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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 States5 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... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL5 days ago - ...To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client...Remote workFull timeWork at office
Virtual Vocations Inc
United States2 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 workSanta Barbara Cottage Hospital
United States2 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- ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to... ...Management Team is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and...Remote workFull timeWork at office
Ethos Risk Services
United States1 day ago $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 officeLocal areaQuadrant Health Group
Pompano Beach, FL1 day ago$90.9k - $129.9k
...patient interactions for this role, rather you will provide utilization review and quality assurance.Your role in our missionReview and evaluate... ...and proceduresWhat you should expect in this role100% Remote home office.Full-time position.Applications will be accepted...Remote workFull timeHome officeFlexible hours- ...Description Location: Exeter, NH/ South Burlington, VT/ Hybrid/ Remote Employment Status: Full-time FLSA Status: Non-Exempt Reports To: Utilization Review Process Manager Job Summary: Under the supervision of the Utilization Review Process Manager, the Utilization Review...Remote workFull timeWork at office
Socket
Austin, TX2 days ago - ...development, and leadership programs… and more! Description The Utilization Review (UR) Specialist is a Registered Nurse responsible for... ...of the time may be required. Work Type: This position is a remote position outside traditional office, often from home or...Remote workWork at office
Emory Healthcare
Atlanta, GA1 day ago $70k - $100k
...part of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two days...Remote workPermanent employment2 days per weekTEKsystems
Addison, TX2 days ago$2,150 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Remote Case Manager, Utilization Review for a travel nursing job in Minneapolis, Minnesota. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 09/21/2026 ~...Remote workPermanent employmentFull timeTemporary workFor contractorsWork at officeImmediate startShift work$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 States1 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, ID2 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, FL2 days ago- ...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
- 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
- ...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
- To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services... ...collaborating with clinical teams in a fully remote capacity. Key Responsibilities Perform concurrent...Remote workPart time
$78k - $88k
...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services, following clinical criteria, coverage policies, and contract guidelines....Remote workFull timeContract workWork at officeWork from homeFlexible hoursGainwell Technologies
Juneau, AK3 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, MA3 days ago $39.64 - $61.45 per hour
...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 shiftJohns Hopkins Medicine
Hanover, MD4 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 States5 days ago - ...Registered Nurse (RN) | Utilization Review Location: Pennsylvania Agency: Pyramid Consulting, Inc. Pay: Competitive weekly pay... ...ASAP About the Position Key Responsibilities ~100% REMOTE role but candidate has to be in (PA, NJ or DE) ~ Equipment will...Remote workWeekly payFull timeImmediate start
Pyramid Consulting, Inc.
Pennsylvania6 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 States5 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 States2 days ago - ...Centene Management Company LLC is seeking a clinical reviewer for behavioral health with an active North Carolina license. The role... ...appropriateness across the care continuum. The ideal candidate has BH utilization review experience, strong communication skills, and the...Remote work
Centene Management Company LLC
United States2 days ago - ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
Virtual Vocations Inc
United States1 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 States4 days ago
