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- ...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 States4 days ago - ...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...Remote workFull time
Virtual Vocations Inc
United States15 hours 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 workNurseRemotely
United States1 day 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. Your Responsibilities Review...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL15 hours 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
United States3 days ago- ...Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR...Remote workFull timeMonday to FridayFlexible hours
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA1 day 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 States4 days ago - ...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, TX15 hours ago $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 States4 days ago- 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
$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, ID15 hours 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, FL15 hours ago- ...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
- ...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
United States1 day 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.
Pennsylvania14 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 States3 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
United States3 days ago $71.1k - $97.8k
...Hong Kong Study Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a minimum...Remote workWork from homeHong Kong Study Skills Research Institute
Juneau, AK15 hours ago$45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $45 to $50 per hour Shift Information... ...Management Location: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/19/2026 Hours: 40 hours/...Remote workHourly payFull timeContract workWork experience placementImmediate startMonday to FridayShift workWeekend workLancesoft Inc
Fort Myers, FL4 days ago- ...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 shift
Johns Hopkins Medicine
Hanover, MD2 days ago - ...posting to physicians and working with members, providers, and facilities to ensure high-quality care in a remote environment, with rotating weekend utilization review coverage. The candidate should have 1-2 years in utilization management, 3-5 years clinical experience,...Remote job
- ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity reviews for inpatient and outpatient... ...nursing or social work credentials, experience in utilization management, and the ability to work remotely within the US; remote options and weekday schedule...Remote workWeekday work
IntelliResume
Louisiana, MO2 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
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.
Torrance, CA15 hours ago - ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
United States3 days ago - ...Centene Corporation is seeking a Behavioral Health Utilization Review clinician to evaluate and authorize BH services, ensure appropriate levels of care, and collaborate with providers and medical leadership. This role emphasizes quality improvement, case presentations...Remote work
Centene Corporation
Louisiana, MO1 day ago - A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...Remote workFlexible hours
Medical Review Institute
Dallas, TX3 days ago - ...is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide.... ...and provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
CorroHealth Inc
United States1 day ago $30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart timeSanta Barbara Cottage Hospital
United States1 day ago$38 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $38 to $45 per hour Shift Information... ...Position Travel Registered Nurse – Utilization Review (Remote) Location: Fort Myers, Florida Facility: Lee Health –...Remote workHourly payFull timeContract workWork experience placementMonday to FridayShift workWeekend workLancesoft Inc
Fort Myers, FL7 days ago
