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- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
Berkshire Hathaway Homestate Companies
Omaha, NE6 hours agonew Physician / Surgery - Plastic / Vermont / Permanent / Plastic Surgeon - Utilization Review Physician
...Dane Street , a nationally recognized Independent Review Organization (IRO) and leading provider of Utilization Review (UR) services, is expanding its panel of physician... ...to perform Utilization Reviews on a flexible, remote basis. xmvmafu Remote working/work at home options...Remote workPermanent employmentWork from homeFlexible hoursDane Street
Los Angeles, CA1 day ago- A leading healthcare services provider is seeking a Utilization Review & Quality Assurance Specialist to work from home. The role involves evaluating clinical documentation, ensuring compliance with client standards, and conducting peer review processes. Candidates must...Remote jobWork from home
$40 - $45 per hour
...seeking an ER/ICU RN in Austin, TX. This fully remote contract position requires 4+ years of RN experience in utilization management and a Compact RN license. Responsibilities include performing concurrent health reviews, evaluating care delivery for necessity, and assisting...Remote workContract workActalent
Austin, TX6 hours agonew- ...insurance firm in Warwick seeks a UM Specialist to handle medical review decisions, balancing clinical standards with excellent... ...Responsibilities include reviewing medical services and conducting utilization reviews. Ideal candidates have an Associate's degree and three...Remote jobFlexible hours
$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 jobHourly payContract work- A leading healthcare provider is searching for a Utilization Management Physician Reviewer. This remote part-time role demands clinical expertise to review prior authorizations and engage with healthcare professionals while ensuring compliance with regulations. Candidates...Remote workPart timeFlexible hours
- ...A healthcare organization is seeking a Concurrent Review Nurse to perform utilization management activities. This role involves reviewing hospital... ...and knowledge of clinical guidelines are essential. This position offers a remote work environment. #J-18808-Ljbffr...Remote work
Palm Medical Centers
Fort Worth, TX6 hours agonew - ...high-quality care through efficient medical resource utilization. Key responsibilities include reviewing medical records and collaborating with healthcare... ...areas and utilization review. The role supports both remote work and in-person collaboration, ensuring exceptional...Remote job
- ...ensure high-quality, patient-centered care through effective utilization review. The candidate will be responsible for evaluating healthcare... ...’ experience in various healthcare settings. The position is remote and offers a competitive benefits package. #J-18808-Ljbffr GuidehealthRemote job
- ...A healthcare organization in Irving, TX seeks a Claims Review Registered Nurse to provide detailed coding and claims review, ensuring accurate utilization of services. The role requires at least 5 years of nursing experience, along with relevant education and licensure...Remote work
GuideWell
Irving, TX1 day ago - ...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
- A healthcare organization is seeking an experienced RN Case Manager with a strong background in UAS assessments and utilization review. This fully remote position emphasizes data-driven decision-making to ensure appropriate care. Responsibilities include reviewing UAS assessments...Remote job
$29.62 - $45.31 per hour
Description Providence Health Plan is calling an Associate Utilization Review Specialist who will: Be responsible for all core functions in... ...best people, we must empower them. This position offers 100% remote work and is open to candidates residing in: Oregon Washington...Remote jobWork experience placementLocal area- ...A healthcare organization is seeking a Physician Clinical Reviewer for a remote opportunity. In this role, you will be a key member of the utilization management team, performing medical reviews of service requests and collaborating with physicians to ensure compliance...Remote work
Prime Therapeutics
Carson City, NV2 days ago $76k - $85k
...A leading public sector solutions firm is seeking a Utilization Review Nurse to perform medical reviews and ensure healthcare cost compliance... ...authorizations and working closely with healthcare providers. This is a remote position offering competitive compensation ranging from $76,0...Remote workPublic Consulting Group
Montpelier, VT2 days ago- A national medical review organization is seeking Board-Certified physicians in Neurosurgery to conduct independent Utilization Reviews. This flexible, fully remote opportunity requires only 1-2 hours per week with no minimum commitment. Candidates must hold a current medical...Remote workFlexible hours
Medical Review Institute
Dallas, TX6 hours agonew - ...healthcare provider in Los Angeles is seeking a Utilization Management RN responsible for conducting clinical reviews and overseeing medical records for admission. Candidates... ...RN license, and two years of experience in a remote utilization review environment or as an acute...Remote work
Providence Health Plan Group
Los Angeles, CA6 hours agonew $76k - $85k
...A public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization and clinical reviews. Candidates should... ...effective communication, and attention to detail while working remotely. Compensation ranges from $76,000 to $85,000, with...Remote workPublic Consulting Group
Albany, NY6 hours agonew- ...emphasizes high-quality patient-centered care through detailed Utilization Review. Responsibilities include managing healthcare service... ...and over 5 years of relevant experience. The position is fully remote, offering competitive benefits including medical, dental, and...Remote job
- ...A leading healthcare organization is seeking a Physician Clinical Reviewer specializing in cardiology to join the utilization management team remotely. This role involves providing medical review of service requests and ensuring compliance with necessary guidelines. Candidates...Remote work
Prime Therapeutics
Ewing, NJ1 day ago - ...A healthcare company is seeking a remote Physician Clinical Reviewer specializing in Nephrology. The ideal candidate will have over 5 years of experience in utilization management, performing medical reviews, and providing clinical rationale for appeals. Responsibilities...Remote work
Prime Therapeutics
Denver, CO2 days ago $76k - $85k
A leading public sector solutions firm is seeking a Utilization Review Nurse to perform reviews, use medical management software, and ensure quality care. This remote role requires an RN, along with a minimum of 2 years’ clinical nursing experience and proficiency in medical...Remote workPublic Consulting Group
Salt Lake City, UT1 day 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, NC6 hours agonew - ...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 work
Vaya Health
Raleigh, NC1 day ago - ...A healthcare organization is seeking a Physician Clinical Reviewer for cardiology on a remote basis. The role involves key responsibilities in the utilization management team, performing medical reviews and interacting with physicians. Candidates must hold a DO, MBBS,...Remote work
Prime Therapeutics
Raleigh, NC1 day ago - ...Manager to advance high-quality, patient-centered care through Utilization Review. The ideal candidate will have an active RN license in... ...healthcare services and coordinating care effectively. This fully remote position offers flexibility, competitive pay, and comprehensive...Remote job
$1,949.74 per month
...Profession Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review... ...6 Duration 13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent reviews, medical...Remote workWeekly payShift workCynet Health
Eureka, CA3 days ago$75 - $90 per hour
...Rn Case Manager Utilization Review Immediate need for a talented RN Case Manager Utilization Review Onsite Santa Clara, CA. This is a 03+... ...contract opportunity with long-term potential and is located in U.S(Remote). Pay Range: $75 - $90/hour. Employee benefits include,...Remote workContract workImmediate start- ...A leading healthcare company is seeking a Medical Director to perform clinical reviews and assess medical necessity for inpatient cases. This role offers the chance to collaborate with a team of physicians, making a significant impact on patient care. Requires an MD/DO...Remote workWork from home
Humana
Providence, RI2 days ago
