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- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
- ...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
United States2 days ago - ...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...Remote workFull time
Virtual Vocations Inc
United States4 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. Your Responsibilities Review...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL4 days ago $50k
...lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote workNurseRemotely
United States5 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, CA5 days ago- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Remote workWork at office
NurseRemotely
United States2 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 $40k - $50k
...Job Type Full-time Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey...Remote workFull timePart timeWork at officeWeekend workThe Joint Commission
Fort Lauderdale, FL12 hours ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health‑sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health, Inc.
New York, NY2 days ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health Outreach
United States3 days ago- Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas... ...for diverse populations. The position emphasizes utilization review, documentation, and collaboration with stakeholders...Remote jobWork from home
$60k - $75k
...alternative application process. Full Time Office/Clerical Remote, Birmingham, AL, US 14 days ago Requisition ID: 5907... ...communities for every stage of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization Review...Remote workFull timePart timeWork at officeBradford Health Services
Birmingham, AL1 day ago$35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 2009 as Ashwood... ...SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for...Remote workFull timeTemporary workWork at officeMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID4 days ago$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
Jacksonville, FL4 days ago- ...Remote DUR Pharmacist Safe & Cost-Effective Medication Use Work From Home Analyze medication use patterns, apply clinical guidelines... ...collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical...Remote jobWork from home
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
Mass Digital Health
United States5 days ago - ...Job Description Job Description Utilization Review Manager - KVC Missouri Admissions Location: Remote (Statewide - Missouri) KVC Missouri is seeking a dedicated and detail-oriented Utilization Review Manager (URM) to serve as a vital link between our treatment...Remote work
KVC Health Systems
Kansas City, MO7 days ago - ...Apply Refer a Friend Back Remote Work from Home Share This Page Share on Facebook Share on... ...Friday, the core business hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD1 day ago $71.1k - $97.8k
...Hong Kong Study Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a minimum...Remote workWork from homeHong Kong Study Skills Research Institute
Juneau, AK4 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 States2 days ago - ...Centene Corp. is seeking a Utilization Review Clinician - Behavioral Health for a remote role focused on clinical reviews and prior authorization of mental health and substance use services. The role emphasizes ensuring appropriate levels of care and educating providers...Remote work
Centene Corporation
Eastern, KY1 day ago - ...Technician to support retail pharmacy operations remotely. This role involves processing prescriptions, performing prior authorization reviews, and coordinating care for patients.... ...pharmacy, ideally with experience in utilization review. A strong knowledge of insurance processes...Remote work
The Judge Group, LLC
United States1 day ago - ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
IntePros
United States2 days ago - ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity reviews for inpatient and outpatient... ...nursing or social work credentials, experience in utilization management, and the ability to work remotely within the US; remote options and weekday schedule...Remote workWeekday work
IntelliResume
Louisiana, MO1 day ago - ...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely discharges, and refer members to appropriate resources while working remotely. Key responsibilities Assist in building and implementing...Remote workFull time
Virtual Vocations Inc
United States3 days ago - ...Centene Corporation is seeking a Behavioral Health Utilization Review clinician to evaluate and authorize BH services, ensure appropriate levels of care, and collaborate with providers and medical leadership. This role emphasizes quality improvement, case presentations...Remote work
Centene Corporation
Louisiana, MO5 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 - 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
United States2 days ago - ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
United States3 days ago
