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$55k - $70k
...support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000 -... ...position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be considered...Remote workFull timeWork at officeQuadrant Health Group
Boca Raton, FL3 days ago- ...Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical... ...duties as required. This position is full-time, fully remote (work from home) and requires some weekend, evening,...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States2 days ago - ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote work
Santa Barbara Cottage Hospital
New York, NY2 days ago - Enlyte is seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers’ compensation related prospective, concurrent, and retrospective treatment referrals. The role requires clinical judgment to ensure...Remote workWork from home
Genex Services, LLC
New York, NY1 day 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, CA4 days ago- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of...Remote work
Bradford Health Services
United States2 days ago $50k
...the 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 workAdvanced Recovery Systems LLC
New York, NY2 days ago- ...providing low-cost RCM solutions to maximize insurance reimbursements quickly and efficiently. They are seeking a Utilization Review Specialist to join their remote team. This role is responsible for performing utilization reviews, managing concurrent reviews, handling...Remote work
Socket
New York, NY4 days ago - ...week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient...Remote workPart time
ADDICTION AND MENTAL
United States3 days ago - ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...Utilization Review Specialist The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each... ...Office Satisfactory CORI and background check. Satisfactory drug screen Part Time Remote Role Charles River RecoveryRemote workPart timeWork at officeFlexible hours
- ...Job Description Job Description Job Summary Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews... ...may occur outside of standard office hours. Hybrid (onsite/remote) work schedule available. The ideal candidate must be able...Remote workWork at office
Oakland Community Health Network
Troy, MI15 days ago - ...Utilization Review Specialist | Remote | Full-Time Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 5075 patients, conducting admission and...Remote workFull timeTemporary work
$41.6k - $47k
...Utilization Review Specialist At Umpqua Health, we're more than a healthcare organization we're a community-driven Coordinated Care Organization... ...with the ability to stay organized and productive in a remote, independent work environment Proactive communication with...Remote workWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work- ...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
New York, NY2 days ago - ...Registered Nurse - Utilization Review About Company Bestica We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
Bestica Healthcare
United States3 days ago - ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
3B Healthcare, Inc.
United States1 day ago $65k - $85k
...Santa Barbara Cottage Hospital is seeking a Utilization Review Specialist (RN) for a remote position, specifically for candidates based in Florida. The ideal candidate will possess a valid Florida RN License and certifications in OASIS and coding. The role involves thorough...Remote workSanta Barbara Cottage Hospital
New York, NY16 hours ago- 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 workContract work
IntePros
Phoenix, AZ4 days 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
New York, NY16 hours ago $63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your...Remote workFull timeWork experience placementLocal areaFlexible hours$23.76 - $51.49 per hour
...seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...offers a competitive hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly payMolina Healthcare
Nevada, IA1 day ago- ...Providence is seeking a Utilization Review RN for a remote, full-time role in the California region. The position involves performing prospective, retrospective, and concurrent utilization reviews, reviewing medical records daily during admission for all payers, and applying...Remote workFull time
Providence Service
Irvine, CA3 days ago - ...Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit and medical...Remote work
Santa Barbara Cottage Hospital
New York, NY2 days ago $45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote workDane Street
New York, NY2 days ago- ...Job Title Utilization Management Nurse Job Description The Corporate UM and Denials... ...team is responsible for: medical necessity reviews, admission status determinations,... ...Ambulatory/Admin - Office for 3 months, then remote/hybrid. Promotes and facilitates...Remote workWork at office
$130 - $145 per hour
...Hi, we’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ..., Utilization Management. Work Location This is a remote position, open to candidates who reside in the United States...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY4 days ago$45k - $70k
...A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote workDane Street
New York, NY2 days ago$85.99k - $105.34k
...A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams....Remote workFull timeUmpqua Health
Roseburg, OR4 days 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
New York, NY2 days ago
