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$35.62 - $52.99 per hour
A nonprofit health system is seeking a Utilization Review LVN to provide high-quality, cost-effective care for patients. This role requires 3 years of Utilization Management and 5 years of LVN experience, along with a clear CA LVN license. Responsibilities include managing...Remote jobHourly payWork from home- 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
$35.62 - $52.99 per hour
A healthcare organization in Rancho Cordova seeks a Utilization Review LVN to provide high-quality, cost-effective care while monitoring managed care patients. Responsibilities include managing patient charts, ensuring compliance with eligibility and review processes,...Remote jobHourly payWork from home- A healthcare organization is seeking a remote Utilization Management Nurse Consultant to manage medical review cases and ensure timely patient care. The role requires an active RN license and at least 3 years of clinical experience, with expertise in utilization review...Remote jobFull time
- 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 jobFull timeWork at officeWork from home
- A leading behavioral health network in Texas is seeking a full-time UR Coordinator to implement the utilization review process. Responsibilities include monitoring client documentation for compliance, gathering information for insurance, and conducting peer reviews. The...Remote jobFull time
- A healthcare organization in Washington D.C. is seeking a Clinical Utilization Review Nurse (RN) for a remote position. This full-time PRN role involves assessing medical necessity and quality of healthcare services through utilization reviews. The ideal candidate will...Remote jobFull timeReliefWeekend workAfternoon shift
- A leading Independent Review Organization is looking for Board-Certified Psychiatrists for a fully remote role. This position involves conducting utilization reviews and provides flexible scheduling along with supplemental income. Responsibilities include reviewing medical...Remote jobExtra incomeFlexible hours
- ...Provides support for clinical member services review assessment processes. Responsible for... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures.... ...SharePoint Fast learner Remote work experience Must obtain NV RN Licensure...Remote workWork experience placementWork at office
Molina Healthcare
United States2 hours agonew $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- ...seeking a Full-Time Clinical Supervisor to lead clinical and utilization reviews. The successful candidate will have a strong background in... ...thinking, and team management. The position may also allow for remote or hybrid work arrangements. The organization offers...Remote workFull time
- 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
- ...Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective... ...Commission/ Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote work
B2B Staffing Services
Torrance, CA6 hours ago $211.2k - $277.2k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around... ..., Utilization Management. Work Location: This is a remote position, open to candidates who reside in: Arizona;...Remote workFull timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY3 days ago$75 - $90 per hour
...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...Remote workContract workLocal areaImmediate startPyramid Consulting
United States6 hours ago- ***Hybrid/Remote*** Orientation Location: 8501 Wilshire Blvd, Beverly Hills, CA Required: * RN license in CA * 3 years of clinical experience in hospital or urgent care * Utilization review experience * Knowledge of ICD10, CPT, HCPC * Familiarity with HMO, PPO, POS Preferred...Remote workLocal areaWeekend work
Zenex Partners
Beverly Hills, CA3 days ago $54.86k - $71.25k
...Job Description Summary The Utilization Review Registered Nurse is responsible for reviewing medical services to ensure they meet evidence-based guidelines and member benefit plans. This includes precertification, concurrent review, and retrospective review. The...Remote workMinimum wageCurrently hiringLocal areaWork from homeFlexible hoursConduent
United States2 days ago- ...Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet. The purpose of the Utilization Case Manager RN is to conduct initial chart reviews for medical necessity and identify the need for...Remote workFull timeTemporary workWork at officeWorldwide
The University of Miami
United States6 hours ago $33.6 - $51.39 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, MO2 days ago$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson... ...No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~... ...in Utilization Management, Utilization Review, or Case Management ~• Preferred Certifications...Remote workContract workImmediate startMonday to FridayVarite
Aurora, CO3 days ago- ...Depending on business needs and individual circumstances, **remote or hybrid work arrangements may be available** for qualified... ...candidates.* **Required Work Experience:** 5 years clinical and utilization review to include 2 years supervisory or team lead experience or...Remote workFull timeWork experience placementWork at officeMonday to Friday
- ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with...Remote workPrice workExtra incomeFor contractorsFlexible hours
Dane Street
United States1 day ago $90.87 - $154.33 per hour
A healthcare solutions provider is seeking a Physician Clinical Reviewer - Nephrology to join the utilization management team in a remote setting. This role involves reviewing medical requests, engaging with physicians, and ensuring compliance with guidelines. Candidates...Remote job$60 - $70 per hour
A leading staffing agency is seeking a Remote Clinical Pharmacist to ensure safe and effective... ...use for members. The role involves reviewing prior authorization requests, tracking... ...degree and at least 3 years of clinical or utilization review experience. The assignment offers...Remote jobHourly pay- ...elevate outcomes, and love your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the Bay... ...imaging, AI-assisted decision support, virtual nursing, and remote monitoring; clear investment in clinician well-being through...Remote workWeekend work
Clinical Management Consultants
Berkeley, CA3 days ago $1,844.5 per month
...Details Client Name REMOTE (BMCHP - Remote) Job Type Travel Offering Nursing Profession Registered Nurse Specialty Utilization Review Job ID 36555393 Job Title Registered Nurse - Utilization...Remote workWeekly payFlexible hoursShift workCape Fear Valley Health System
Charlestown, MA2 hours agonew- A health insurance company is seeking a Physician Reviewer to join their Utilization Management team. This remote role involves determining the medical appropriateness of services by reviewing clinical information and adhering to evidence-based guidelines. Candidates must...Remote job
- A leading health insurance company is hiring a remote Physician Reviewer to join their Utilization Management team. This role involves determining the medical appropriateness of services based on clinical information and evidence-based guidelines. Candidates should have...Remote job
- A leading Independent Review Organization is looking for Board-Certified Orthopedic Spine Surgeons for a fully remote role performing utilization reviews. Candidates must have an active New York medical license and Workers' Compensation Board Certification. This non-clinical...Remote jobExtra income
- A healthcare solutions provider is seeking an experienced Inpatient RN Utilization Reviewer to manage a complex inpatient caseload remotely. The ideal candidate will possess strong clinical judgment and experience in utilization management. Responsibilities include applying...Remote jobContract work
