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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, MS1 day 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, MI1 day 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
- ...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 - ...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 States1 day 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 States2 days ago - ...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
United States3 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, NY3 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
United States3 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, CA2 days ago- ...To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and accurate processing... ...Utilization Management and Independent Review requests while working remotely and providing exceptional client service. Key...Remote workFull timeWork at office
Virtual Vocations Inc
United States4 days ago - ...Sedgwick is seeking a remote RN Utilization Review professional in Tennessee to provide timely utilization reviews and advocate for cost-effective patient care. You will assess medical conditions, coordinate with clinicians, and support evidence-based treatment decisions...Remote workFlexible hours
Sedgwick Claims Management Services
United States23 hours ago $65.52k - $95.5k
...Utilization Review Specialist The Utilization Review Specialist will ensure regulatory compliance with CMS Conditions of Participation with regard to Utilization Management. Perform Utilization Review according to CMS and commercial payor guidelines. Participate in...Remote workECU Health
United States3 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
Columbus, OH4 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
$71.03k
...supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned... ...dynamic and dedicated team. Behavioral Health Prior Authorization Utilization Review Consultant Division of Fee for Service Management (DFSM) Job...Remote workFull timePart timeInternshipWork from homeFlexible hours- ...Intermountain Health’s St. Marys Regional Hospital seeks an RN Utilization Review Care Management I to perform utilization review screenings,... ...ensure compliant, efficient, and patient-centered services. Remote work is offered where approved, with shifts enterprise-wide and...Remote workShift work
Intermountain Healthcare
Helena, MT23 hours ago - ...Intermountain Healthcare Inc. is seeking an RN Utilization Review Care Management I for a fully remote, part-time role. You will review records, apply clinical guidelines, and collaborate with providers and members to ensure appropriate, cost-effective care across multiple...Remote workPart timeWeekend work
Intermountain Healthcare
Augusta, ME2 days 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
United States4 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
United States1 day ago $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
Tallahassee, FL2 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, TN2 days ago - ...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
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA5 days ago - ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to... ...Management Team 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
Ethos Risk Services
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 States3 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
United States5 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, KS2 days ago- ...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
...continuous learning, and career development. Summary Review and evaluate prior authorization submissions utilizing multiple computer systems, and when appropriate... ...What you should expect in this role ~100% Remote home office. ~ Full-time position. Applications...Remote workFull timeWork experience placementHome officeFlexible hoursGainwell Technologies LLC
Seattle, WA3 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
