Get new jobs by email
- ...Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical... ...duties as required. This position is full-time, fully remote (work from home) and requires some weekend, evening,...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States3 days ago - ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
Berkshire Hathaway Homestate Companies
Omaha, NE3 days ago - ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workContract workWork from home
Medix
New York, NY16 hours 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, CA5 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, NY3 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... ...working in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Responsibilities Review...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL4 days ago - ...Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and... ...collaborating with providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive...Remote work
Guidehealth
Chicago, IL5 days ago $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 hoursExact Billing Solutions
Florida, NY5 days ago- ...while making a meaningful difference every day. Job Summary The Utilization Review department manages all aspects of a patient’s stay related to... ...to work a hybrid schedule of 2 days in office and 3 days remote after successfully completing their first 90 days in office and...Remote workFull timeWork at officeMonday to Friday
KVC Health Systems
Wichita, KS5 days ago $75k
...Santa Barbara Cottage Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical necessity reviews and collaborating with clinical teams to make informed decisions. Candidates must hold an...Remote workSanta Barbara Cottage Hospital
New York, NY4 days ago$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K About the Role As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare...Remote workFlexible hoursICBD
Florida, NY3 days ago- ...Quorum Health is seeking a Case Manager - Utilization Review Specialist for a remote role. The Specialist will manage admission reviews, conduct appeals, and identify workflow improvements. This position requires a current RN license and significant experience in healthcare...Remote work
Quorum Health
Brentwood, TN1 day ago - ...State and Territorial Epidemiologists is seeking a Clinical Review Supervisor to provide operational supervision of clinical staff conducting utilization reviews and specialty review activities. This fully remote position requires a strong background in health care and...Remote work
Council Of State and Territorial Epidemiologists
Las Vegas, NV4 days ago - ...The Council of State and Territorial Epidemiologists is looking for a Clinical Review Supervisor to oversee clinical staff conducting utilization reviews. This fully remote position requires strong leadership in a healthcare context and a proactive approach to quality...Remote work
Council Of State and Territorial Epidemiologists
Seattle, WA4 days ago - ...Excellus BCBS is hiring for a Utilization Management position based in Albany, New York. This... ...such as performing pre-service clinical reviews and collaborating with healthcare... ...competitive salary range and potential for remote work based on departmental needs. #J-188...Remote work
Excellus BlueCross BlueShield
Albany, NY4 days ago $69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare... ...candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote workMVP Health Care
Schenectady, NY4 days ago$2,210 per week
...and nights! Paid Holidays Work-life balance. Remote/hybrid setting (once trained) ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication skills... ...individual will defer decision to a second level reviewer. This individual interfaces with case...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hoursHines
Freeport, IL5 days ago- ...Shift: Any Work Hours: As Needed *This position will be remote only** Employment Type: PRN Primary Purpose Establishes... ...for the maintaining the knowledge and skill set related to utilization review, care coordination, performance improvement and professional...Remote workTemporary workReliefShift work
Parkland Health and Hospital System (PHHS)
Dallas, TX5 days ago $78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced RNs aiming to utilize their clinical expertise without direct patient care. The role involves...Remote workTalentLNX LLC
New York, NY3 days ago- ...Concierge Home Care in Jacksonville, FL is seeking an experienced Utilization Review Specialist (RN) to join its remote home health team. The ideal candidate should have strong expertise in OASIS, coding, QA, and home health documentation review. This role offers flexibility...Remote work
Concierge Home Care
Jacksonville, FL3 days ago - ...work. Preferred Skills & Certifications: Experience in Utilization Review or case management roles. Specialty certifications... ...transportation. Strong ability to work independently in remote settings. Must be able to handle fast-paced and complex...Remote workFlexible hours
vTech Solution
Santa Rosa, CA5 days ago - ...Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective... ...Commission/ Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote work
B2B Staffing Services
Torrance, CA4 days ago - ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
3B Healthcare, Inc.
United States2 days ago - ...work from home team. This is a great opportunity for a local remote position. Schedule PRN (As needed) ~ Shifts will fall... ...experience performing care for hospitalized patients. ~2 years of utilization review (UR) experience reviewing hospital admissions for medical...Remote workReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO5 days ago - ...Humana is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge... ...or military spouses. Interns will conduct clinical reviews, communicate with providers, and document findings....Remote workInternship
Humana
Phoenix, AZ1 day ago - ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of Assignment: 13 weeks Shift / Hours...Remote workShift workWeekend work
AMN Healthcare
United States2 days ago - ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
United States3 days ago - ...experience. Responsibilities include clinical reviews and collaboration with providers to... .... Preferred candidates will have utilization management experience and strong communication... ...Competitive salary offered based on experience, and potential for remote work. #J-18808-Ljbffr...Remote work
Excellus BlueCross BlueShield
Jamestown, NY1 day ago - ...Department: Utilization Management Schedule: M-F 8am-5pm Work Location: Remote Benefits for eligible positions generous paid time off paid parental leave... ...management, discharge planning and utilization review. Review admissions and service requests...Remote work
UAB Medicine
Birmingham, AL4 days ago - ...in Town of De Witt, NY. The position demands extensive clinical experience and knowledge of utilization management, with responsibilities including performing clinical reviews and collaborating with providers. Applicants should possess an Associate degree and active NYS...Remote work
Excellus BlueCross BlueShield
East Syracuse, NY4 days ago
