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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
- ...leading health organization is seeking a Utilization Management Nurse Consultant to ensure... ...care. The role involves evaluating medical review cases and collaborating with providers,... ...You will work independently in this fully remote position, making critical decisions that...Remote job
- 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 - $20 per hour
...using evidence-based practices to help families heal. As our Utilization Review Specialist, you will be responsible for maintaining organizational... ...psychiatric and behavioral health services. This fully remote role requires strong clinical judgment, payor communication skills...Remote workFull timeHome office$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- 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
- RN-Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN...Remote workFull timeLocal areaWork from home
$29.62 - $45.31 per hour
Associate Utilization Review Specialist - Remote Responsibilities Be responsible for all core functions in the Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department Investigate, review, and...Remote jobWork experience placementLocal area- ...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
- ...leading academic healthcare system is seeking an RN Manager for the Rev Cycle Department. This hybrid position requires overseeing utilization review operations across multiple sites, ensuring compliance and effective communication. Responsibilities include developing...Remote job
- ...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
- .... 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
- 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
$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- ...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
$35 - $45.94 per hour
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. Oscar is the first health insurance company built... ...the Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Texas, Georgia,...Remote workHourly payFull timeWork from homeHome office- ...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 States2 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
$108k
Utilization Review Nurse page is loaded## Utilization Review Nurseremote type: Remote (100% telework)locations: Seattle, WAtime type: Part timeposted on: Posted Todayjob requisition id: REQ-0000126422**Job Description****UW Medical Center** has an outstanding opportunity...Remote workFull timeWork experience placementWork at officeWork from homeShift workDay shift1 day per week$27.5 - $44 per hour
...healing across our broad footprint. Facility: Remote MN Location: Remote, MN Address: Shift: 8... ...for inpatients/residents. The CDS utilizes the hospital's designated clinical documentation... ...organizations. May perform record reviews on clients in all age groups. Coordinates...Remote workFull timePart timeWork experience placementWork from homeShift workDay shift- ...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
- ...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
- ...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
- 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
