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  •  ...this dept is 100% remote, with a variety of service lines and levels of care (inpatient, Extended Hospital Outpatient and OBS)....  ...3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group) • InterQual... 
    Remote work

    Pacer Group

    Torrance, CA
    3 days ago
  •  ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist...  ...in a cohesive and rewarding environment. This is a remote or office/home hybrid position. Your Responsibilities:... 
    Remote work
    Full time
    Work at office
    Flexible hours

    Spectrum Billing Solutions

    Skokie, IL
    24 days ago
  • ***Hybrid/Remote*** Orientation Location: 8501 Wilshire Blvd, Beverly Hills, CA Required: * RN license in CA * 3 years of clinical experience in hospital or urgent care * Utilization review experience * Knowledge of ICD10, CPT, HCPC * Familiarity with HMO, PPO, POS Preferred... 
    Remote work
    Local area
    Weekend work

    Zenex Partners

    Beverly Hills, CA
    4 days ago
  • $35 - $50 per hour

     ...experienced RN or LVN with an active license to join our team as a Utilization Review Nurse . In this role, you will conduct retrospective reviews...  ...Review Nurse Work Environment: Hybrid (onsite & remote) Schedule: Full-time, Monday–Friday, flexible start between... 
    Remote work
    Permanent employment
    Full time
    Contract work
    Temporary work
    Monday to Friday
    Flexible hours
    Shift work
    Canoga Park, CA
    2 days ago
  • $8 per hour

     ...Description Job Opportunity: Registered Nurse - Utilization Review Facility: CSMN - 8714024 - MNS Quality Management Location: Los...  ...% Holiday Pay: 1.5% Additional Information: ***Hybrid/Remote within a commutable distance to Beverly Hills/Los Angeles***... 
    Remote work
    Hourly pay
    Contract work
    Shift work

    Zenex Partners

    Los Angeles, CA
    3 days ago
  •  ...Job Title: Care review Clinician | Utilization review nurse Location: 100% Remote in CA Duration: 06 months+ contract (Possibility of extension) Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri) Pay Rate - $47.14/hr on W2 Job Summary:... 
    Remote work
    Contract work
    Work at office
    Shift work

    Integrated Resources

    Long Beach, CA
    1 day ago
  •  ...Job Description Position Title: Utilization Review Nurse Location: Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and... 
    Remote work
    Flexible hours
    Weekend work

    IntePros

    Phoenix, AZ
    20 days ago
  •  ...Job Title: Utilization Management RN Location: Remote – must reside within the PA/NJ/DE tri-state area for potential conversion to full-time License...  ...’ clinical conditions through detailed medical record review to determine medical necessity for services. Using... 
    Remote work
    Full time
    Part time

    IntePros

    Philadelphia, PA
    4 days ago
  • $85 - $90 per hour

     ...LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Poughkeepsie, New York. Job Description...  ...TIMES: 08:00:00 AM - 04:30:00 PM - Every other weekend - REMOTE *REMOTE* Utilization Review Nurse Case Manager position... 
    Remote work
    Hourly pay
    Weekly pay
    Long term contract
    Permanent employment
    Full time
    Contract work
    Temporary work
    Work at office
    Local area
    Shift work
    Weekend work

    LanceSoft

    Poughkeepsie, NY
    19 hours ago
  • $65k - $78k

     ...career development.     Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent...  ...applications on an ongoing basis.     #LI-AC1 #LI-REMOTE   The pay range for this position is $65,000.00 - $78,000... 
    Remote work
    Full time
    Contract work
    Work at office
    Work from home
    Flexible hours

    Gainwell Technologies LLC

    North Carolina
    17 hours ago
  •  ...Utilization Review Nurse Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities...  ...Certified (CMGT-BC) Expectations Comfortable with remote work arrangements and virtual collaboration tools Physical... 
    Remote work
    Full time
    Work at office
    Shift work
    Weekend work
    Weekday work

    Netsmart

    Winston Salem, NC
    12 hours ago
  • $35 - $41 per hour

    Job Title: Utilization Review - FULLY REMOTE Job Description This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and inpatient admissions. The position requires telephonic reviews... 
    Remote work
    Permanent employment
    Contract work
    Temporary work
    Work at office
    Work from home

    Actalent

    Atlanta, GA
    8 days ago
  •  ...Title: Utilization Review Manager (URM) FLSA Status: Exempt Location:  Fully Remote or Remote/In-Office Hybrid Approved by: Executive Leadership   Skyway Behavioral Health is an innovative behavioral health center that goes beyond the treatment of psychiatric... 
    Remote work
    Temporary work
    Work at office
    Local area

    Skyway Behavioral Health

    Downers Grove, IL
    28 days ago
  • $34 - $52.7 per hour

     ...Utilization Management Nurse Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility. This job is remote. Standard Hours: 35.00 Shift: Shift 1 Shift Details: 7/70 schedule (7...  ..., PA moonlighter, for a second level review as needed. Facilitates communication... 
    Remote work
    Hourly pay
    Temporary work
    Shift work
    Weekend work

    Froedtert Memorial Lutheran Hospital

    Albuquerque, NM
    3 days ago
  •  ...find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees... 
    Remote work
    Work at office

    Portland Staffing

    Portland, ME
    12 hours ago
  • $56.44 - $87.63 per hour

     ...Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Full- time and will work...  ...Registered Nurse License. ~2 years Experience working in a remote UR environment or working as an acute hospital case manager.... 
    Remote work
    Full time
    Shift work
    Day shift

    Providence Health & Service

    Mission Hills, CA
    3 days ago
  • $38.49 - $47.05 per hour

     ...RN Utilization Management Reviewer The RN Utilization Management Reviewer is responsible for facilitating care for members who may have complex...  ...Mobile, and Resident personas. This position can be fully remote with an in-office requirement to work 1-3x/month at our... 
    Remote work
    Hourly pay
    Full time
    Work at office
    Flexible hours

    Blue Cross Blue Shield of Massachusetts

    Hingham, MA
    2 days ago
  •  ...POSITION Customer Solutions Representative II Utilities Company Position Type: Temporary/Remote Schedule : M-F, 8:00 am - 5:00 pm (Shift may...  ...and program databases (e.g., PV, SBP, MAR). Review submitted MSA applications for completeness and... 
    Remote work
    Temporary work
    For contractors
    Work at office
    Shift work

    Alura Workforce Solutions

    Azusa, CA
    3 days ago
  • $72.48k - $108.72k

    013650 CCA-Auth & Utilization Mgmt Position Summary: Reporting to the Manager Utilization...  ..., the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely...  ...environment This position is available to remote employees residing in Massachusetts.... 
    Remote work
    Work at office
    Local area
    Home office

    Commonwealth Care Alliance

    Boston, MA
    4 days ago
  •  ...PRN Clinical Review Nurse Children's is one of the nation's leading children's hospitals...  ...applicable patients as stated in system utilization management plan. Oversees Clinical...  ...days/week for 8-10 weeks. This role can be remote, including training but occasional... 
    Remote work
    Relief
    3 days per week

    Children's Healthcare of Atlanta

    Atlanta, GA
    3 days ago
  • $56.44 - $87.63 per hour

     ...Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work...  ...Nurse License upon hire. ~2 years - Experience working in a remote UR environment or working as an acute hospital case manager.... 
    Remote work
    Part time
    Local area
    Shift work
    Day shift

    Providence Service

    Mission Hills, CA
    4 days ago
  • $75k - $85k

     ...Location Huntington Beach Office - Huntington Beach, CA Remote Type Fully Remote Position Type Full Time...  ...celebrates diversity and innovation. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity... 
    Remote work
    Full time
    Weekend work

    Clever Care Health Plan

    Huntington Beach, CA
    4 days ago
  •  ...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 work
    Price work
    Extra income
    For contractors
    Flexible hours

    Dane Street, LLC

    New York, NY
    more than 2 months ago
  •  ...Job Description Job Description Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient...  ...answers first level calls in Utilization Review for HealthCheck360 participants. They will... 
    Remote work
    Full time
    Work at office

    HealthCheck360

    Dubuque, IA
    14 days ago
  •  ...Drug Utilization Review Pharmacist – Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a...  ...pharmacy. Flexibility: Many DUR roles offer hybrid or fully remote schedules. Rewards: Competitive salary, benefits, and... 
    Remote work

    Pharmacy Careers

    Fargo, ND
    a month ago
  •  ...About Dane Street: Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking... 
    Remote work
    Extra income
    Contract work
    For contractors
    Flexible hours

    Dane Street, LLC

    New York, NY
    more than 2 months ago
  •  ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician...  ...preferred) licensed in Mississippi to perform Utilization Reviews . This is a non-clinical, fully remote role designed to offer supplemental income with... 
    Remote work
    Price work
    Extra income
    Contract work
    For contractors

    Dane Street, LLC

    Parchman, MS
    more than 2 months ago
  •  ...Dane Street, a nationally recognized Independent Review Organization (IRO) and a leading provider of Utilization Review (UR) services, is expanding our panel of expert...  ...independent medical reviews on a flexible, remote basis. This non-clinical, contract-based role... 
    Remote work
    Extra income
    Contract work
    Flexible hours

    Dane Street, LLC

    New York, NY
    9 days ago
  •  ..., is seeking an Emergency Medicine physician to work in a non-clinical utilization review setting. Opportunity Highlights ~ Daytime Monday through Friday position. Potential to work remotely part of the time. ~ Strong CDI Program ~ Salary and incentive of $2... 
    Remote work
    Part time
    Monday to Friday

    Enterprisemed

    Abington, PA
    2 days ago
  •  ...purpose to deliver a better world. Join us. **Job Description** **AECOM** is seeking an **Assistant Project Manager - Utility Design Reviewer** to work **remotely** . The client is located in Sacramento, CA and thus it's expected that this individual's working hours align... 
    Remote work
    For contractors
    For subcontractor
    Local area
    Worldwide
    Relocation
    Flexible hours

    AECOM

    Sacramento, CA
    29 days ago