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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 - ...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, NE3 days ago - ...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
New York, NY3 days ago - ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
Industrial Asset Management Council
Kansas City, MO4 days ago $23.15 - $30.03 per hour
...new members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization review and... ...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
Cottonwood, CA1 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 work
Guidehealth
Chicago, IL5 days ago $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- Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote jobContract workWork from home
- ...Quorum Health is seeking a Case Manager - Utilization Review Specialist for a remote role. The Specialist will manage admission reviews, conduct appeals, and identify workflow improvements. This position requires a current RN license and significant experience in healthcare...Remote work
Quorum Health
Brentwood, TN1 day 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 - Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
- ...The Council of State and Territorial Epidemiologists is looking for a Clinical Review Supervisor to oversee clinical staff conducting utilization reviews. This fully remote position requires strong leadership in a healthcare context and a proactive approach to quality...Remote work
Council Of State and Territorial Epidemiologists
Seattle, WA4 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 hoursExact Billing Solutions
Florida, NY5 days ago- ...! ~ Paid Holidays ~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication skills to... ...individual will defer decision to a second level reviewer. This individual interfaces with case managers...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
Hines
United States3 days ago $69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare... ...candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote workMVP Health Care
Schenectady, NY4 days ago- ...Excellus BCBS is hiring for a Utilization Management position based in Albany, New York. This... ...such as performing pre-service clinical reviews and collaborating with healthcare... ...competitive salary range and potential for remote work based on departmental needs. #J-188...Remote work
Excellus BlueCross BlueShield
Albany, NY4 days ago - ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...in Town of De Witt, NY. The position demands extensive clinical experience and knowledge of utilization management, with responsibilities including performing clinical reviews and collaborating with providers. Applicants should possess an Associate degree and active NYS...Remote work
Excellus BlueCross BlueShield
East Syracuse, NY4 days ago - ...Concierge Home Care in Jacksonville, FL is seeking an experienced Utilization Review Specialist (RN) to join its remote home health team. The ideal candidate should have strong expertise in OASIS, coding, QA, and home health documentation review. This role offers flexibility...Remote work
Concierge Home Care
Jacksonville, FL2 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- ...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 $35 - $50 per hour
AMN Healthcare is seeking a Remote RN for Utilization Review in Providence, Rhode Island. This position requires a valid RN license and experience in utilization review. The role offers a pay rate between $35.00 and $50.00 per hour, working M-F for 40 hours a week. Applicants...Remote jobHourly pay- ...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 $85k - $105.34k
...Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure quality care. This role includes conducting prior authorizations, collaborating with healthcare teams, and ensuring compliance with regulations. The ideal candidate will have...Remote workUmpqua Health
New York, NY4 days ago- 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 workContract work
IntePros
Phoenix, AZ5 days ago $78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced RNs aiming to utilize their clinical expertise without direct patient care. The role involves...Remote workTalentLNX LLC
New York, NY3 days ago- ...experience. Responsibilities include clinical reviews and collaboration with providers to... .... Preferred candidates will have utilization management experience and strong communication... ...Competitive salary offered based on experience, and potential for remote work. #J-18808-Ljbffr...Remote work
Excellus BlueCross BlueShield
Jamestown, NY1 day ago - ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
Solving IT
New York, NY3 days ago - ...A national insurance group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and ensure compliance with guidelines... ...accurate documentation. The position offers options for remote work, health insurance, and other competitive benefits. #J-18...Remote workFull time
Berkshire Hathaway Homestate Companies
Omaha, NE2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
Hispanic Alliance for Career Enhancement
Springfield, IL4 days ago
