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- A recognized Independent Review Organization is seeking Board-Certified Orthopedic Spine Surgeons for a fully remote position. This role involves conducting Utilization Reviews based on objective, evidence-based opinions, with no patient contact. Ideal candidates will possess...Remote jobExtra incomeFlexible hours
- A leading healthcare provider is searching for a Medical Director to support the Medical Management staff with utilization reviews, appeals, and pharmacy oversight. This role requires an MD or DO with at least 3-5 years of clinical experience and a current medical license...Remote jobFull timeWork from home
- A leading medical management firm is seeking a full-time Utilization Review Specialist to ensure efficient processing of Utilization Management... ..., along with knowledge of HIPAA regulations. This is a fully remote position, requiring standard business hours and a dedicated...Remote jobFull time
- A healthcare management company is seeking a full-time Utilization Review Specialist for a remote position. The role focuses on efficiently processing Utilization Management and Independent Review requests, reviewing case requests, maintaining compliance, and delivering...Remote jobFull timeWork at office
- A leading healthcare organization in California is seeking an RN Utilization Review professional for a full-time remote role. The position entails conducting utilization reviews and managing a varied workload in a fast-paced environment. Required qualifications include...Remote jobFull time
- A leading professional services firm is seeking a Utilization Review Specialist to perform utilization review services in compliance with regulations. The role involves conducting precertification and concurrent reviews while advocating for patients. Ideal candidates will...Remote job
$18 - $22 per hour
Our Ethos Medical Management Team is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and timely processing of Utilization Management and Independent Review requests for our clients. This role involves reviewing...Remote workHourly payFull timeWork at office$55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue‑cycle management professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hours- Overview Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote About Exact Billing Solutions Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hours
- ...Care Manager to advance patient-centered care through precise Utilization Review. The role involves evaluating healthcare services, ensuring... ...experience in healthcare settings. This position supports a remote work model, allowing for flexibility while ensuring impactful...Remote job
- ...ensure high-quality, patient-centered care through effective utilization review. The candidate will be responsible for evaluating healthcare... ...’ experience in various healthcare settings. The position is remote and offers a competitive benefits package. #J-18808-Ljbffr GuidehealthRemote job
$40 per hour
Clinical Support Manager (temporary) Utilization Review RN/LPN Job Category : Advisory Services Requisition Number : CONSU005289 Posted : November 25, 2025 Full-Time Remote Locations Showing 1 location Remote United States Description About Sound Physicians: Headquartered...Remote workHourly payFull timeTemporary workPart timeWork at officeLocal areaWork from homeShift workWeekend work- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...case requirements Additional Details Remote, work‑from‑home position—work anywhere...Remote workFor contractorsWork from homeFlexible hours
- ...emphasizes high-quality patient-centered care through detailed Utilization Review. Responsibilities include managing healthcare service... ...and over 5 years of relevant experience. The position is fully remote, offering competitive benefits including medical, dental, and...Remote job
- A national risk management solutions provider seeks a remote Utilization Review Case Manager in California to assess patient admissions and treatment. Responsibilities include certifying medical necessity and collaborating with healthcare teams. Applicants should have nursing...Remote job
- A leading risk management company in Massachusetts seeks a Utilization Review Case Manager for a hybrid position. The role involves gathering clinical information, certifying medical necessity, and analyzing treatment data. Candidates should have a nursing degree, active...Remote job
- ...Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet. The purpose of the Utilization Case Manager RN is to conduct initial chart reviews for medical necessity and identify the need for...Remote workFull timeTemporary workWork at officeWorldwide
The University of Miami
United States4 days ago - ...Medicine physicians to support our clinical review services. In this role, you’ll evaluate... ...a leading provider of technology-driven utilization management and clinical review services.... ...your medical expertise while working remotely from home. Reduce or step away from hands...Remote workFor contractorsReliefWork at officeWork from homeFlexible hours2 days per week1 day per week
- ...work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position... ...performing care for hospitalized patients 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity...Remote workLocal areaWork from homeMonday to FridayFlexible hoursShift work
$108k
Job Description UW Medical Center has an outstanding opportunity for an experienced Utilization Review Nurse to join our team. WORK SCHEDULE Fully remote / work from home Must be available to work day shifts during Pacific Standard Time Sat, Sun and one day during the...Remote workFull timeTemporary workWork experience placementWork at officeWork from homeShift workDay shift1 day per week- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
- ...healthcare provider is seeking a dedicated professional for a remote Utilization Management Clinical Manager role. This position requires... ...Candidates should have an RN license and experience in utilization review. Strong communication and problem-solving skills are...Remote job
- A major healthcare organization is seeking a registered nurse for a remote position focused on utilization review. Candidates should have 2 years of experience in a hospital setting and expertise in evaluating medical necessity. Responsibilities include assessing care levels...Remote job
- A leading healthcare provider is seeking a Utilization Review RN for a fully remote position. The role involves administering medical management programs such as prior authorization and concurrent reviews. Candidates must have at least 5 years of clinical nursing experience...Remote job
- ...organization is seeking a clinical professional to change the lives of its 28 million members. In this role, you will perform clinical reviews and assess mental health and substance abuse care, ensuring the appropriateness of services. Ideal candidates will have a nursing...Remote job
- ...provider in Somerville, MA is seeking a knowledgeable UMCM to utilize clinical expertise for reviewing and approving physician requests. The ideal candidate... ...to manage multiple tasks effectively. This is a remote position with occasional onsite meetings. #J-18808-Ljbffr...Remote job
- ...augmentation firm is seeking an experienced Clinical Reviewer RN to manage a clinically complex inpatient caseload remotely. The ideal candidate will have a current,... ...RN license and a strong background in utilization management with at least 3 years of experience...Remote jobContract work
- ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with...Remote workPrice workExtra incomeFor contractorsFlexible hours
Dane Street
United States17 hours ago - A leading medical review organization is seeking a Board-Certified Sports Medicine/Family Medicine physician for a remote Independent Contractor role. The physician will perform utilization review work, ensuring healthcare services are necessary and compliant. Responsibilities...Remote jobFor contractors
- A leading healthcare provider in Miami is seeking a Utilization Nurse responsible for conducting clinical reviews to ensure the appropriateness of services for aging adults. The role requires collaboration with hospitals and healthcare teams, maintaining compliance with...Remote job
