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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, MS3 days ago - ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...Remote work
Northpoint-Recovery-Holdings,-LL
United States1 day 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 States3 days ago - ...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 States4 days ago - ...Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for... ...and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter. #J-18808-Ljbffr...Remote work
MnAdultTeenChallenge
Minneapolis, MN3 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- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials... ...appropriate levels of care and timely approvals. This remote role requires PA RN licensure (or multi-state eNLC), a care-management...Remote work
Highmark Health
United States3 days ago - ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented...Remote workFull timeMonday to FridayFlexible hours
Diversified Treatment Alternative Centers
Wyomissing, PA1 day ago - ...Bradford Health Services seeks an experienced Utilization Review Specialist to join our Birmingham-based team. You will evaluate patient records, treatment plans, and clinical data to determine medical necessity and appropriate level of care while ensuring regulatory...Remote work
Addiction And Mental Health Services
United States4 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
HealthHelp
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
United States2 days ago- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
Cleveland Clinic
New York, NY5 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 States1 day ago- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Remote workWork at office
CCF
New York, NY4 days ago - ...Utilization Review Specialist – Join a Top 1% Workplace Are you looking for a fast-paced clinical role where your contributions are truly valued... .... 2 days in office at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary point of contact...Remote workWork at office
KVC Missouri
Olathe, KS1 day ago $40k - $50k
...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 are strongly encouraged to apply. Job Details...Remote workFull timePart timeWork at officeWeekend workRecovery Unplugged
Fort Lauderdale, FL5 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
United States4 days ago$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $30-35/hour Northpoint Recovery Holdings, LLC began... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for...Remote workFull timeTemporary workFor contractorsWork at officeMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID1 day ago$60k - $70k
...alternative application process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range: $60,000.00 To $70,000.00... ...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, AL3 days ago$24.65 - $30.03 per hour
...members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization review... ...will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The...Remote workFull timeWork at officeLocal areaShift workPrime Healthcare Management Inc
Ontario, CA3 hours 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-...Remote workDaily paidFull time
- ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for...Remote jobWork from home
- ...provide operational supervision of clinical staff performing utilization reviews and specialty reviews using InterQual criteria. You will... ...internal and external stakeholders. This role supports a flexible remote work model with occasional on-site collaboration, based out...Remote workFlexible hours
Comagine Health
United States4 days ago - ...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
Quincy, MA2 days ago $34.82k - $55.99k
...The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and... ...CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assess care for mental health and substance use. This remote role supports clinicians across the continuum of care while collaborating with providers to determine appropriate...Remote work
IntelliResume
United States1 day ago - ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity...Remote work
Medix
United States3 days ago $63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt Unit : UAW Department/Location : Utilization Management... ...requirements for this position. While the position is remote, the individual in this position will have occasional travel...Remote workFull timeTemporary workMonday to Friday- ...Centene Corp. is seeking an Utilization Review Clinician - Behavioral Health to conduct clinical reviews for mental health and substance use... ...ensuring appropriate level of care for Oregon Medicaid in a fully remote role. The position follows a Monday–Friday 8–5 Pacific...Remote workMonday to Friday
Centene Corporation
United States4 days ago $92.4k - $138.6k
...of redefining the possible in healthcare. The Manager for Utilization Review is responsible for the leadership and management of the centralized... ..., experimentation, and application of AI. This is a remote position; however, candidates must be willing and able to travel...Remote workTemporary workWork at officeLocal area
