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- ...healthcare management company is seeking a Nurse to conduct concurrent reviews of members' health and care setting. The role requires a Texas... .... Candidates should be able to multitask, learn quickly, and utilize technology effectively. This is a work-from-home position with...Remote jobWork from home
- 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 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
$45 per hour
...staffing company is seeking a local contract Registered Nurse for Utilization Review in Torrance, California. The position requires extensive... ...acute care and proficiency in InterQual and Epic. This fully remote role offers a stable schedule with competitive pay of $45/hour...Remote jobContract workTemporary workLocal areaFlexible hours- 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 medical institution in Chicago is seeking an RN Manager for the Rev Cycle Department. In this hybrid role, you will lead utilization review activities, ensuring compliance with medical necessity criteria and overseeing operations across multiple sites. Candidates...Remote job
- ...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
- 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 States4 days ago $108k
Utilization Review Nurse page is loaded## Utilization Review Nurseremote type: Remote (100% telework)locations: Seattle, WAtime type: Part timeposted on: Posted Todayjob requisition id: REQ-0000126422**Job Description****UW Medical Center** has an outstanding opportunity...Remote workFull timeWork experience placementWork at officeWork from homeShift workDay shift1 day per week- ...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 States5 hours ago - A leading healthcare provider is looking for an RN Utilization Management Reviewer to facilitate care for members with complex needs. This role involves... ...-5 years of relevant experience. The position allows for remote work with occasional office visits in Hingham, MA. The...Remote jobWork at office
- 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
- 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
- ...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
$60.2k - $107.4k
A healthcare organization is seeking a Utilization Review Nurse to manage inpatient utilization efficiently. This role, which can be performed remotely within the U.S., requires a current RN license and at least 3 years of clinical nursing experience. Key responsibilities...Remote job- 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
$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- A national addiction treatment provider has an exciting opportunity for a Utilization Review Clinician. This role focuses on coordinating clinical utilization and insurance expectations for patient admissions. The position requires clinical credentials along with experience...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- A leading health plan organization in Hingham is seeking an RN Utilization Management Reviewer responsible for authorizing medically necessary services and facilitating care for members. The ideal candidate should have 3-5 years in clinical settings, excellent communication...Remote 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
- A healthcare organization is seeking a skilled Registered Nurse Utilization Management (UM) Reviewer for a remote position. The role involves analyzing patient statuses and ensuring they receive appropriate care. Candidates should have at least a BSN, 3+ years of acute...Remote job
- ...work from home team. This is a great opportunity for a local remote position. Schedule PRN (As needed) Shifts will fall between Monday... ...performing care for hospitalized patients. 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity...Remote workReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
- ...adverse organization determinations. Candidates must hold a current CA LVN licensure and have two or more years of experience in utilization review within a health plan environment. Strong communication and analytical skills are essential. This role offers a flexible...Remote jobFlexible hours
- A national Independent Review Organization is looking for Board-Certified physicians in Oncology for a flexible, remote independent contractor position. The role involves conducting independent Utilization Reviews and requires specific state medical licenses (Florida,...Remote jobFor contractorsFlexible hours
- ...organization is seeking a clinical professional to change the lives of its 28 million members. In this role, you will perform clinical reviews and assess mental health and substance abuse care, ensuring the appropriateness of services. Ideal candidates will have a nursing...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
- ...Carolina healthcare provider is looking for an IDD UM Clinician to manage utilization reviews and facilitate service planning for individuals with intellectual and developmental disabilities. This remote role requires a Master's degree in a relevant field and a valid...Remote job
$76k - $85k
A leading public sector solutions firm is seeking a Utilization Review Nurse to perform medical management activities and healthcare reviews.... ...communication skills and a commitment to quality. This role is remote and requires a nursing degree with clinical experience....Remote job
