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- ...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 States3 days ago - ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
Virtual Vocations Inc
United States3 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, CA5 days ago- ...necessary and efficient healthcare services, the full-time Utilization Review Specialist will evaluate patient records and treatment plans... ...maintain compliance with regulatory standards while working remotely. Key responsibilities: Review and analyze medical records and...Remote workFull time
Virtual Vocations Inc
United States3 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... ...working in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Responsibilities Review...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL4 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 States4 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 jobWork from home
- 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 job
$75k
...Santa Barbara Cottage Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical necessity reviews and collaborating with clinical teams to make informed decisions. Candidates must hold an...Remote workSanta Barbara Cottage Hospital
New York, NY4 days ago- ...while making a meaningful difference every day. Job Summary The Utilization Review department manages all aspects of a patient’s stay related to... ...to work a hybrid schedule of 2 days in office and 3 days remote after successfully completing their first 90 days in office and...Remote workFull timeWork at officeMonday to Friday
KVC Health Systems
Wichita, KS5 days ago $55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hoursICBD Holdings
Florida, NY4 days ago$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K About the Role As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare...Remote workFlexible hoursICBD
Florida, NY4 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 reviews...Remote job$56.17k - $70.21k
...Salary Range: $56,165.00 To $70,206.00 Annually 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 workFull timeWork at office- ...Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and... ...collaborating with providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive...Remote job
$65k - $75k
...insurance companies and clinical teams while conducting reviews to ensure optimal client coverage. Candidates should... ...Bachelor’s degree in Mental Health, with experience in utilization review preferred. This remote role offers a pay range of $65-75k, Monday to Friday schedule...Remote jobFull timeMonday to Friday- ...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 States2 days ago - ...Blue Cross and Blue Shield of Kansas City is looking for a Clinical Review Nurse to utilize clinical expertise in managing healthcare services efficiently. Candidates must have at least 3 years of direct patient care experience and an Associate degree in nursing, along...Remote work
Blue Cross and Blue Shield of Kansas City
Kansas City, MO3 days ago $1,966 per week
...and nights! Paid Holidays Work-life balance. Remote/hybrid setting (once trained) ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication skills... ...individual will defer decision to a second level reviewer. This individual interfaces with case...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hoursHines
Rockford, IL4 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
New York, NY3 days ago - A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
Insight Global
Raleigh, NC3 days ago - ...is seeking an experienced Medical Director to conduct clinical reviews and guide decision-making in inpatient care. The role... ...of clinical experience, with a focus on hospital medicine and utilization review. Join a distinguished team to impact patient outcomes while...Remote work
Humana
Columbus, OH5 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 jobContract workWork from home
$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, NY3 days 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, NY1 day 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
$223.8k - $313.1k
A leading U.S. healthcare company seeks a Medical Director to conduct inpatient medical necessity reviews. This role requires an MD or DO with over 5 years of clinical experience. Responsibilities include performing clinical assessments, collaborating with a multidisciplinary...Remote workWork from homeHumana
Dover, DE5 days ago- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of Assignment: 13 weeks Shift / Hours...Remote workShift workWeekend work
AMN Healthcare
United States3 days ago - ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
IntePros
New York, NY3 days ago
