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- ...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 workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
JobTarget
Freeport, IL1 day ago $60k - $75k
...Quadrant Health Group, i s seeking a passionate and dedicated Utilization Review Specialist to join our growing team. You will play a vital... ...office position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be...Remote workFull timePart timeWork at officeQuadrant Health Group
Boca Raton, FL6 days ago$23.15 - $30.03 per hour
...members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization review... ...will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The...Remote workFull timeWork at officeLocal areaShift workPrime Healthcare Management Inc
Ontario, CA1 day ago- ...RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated...Remote workFull timeLocal areaWork from home
VillageCare
New York, NY2 days ago $59.24k - $76k
...real difference. Job Description This is a full-time remote position that can be located anywhere in the U.S. PA RN license is required We are seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization...Remote workFull timePart timeLocal areaWork from homeFlexible hoursEnlyte
Arlington, TX3 days ago- ...Community Health Choices Long Term Services and Supports (LTSS) Review Utilization Management program and staff under the supervision of the... ...Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time...Remote workLive inWork at officeFlexible hours
AmeriHealth Caritas
Newtown Square, PA4 days ago - ...Job Description Position Title: Utilization Review Nurse Location: Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and...Remote workFlexible hoursWeekend work
IntePros
Phoenix, AZ5 days ago $40 per hour
...months Must reside in TX Full time remote Candidates must be based in TX. RN... ...for performing initial, concurrent review activities; discharge care coordination... ...guidelines. Provides information regarding utilization management requirements and operational...Remote workFull timeContract workWork at officeHireOps Staffing LLC
Dallas, TX1 day ago- ...Job Title: Care review Clinician | Utilization review nurse Location: 100% Remote in CA Duration: 06 months+ contract (Possibility of extension) Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri) Pay Rate - $47.14/hr on W2 Job Summary:...Remote workContract workWork at officeShift work
Integrated Resources
Long Beach, CA1 day ago - ...Medical Solutions Direct Hire is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in White Plains, New York. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: ASAP ~ Duration:...SuggestedFull timeImmediate startWork from homeShift work
Medical Solutions Direct Hire
White Plains, NY5 days ago $41.04 per hour
...Now Hiring: Remote RN Prior Authorization & Utilization Review (Texas Medicaid) &##128313; &##128188; Contract | Up to $41.04/hr &##128205; Remote (Must reside near in TX) &##128338; Full-time | Primary shift: 10 AM 7 PM Are you a detail-oriented RN looking...Remote workFull timeContract workPart timeImmediate startShift workManpower
Austin, TX18 hours ago$51.43 - $79.84 per hour
...Description This is a remote role. You MUST live in the state of Washington (WA) to be considered Care Manager RN Per diem / On call Day shift The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge...Remote workDaily paidFull timeLive inLocal areaShift workDay shiftProvidence Health and Services
Seattle, WA1 day ago- ...Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non-traditional hours to provide... ...clarification when necessary.; Work Arrangement: Remote role. Saturday through Wednesday from 4:00p EST to 12...Remote workFlexible hoursSaturday
AmeriHealth Caritas
Newtown Square, PA3 days ago - ...find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the receipt of high quality, cost efficient medical outcomes for...Remote workWork at office
Martins Point Health Care
United States1 day ago $26.5 - $47.59 per hour
...Position Purpose: Performs a clinical review and assesses care related to mental health... ...data to improve quality and appropriate utilization of services Provides education to... ...holidays, and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workHourly payFull timePart timeWork at officeFlexible hoursCentene Corporation
Atlanta, GA3 days ago- ...Advocate will complete telephonic clinical reviews directly with Providers to ensure... ...position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm... ...~ Telephone queue experience ~ Utilization review/management experience Explore...Remote workMinimum wageFull timeWork experience placementLocal areaHome officeMonday to Friday
UnitedHealth Group
Maryland Heights, MO4 days ago - ...agencies to ensure the approved services are provided. Our Utilization Management Reviewers cultivate and maintain relationships with our members'... ...reaches their 21st birthday. ; Work Arrangement:; Remote role. Monday through Friday from 8:30a EST to 5:00p EST...Remote workContract workMonday to FridayFlexible hoursShift work
AmeriHealth Caritas
Newtown Square, PA5 days ago - ...We save lives while providing the opportunity for people to realize their healthy selves. Utilization Review Clinician Monte Nido Remote Monte Nido has been delivering treatment for eating disorders for over two decades. Our programs offer a model of treatment...Remote workFull timeTemporary workFlexible hours
Monte Nido
Miami, FL5 days ago - ...Role Overview: Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient... ...will also be counted upon to: Work Arrangement: Remote role. Availability to work Monday through Friday, 8 AM...Remote workMonday to FridayFlexible hoursAfternoon shift
AmeriHealth Caritas
Newtown Square, PA4 days ago - ...patient experience. Learn more at: Job Summary: The Utilization Review (UR) Nurse (initial clinical reviewer) is a registered nurse... ...provides timely verbal and written reports as directed. **Remote position but MUST be able to work pacific standard time (PST)...Remote workLocal area
UHS
Reno, NV5 days ago $26.5 - $47.59 per hour
...License or Identification card. Position Purpose: The Utilization Review Nurse I provides first level clinical review for all outpatient... ...time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be...Remote workHourly payFull timePart timeWork at officeFlexible hoursCentene Corporation
New York, NY1 day ago- ...and Supports (LTSS) Supervisor, the LTSS Reviewer is responsible for completing care and... ...request was received, nature of the request, utilization determination (and events leading up to... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workFlexible hours
AmeriHealth Caritas
Newtown Square, PA3 days ago $35 - $38 per hour
...Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing... ...on-site on Tuesdays and will be logged into Teams for remote shadowing. Job Type & Location This is a Contract to Hire...Remote workContract workTemporary workWork at officeActalent
Sunrise, FL5 days ago$78.54k - $121.72k
...Employment Type: Full time Shift: Day Shift Description: Utilization Review- RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal Hospitals. Utilization Review- RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal Hospitals. *...Full timeWork at officeLocal areaShift workDay shiftTrinity Health
Maywood, IL1 day ago$38.49 - $47.05 per hour
...healthcare? Bring your true colors to blue. The RoleThe Clinical Utilization Reviewer is responsible for facilitating care for members who may... ..., Mobile, and Resident personas. This position can be fully remote, with the expectation to work in our Hingham office 1x month...Remote workHourly payWork at officeFlexible hoursShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA4 days ago$25 per hour
...respected. We have an ongoing need for Document Reviewers. Document Reviewers will review... ...litigation! Position Details ~ Remote work-from-home opportunity ~ Pay rate... ...later is required. ~ Proficiency in utilizing modern technology, especially computers...Remote workHourly payTemporary workPart timeWork from homeHome officeMonday to ThursdayFlexible hoursKLDiscovery
Portland, OR4 days ago- ...Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract for about 9 months.... ...Position Is Responsible For Performing Accurate And Timely Medical Review Of Claims Suspended For Medical Necessity, Contract...Remote workContract work
HireOps Staffing LLC
Dallas, TX4 days ago - ...person band for producing weekly YouTube videos and accompanying review articles. You will be creating video similar to this channel:... ...super high-quality written articles. You will have the support of a remote video editor and a web-developer. Key Responsibilities...Remote workWork at office
eNNOVATION Brands
El Segundo, CA8 days ago - ...Responsibilities Utilization Review Specialist Opportunity Emerald Coast Behavioral Hospital provides inpatient treatment services to adolescents and adults at our 86-bed facility in Panama City, FL and outpatient services to adolescents and adults at our...Part timeLocal area
Universal Health Services, Inc.
Panama City, FL4 days ago - ...Responsibilities Utilization Review Specialist Rivendell Behavioral Health Services is an 80-bed full-service behavioral healthcare acute care facility located in Benton, AR, that has been providing quality health care to the residents of Arkansas since 198...Full timePart timeLocal areaImmediate start
Universal Health Services, Inc.
Benton, AR4 days ago
