
- ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing... ...is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and...Remote workFull timeWork at office
- ...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 a detail-oriented and experienced Utilization Review (UR...Remote workFull timeMonday to FridayFlexible hours
$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- ...Exeter, NH/ South Burlington, VT/ Hybrid/ Remote Employment Status: Full-time FLSA Status: Non-Exempt Reports To: Utilization Review Process Manager Job Summary: Under the supervision... ...Process Manager, the Utilization Review Specialist will use professional discretion and...Remote workFull timeWork at office
$35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 200... ...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 workWork at officeMonday to Friday- 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
- Position Overview: The UR Representative is responsible for conducting Utilization Reviews (UR) to ensure appropriate authorization for behavioral health services. This role involves reviewing cases via multiple platforms, coordinating peer reviews, entering authorization...
$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 jobHourly payContract work$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- 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, assisting...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- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The... ...or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills...Remote work
- To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client...Remote workFull timeWork at office
- ...Job Description Job Description Job Title: Utilization Review Specialist LPN Job Location: Baton Rouge, LA Company: Seaside Health System Seaside Health System is seeking a dedicated and compassionate Utilization Review-LPN to join our team in our Baton...Full timeLocal area
$55k - $70k
...support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000 - $70,000 a... ...position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be...Remote workFull timeWork at officeLocal area$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... ...Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible 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
$65.8k - $130.8k
Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST... ...and Responsibilities The UM Denial Nurse Reviewer supports high-quality, cost-effective care... ...required Two or more years of utilization review/utilization management experience...Remote workMonday to FridayFlexible hours- ...Utilization Specialist Part time 20 hours a week then will go to a Full Time Opportunity Location: Central... ...to Orlando or Villages from time to time (remote, but available for onsite meetings) Key Responsibilities Review any new Medicare patients from last 3...Remote workFull timePart time
- ...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
- ...talented Team. Job Title: Utilization Management Specialist- 49936-1 Location(s): Remote Job Summary: Utilizing... ...utilization management, the Utilization Review Specialist will perform... ...experience. ~ RN/LPN state licensing or compact....Remote workWork experience placementWork at office
- ...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 workFull timeWork from home
$60k
...Integra is looking for a LPN/LVN experienced in the managed care payor environment... ...to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual... ...Career development opportunities Remote Opportunities We are actively seeking new...Remote workTemporary workLocal area- ...Memorial Physician Practices is hiring a Utilization Review Specialist in Tucson, Arizona, who will facilitate clinical reviews and advocate for patients accessing mental health services. This PRN role involves working with managed care organizations and is vital for ensuring...Relief
- ...Utilization Review Specialist # Utilization Review SpecialistHettinger, ND 58639## OverviewSalary Range$21.35 - $26.33 HourlyLevelExperiencedPosition... ...care environment placement## Qualifications**Required**- LPN license or RHIT credential (coding certifications also acceptable...
- ...A healthcare service provider in Alabama is looking for a Utilization Review Specialist. This entry-level role involves ensuring healthcare services provided to patients are necessary and compliant. Candidates should have a Bachelor's degree in Nursing or Health Administration...Full time
- ...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...
- ...supports inpatient psychiatric, substance abuse detoxification, SUD and mental health outpatient clinics. Position Title: Utilization Review Specialist Responsibilities Initiate pre‑certification and continued stay authorizations based on ASAM criteria Communicate...Full timeWork at officeVisa sponsorshipWeekend work
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