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- 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
- 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
$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
- ...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
$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- A leading educational institution in Miami is seeking a Case Manager RN for Utilization Review. The role involves conducting medical necessity chart reviews and coordinating with the healthcare team to ensure optimal patient outcomes. The ideal candidate will have a Bachelor...Remote jobFull time
- ...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 States1 day ago $76k - $85k
A public sector solutions firm is seeking a Utilization Review Nurse to manage prior authorizations and reviews concerning healthcare costs.... ...with effective communication and problem-solving skills. This remote position offers a compensation range of $76,000 - $85,000, with...Remote job- ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with...Remote workPrice workExtra incomeFor contractorsFlexible hours
Dane Street
United States2 days ago - A healthcare management company is seeking a Utilization Review Nurse to support evaluating medical necessity requests remotely. Responsibilities include reviewing requests, ensuring compliance, and advocating for members' care needs. Candidates must be licensed nurses...Remote job
- A public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization reviews and utilize a medical management... ...communication skills and the ability to work efficiently in a remote environment while adhering to protocols and standards. This position...Remote job
$76k - $85k
A leading public sector solutions firm is seeking a Utilization Review Nurse to work remotely. The role involves performing prior authorization and clinical reviews, ensuring compliance with established criteria. Candidates must have an RN license and a minimum of two years...Remote job- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
$89.07k - $162.8k
...Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines.... ...*UR experience required. Must live in area. Remote after completion of on-site orientation. *...Remote workFull timeLive inRelocationMedStar Health
Bowie, MD20 hours ago- ...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
- ...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
- 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
$76k - $85k
A public sector solutions firm is seeking a Utilization Review Nurse to perform medical management and review tasks in a remote capacity. The ideal candidate will have at least 2 years of clinical nursing experience and must possess effective communication and organizational...Remote job$76k - $85k
A leading public sector solutions firm is seeking a Utilization Review Nurse responsible for authorizations and reviews of health care costs.... ...of clinical experience in a managed care setting. This is a remote role with a salary range between $76,000 and $85,000. Strong...Remote job- An established industry player is seeking Board-Certified Orthopedic Spine Surgeons for a fully remote, non-clinical role in Utilization Review. This opportunity offers flexibility and supplemental income, allowing physicians to provide evidence-based opinions on treatment...Remote jobExtra income
$76k - $85k
A leading public sector solutions firm is seeking a Utilization Review Nurse in Nashville, TN. The role involves performing reviews, communicating... ...a variety of health and wellness benefits as part of a fully remote working environment. #J-18808-Ljbffr Public Consulting GroupRemote job- A health services provider is seeking a Utilization Review Specialist in Malibu, CA. This part-time remote role requires effective communication skills and knowledge of medical terminology. Responsibilities include managing cases for clients in treatment and ensuring compliance...Remote jobPart time
$93.6k - $104k
A healthcare solutions provider is seeking an experienced Utilization Review RN (Lead II) for a remote position. The role involves reviewing medical service requests, preparing documentation for compliance, and coordinating discharge planning. Candidates must possess a...Remote job$76k - $85k
A leading public sector solutions firm seeks a Utilization Review Nurse to perform health care reviews and determinations related to funding... ...years of nursing experience, preferably in managed care. This remote position offers a salary range of $76,000 - $85,000, along with...Remote job- A leading healthcare provider is seeking an experienced Utilization Review Nurse for a fully remote position. This role requires 3 years in utilization management and 5 years in an acute care setting. The nurse will be responsible for patient admissions, communication with...Remote jobPart time
- A healthcare services provider is seeking a Clinical Review Nurse to work remotely. The role involves reviewing medical information to ensure care... ...a minimum of 2 years of nursing experience, preferably in utilization management or managed care. #J-18808-Ljbffr SPECTRAFORCERemote job
- ...administrative solutions provider is seeking an experienced Utilization Review Manager to lead its UR department in Pikesville, MD. The role... ...strong communication skills. This hybrid role requires a blend of remote work and commuting to the office. #J-18808-Ljbffr Walker...Remote workWork at office
