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- A health care organization is seeking a Utilization Management Specialist for a remote position. This role utilizes clinical expertise to improve patient... ...effective management practices. Key responsibilities include reviewing admissions, collaborating with interdisciplinary...Remote jobFlexible hours
- ...of a partner company. We are currently looking for a Utilization Management Specialist - REMOTE. In this role, you will leverage your clinical expertise... ...management practices. This position involves reviewing patient admissions and collaborating with multidisciplinary...Remote jobFlexible hours
- 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
- ...Job Title: Utilization Review Nurse Job Location: 100% Remote Job Duration: 06+ Months (Possibility of extension) remote within one of our plan states, IL, TX, NM, OK, MT or TN Hourly pay Rate - $41.45 - $45/Hr. on w2 Job Description: · Not a Case Management or Member...Remote workHourly payFull timeWork from home
Careers Integrated Resources Inc
Atlanta, GA9 hours ago - A healthcare management company is seeking a full-time Utilization Review Specialist for a remote position. The role focuses on efficiently processing Utilization Management and Independent Review requests, reviewing case requests, maintaining compliance, and delivering...Remote jobFull timeWork at office
- ...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
- 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
- A healthcare organization is seeking a Utilization Management Specialist to work remotely. The role involves reviewing patient admissions, assessing documentation, and collaborating with multidisciplinary teams to ensure appropriate care levels. Candidates must have a current...Remote job
$18 - $22 per hour
Our Ethos Medical Management Team is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and timely processing of Utilization Management and Independent Review requests for our clients. This role involves reviewing...Remote workHourly payFull timeWork at office$108k
...Experienced Utilization Review Nurse UW Medical Center has an outstanding opportunity for an experienced Utilization Review Nurse to join our team. Work schedule includes fully remote/work from home, availability to work day shifts during Pacific Standard Time, and...Remote workFull timeWork experience placementWork from homeShift workDay shift1 day per weekIntelyCare
Seattle, WA2 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 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
$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- ...Care Manager to advance patient-centered care through precise Utilization Review. The role involves evaluating healthcare services, ensuring... ...experience in healthcare settings. This position supports a remote work model, allowing for flexibility while ensuring impactful...Remote job
- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...case requirements Additional Details Remote, work‑from‑home position—work anywhere...Remote workFor contractorsWork from homeFlexible hours
$40 per hour
Clinical Support Manager (temporary) Utilization Review RN/LPN Job Category : Advisory Services Requisition Number : CONSU005289 Posted : November 25, 2025 Full-Time Remote Locations Showing 1 location Remote United States Description About Sound Physicians: Headquartered...Remote workHourly payFull timeTemporary workPart timeWork at officeLocal areaWork from homeShift workWeekend work- ...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
- ...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
$29.95 - $44.77 per hour
A national risk management company is seeking a Utilization Review Case Manager responsible for gathering clinical information and certifying medical necessity. This fully remote position requires strong knowledge of CPT and ICD coding, excellent communication skills,...Remote jobHourly pay$32.8 - $50.39 per hour
...work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position... ...performing care for hospitalized patients 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity...Remote workHourly payFull timeWork experience placementReliefLocal areaWork from homeMonday to FridayFlexible hoursShift workBJC HealthCare
Saint Louis, MO17 hours ago- ...Immediate need for a talented RN Case Manager – Utilization Review - Onsite-Santa Clara, CA. This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote) . Please review the job description below and contact me ASAP if you are interested...Remote workContract workLocal areaImmediate start
Pyramid Consulting
Atlanta, GA4 days ago $31 - $61 per hour
...Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in New York, New York. Job Description &... ...Staff Pre-Authorization RN Pre-Authorization RN Remote after training which is a hybrid schedule 2 days onsite, 3...Remote workHourly payPermanent employmentWork at officeRelocation packagePerm Staff Jobs
New York, NY1 day ago- ...Medicine physicians to support our clinical review services. In this role, you’ll evaluate... ...a leading provider of technology-driven utilization management and clinical review services.... ...your medical expertise while working remotely from home. Reduce or step away from hands...Remote workFor contractorsReliefWork at officeWork from homeFlexible hours2 days per week1 day per week
- ...Opportunity Description Hybrid Utilization Review Nurse Location: Uniondale, Long Island, Nassau County Schedule: Monday... ...Nurse in a hybrid role that offers a mix of in-office and remote work. Based in Uniondale, Long Island, this position ensures...Remote workWork at officeMonday to FridayFlexible hours
HumanEdge
Bronx, NY2 days ago - ...Provider Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of... ...Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with flexible...Remote workPrice workExtra incomeFor contractorsFlexible hours
Dane Street
New York, NY17 hours ago - ...augmentation firm is seeking an experienced Clinical Reviewer RN to manage a clinically complex inpatient caseload remotely. The ideal candidate will have a current,... ...RN license and a strong background in utilization management with at least 3 years of experience...Remote jobContract work
- 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
$90.87 - $154.33 per hour
A pharmacy benefit management company is seeking a Physician Clinical Reviewer (Nephrology) for a remote role. The successful candidate will be part of the utilization management team, conducting medical reviews and working closely with physicians and management staff....Remote job- A health organization in New Jersey is seeking a Full Time Utilization Review Physician. In this hybrid role, the physician will oversee compliance with healthcare regulations and ensure accurate patient status determinations. The ideal candidate brings strong clinical...Remote jobFull time
- ...Job Title: Care Review Clinician I | Utilization Review Nurse Location: Fully Remote Duration: 03+ months (possible extension) Schedule: After 6 weeks of training/onboarding → Sunday–Thursday or Tuesday–Saturday, 8:00 AM – 5:00 PM PST Pay rate: $40- $41/hr. on W2 CANDIDATES...Remote workLive inWork at office
Careers Integrated Resources Inc
Atlanta, GA9 hours ago
