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- ...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
CVS Health
Jackson, MS3 days ago $60k - $62k
...Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States Exempt Location USA/Remote Reports... ...to your geography and expertise. Position Overview The Utilization Review Specialist is responsible for all aspects of the...Remote workFull timePart timeWork from homeFlexible hoursCoronis Health
Jackson, MI2 days ago- 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
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications with insurance payers. You will support patient access by securing initial and continued...Remote work
The Florida House
New York, NY4 days ago - ...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
Recovery Unplugged
United States3 days ago - ...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
ExamWorks
New York, NY5 days ago - ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
Hansei Solutions
United States4 days ago - ...Kent County Cmh Authority is seeking a Utilization Review Specialist to perform reviews for I/DD, mental health, and SUD services. You will... ...to appropriate intensity settings. The role is full-time and remote with occasional local travel within the Kent County area. Strong...Remote workFull timeLocal area
Kent County CMH Authority
Grand Rapids, MI3 days ago - ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...Remote work
State of Arizona
New York, NY5 days ago - ...accredited college or university in Nursing, Social Work, Behavioral Health or related field required preferred. 2-3 years of utilization review experience in behavioral health, addiction treatment, or managed care. Strong understanding of ASAM criteria, LOCUS, DSM-5,...Remote workDaily paidFull time
The Florida House
New York, NY5 days ago $30 - $45 per hour
...and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure... ...accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various...Remote workHourly payContract workPyramid Consulting
Long Beach, CA4 days ago- ...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
Virtual Vocations Inc
United States5 days ago - ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
Sedgwick Claims Management Services
United States1 day ago $69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote workFull timeCincinnati Children's
New York, NY1 day ago- ...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
HealthHelp
United States3 days ago - ...Utilization Review Specialist The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each... ...in Microsoft Office Satisfactory CORI and background check. Satisfactory drug screen Part Time Remote Role...Remote workPart timeWork at officeFlexible hours
Charles River Recovery
United States5 days ago - 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
$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 adolescent...Remote workFull timeMonday to FridayPrinciples Recovery Center
United States2 days ago$18 - $20 per hour
...seeking a detail-oriented, compassionate professional to join our Utilization Review department. At Camber, we do not just talk about a... ...review. 2 days in office at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary point of contact for...Remote workHourly payFull timeWork at officeKVC Shared Services
Olathe, KS4 days ago- ...As Utilization Review Specialists, we are the liaisons between insurance payors and the treatment facilities we service, advocating for clients... ...if personally represented as "recovering".Benefits100% remote first company to foster flexibility, inclusivity, and autonomy...Remote workWork at office
Hansei Solutions
Franklin, TN4 days ago - ...Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical necessity, coordinating care, and ensuring compliance with reimbursement guidelines. It supports...Remote work
Ascension
Austin, TX3 days ago - ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...Remote work
Cincinnati Children's Hospital
Cincinnati, OH2 days ago - ...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
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA1 day ago $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 workConcierge Home Care
United States4 days ago- American Health Holding, Inc. (an division of CVS Health) is seeking a Utilization Management Nurse Consultant specializing in Medical Review. This fully remote role emphasizes precise clinical review, collaboration with providers, and compassionate patient care in a fast...Remote job
- ...Jobgether, in partnership with a healthcare team, seeks a Case Manager – Utilization Review Specialist based in the United States. This fully remote role focuses on admission and concurrent reviews, denials prevention, and coordinated appeals to support patient care and...Remote work
Jobgether
Clifton, TX3 days ago $90.9k - $129.9k
...patient interactions for this role, rather you will provide utilization review and quality assurance. Your role in our mission Review... ...and procedures What you should expect in this role ~100% Remote home office. ~ Full-time position. Applications will be...Remote workFull timeWork experience placementHome officeFlexible hoursGainwell Technologies LLC
Madison, WI3 days ago- ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for...Remote jobWork from home
$63.1k - $83.65k
...about making a difference by helping others. We are seeking a Utilization Review Specialist to perform utilization review of intellectual and... ...requirements for this position. While the position is remote, the individual in this position will have occasional travel...Remote workFull timeTemporary workMonday to FridayKent County CMH Authority
Grand Rapids, MI4 days ago- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist. The role supports review of clinical data to determine medical necessity... ...authorizations for ABA and related services. It is a fully remote or office/home hybrid position with a collaborative, detail-...Remote jobWork at office
