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- ...is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant...Remote workWork from home
Guidehealth
Peoria, IL2 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, NE1 day ago Physician / Surgery - Plastic / Vermont / Permanent / Plastic Surgeon - Utilization Review Physician
...Dane Street , a nationally recognized Independent Review Organization (IRO) and leading provider of Utilization Review (UR) services, is expanding its panel of physician... ...to perform Utilization Reviews on a flexible, remote basis. xmvmafu Remote working/work at home options...Remote workPermanent employmentWork from homeFlexible hoursDane Street
Los Angeles, CA2 days ago$275k - $300k
...Remote or hybrid Medical Director for MediCare service line 100% administrative, non-clinical role Work from home, but candidate... ...CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license...Remote workPermanent employmentFull timeWork from homeMonday to FridayIntegrity Healthcare
Sacramento, CA11 hours ago- A leading healthcare services provider is seeking a Utilization Review & Quality Assurance Specialist to work from home. The role involves evaluating clinical documentation, ensuring compliance with client standards, and conducting peer review processes. Candidates must...Remote jobWork from home
- 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 healthcare solutions company seeks a skilled Utilization Review Nurse to conduct vital reviews for medical necessity and appropriateness. The ideal candidate will have an active RN license, 3+ years of inpatient clinical experience, and strong written communication...Remote jobWork from homeFlexible hours
- ...insurance firm in Warwick seeks a UM Specialist to handle medical review decisions, balancing clinical standards with excellent... ...Responsibilities include reviewing medical services and conducting utilization reviews. Ideal candidates have an Associate's degree and three...Remote jobFlexible hours
- 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
$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$29.95 - $44.77 per hour
A national risk management firm is seeking a Utilization Review Case Manager to analyze clinical information for patient admissions and treatment. This remote position requires strong CPT and ICD coding knowledge, along with effective organizational and communication skills...Remote jobHourly pay- ...A healthcare organization is seeking a Concurrent Review Nurse to perform utilization management activities. This role involves reviewing hospital... ...and knowledge of clinical guidelines are essential. This position offers a remote work environment. #J-18808-Ljbffr...Remote work
Palm Medical Centers
Fort Worth, TX1 day ago - ...high-quality care through efficient medical resource utilization. Key responsibilities include reviewing medical records and collaborating with healthcare... ...areas and utilization review. The role supports both remote work and in-person collaboration, ensuring exceptional...Remote job
- ...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 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
$76k - $85k
...A public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization and clinical reviews. Candidates should... ...effective communication, and attention to detail while working remotely. Compensation ranges from $76,000 to $85,000, with...Remote workPublic Consulting Group
Albany, NY1 day ago- ...A healthcare facility in Gibson City, Illinois, is seeking a Utilization Review/Case Management Nurse. The role involves reviewing patient admissions... ...a hybrid work model, balancing in-person meetings with remote collaboration, aiming to enhance patient outcomes and...Remote work
Gibson Area Hospital
Gibson City, IL19 hours ago - ...A healthcare organization in Irving, TX seeks a Claims Review Registered Nurse to provide detailed coding and claims review, ensuring accurate utilization of services. The role requires at least 5 years of nursing experience, along with relevant education and licensure...Remote work
GuideWell
Irving, TX2 days ago - ...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 healthcare organization is seeking an experienced RN Case Manager with a strong background in UAS assessments and utilization review. This fully remote position emphasizes data-driven decision-making to ensure appropriate care. Responsibilities include reviewing UAS assessments...Remote job
- A national medical review organization is seeking Board-Certified physicians in Neurosurgery to conduct independent Utilization Reviews. This flexible, fully remote opportunity requires only 1-2 hours per week with no minimum commitment. Candidates must hold a current medical...Remote workFlexible hours
Medical Review Institute
Dallas, TX1 day ago $76k - $85k
...A leading public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization and medical reviews in a remote environment. The role requires at least 2 years of clinical nursing experience and an RN license. Responsibilities include using...Remote workPublic Consulting Group
Helena, MT19 hours ago- ...healthcare provider in Los Angeles is seeking a Utilization Management RN responsible for conducting clinical reviews and overseeing medical records for admission. Candidates... ...RN license, and two years of experience in a remote utilization review environment or as an acute...Remote work
Providence Health Plan Group
Los Angeles, CA1 day ago - ...A healthcare company is seeking a remote Physician Clinical Reviewer specializing in Nephrology. The ideal candidate will have over 5 years of experience in utilization management, performing medical reviews, and providing clinical rationale for appeals. Responsibilities...Remote work
Prime Therapeutics
Denver, CO3 days ago - ...A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
Insight Global
Raleigh, NC1 day ago - ...A healthcare organization is seeking a Physician Clinical Reviewer for cardiology on a remote basis. The role involves key responsibilities in the utilization management team, performing medical reviews and interacting with physicians. Candidates must hold a DO, MBBS,...Remote work
Prime Therapeutics
Raleigh, NC2 days ago $1,949.74 per month
...Profession Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review... ...6 Duration 13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent reviews, medical...Remote workWeekly payShift workCynet Health
Eureka, CA4 days ago- ...Manager to advance high-quality, patient-centered care through Utilization Review. The ideal candidate will have an active RN license in... ...healthcare services and coordinating care effectively. This fully remote position offers flexibility, competitive pay, and comprehensive...Remote job
$76k - $85k
...A leading public sector solutions provider is seeking a Utilization Review Nurse based in Atlanta, GA. The role involves conducting healthcare... ...and experience in a managed care setting to qualify for this remote opportunity. Competitive compensation ranging from $76,000 to...Remote workPublic Consulting Group
Atlanta, GA19 hours ago- ...A leading healthcare company is seeking a Medical Director to perform clinical reviews and assess medical necessity for inpatient cases. This role offers the chance to collaborate with a team of physicians, making a significant impact on patient care. Requires an MD/DO...Remote workWork from home
Humana
Providence, RI3 days ago
