Get new jobs by email
- ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a liaison between clinical operations...Remote workFull time
Virtual Vocations Inc
United States3 days 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
Long Beach, CA1 day ago- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
Alliance Health in
Morrisville, NC22 hours ago - ...Compass Health Center is seeking a Remote Utilization Review Specialist to obtain insurance authorization for patients receiving Behavioral Health treatment at high levels of care. The UR Specialist serves as a liaison between the clinical team and insurers, helping patients...Remote work
COMPASS HEALTH CENTER, LLC.
Brooklyn, NY3 days 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
United States1 day 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
United States1 day ago - Red Oak Recovery Center is seeking a Utilization Review Coordinator to ensure medical necessity, regulatory compliance, and efficient resource use across patient care. You will review medical records and treatment plans, coordinate with providers, insurers, and case managers...Remote job
- ...accredited college or university in Nursing, Social Work, Behavioral Health or related field required preferred. ~2-3 years of utilization review experience in behavioral health, addiction treatment, or managed care. ~ Strong understanding of ASAM criteria, LOCUS, DSM-...Remote workDaily paidFull time
The Florida House
Deerfield Beach, FL22 hours ago - Major Hospital in the United States is seeking a skilled utilization review professional to review medical records for necessity and appropriateness of care. You will collaborate with providers, staff, insurers, and case managers to ensure patients receive the right level...Remote jobReliefWeekend workAfternoon shift
- ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL1 day ago - FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance...Remote job
- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of...Remote work
Bradford Health Services
Jacksonville, FL1 day ago $50k
...the 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 workAdvanced Recovery Systems LLC
New York, NY2 days ago- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- Palmetto GBA is seeking an experienced RN for remote utilization review to evaluate medical claims using established criteria and guidelines. The role emphasizes timely decisions, documentation, and collaboration with internal teams. You will work from a home office and...Remote jobWork from homeHome office
$24.65 - $30.03 per hour
...Utilization Review TechPrime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54... ...will also function as an SME to support the UR tech team and remote counterparts with the specific processes as applicable. The Utilization...Remote workWork at officeLocal areaPrime Healthcare
Ontario, CA2 days ago- ...week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient...Remote workPart time
ADDICTION AND MENTAL
United States3 days ago $80 per hour
...healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization... ...healthcare operations.This role supports current and upcoming remote consulting opportunities focused on AI-assisted prior...Remote workHourly payPart timeFor contractorsWork at officeFlexible hours24-MAG LLC
New York, NY2 days ago- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing...Remote workTemporary work
Banyan Treatment Centers
Pompano Beach, FL3 days ago - ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs. You will review cases, coordinate with providers, and ensure timely decisions in line with policy and regulatory requirements. Ideal...Remote workWork at office
HealthHelp
Houston, TX1 day ago $219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with...Remote jobWork from home$45k - $55k
...below to learn more. If you are a current employee wanting to apply for a different position, clickhere . Back to jobs Utilization Review Specialist Remote Weekly outpatient therapy isn't always enough, and a trip to the ER isn't the only answer. Patients and their...Remote workWork at officeCOMPASS HEALTH CENTER, LLC.
Brooklyn, NY3 days ago$70k - $100k
...part of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two days...Remote workPermanent employment2 days per weekTEKsystems
Addison, TX3 days ago- ...Utilization Review Analyst Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews of service authorizations... ...may occur outside of standard office hours. Hybrid (onsite/remote) work schedule available. The ideal candidate must be able to...Remote workWork at office
- ...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
Quincy, MA4 days ago - ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...an accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
Medix
New York, NY2 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, CA2 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 States1 day ago $219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY3 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
United States4 days ago
