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$50k - $65k
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend Availability as Needed) Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role...Remote workFull timeTemporary workWeekend workWeekday work- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote work
Santa Barbara Cottage Hospital
New York, NY1 day ago - ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
Virtual Vocations Inc
United States1 day ago - ...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 States1 day ago - ...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 States2 days ago - Enlyte is seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers’ compensation related prospective, concurrent, and retrospective treatment referrals. The role requires clinical judgment to ensure...Remote workWork from home
Genex Services, LLC
New York, NY6 hours agonew $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, NY1 day 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, CA3 days ago- ...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
United States1 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, IL3 days ago - ...Job Description Job Description Job Summary Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews... ...may occur outside of standard office hours. Hybrid (onsite/remote) work schedule available. The ideal candidate must be able...Remote workWork at office
Oakland Community Health Network
Troy, MI9 days ago - ...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, MA3 days ago $41.6k - $47k
...Utilization Review Specialist At Umpqua Health, we're more than a healthcare organization we're a community-driven Coordinated Care Organization... ...with the ability to stay organized and productive in a remote, independent work environment Proactive communication with...Remote workWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work- ...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, NY1 day ago - ...Registered Nurse - Utilization Review About Company Bestica We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
Bestica Healthcare
United States7 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.
United States17 hours 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, AZ3 days ago $130 - $145 per hour
...Hi, we’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ..., Utilization Management. Work Location This is a remote position, open to candidates who reside in the United States...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY3 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, LLC
New York, NY4 days ago $65k - $85k
...Santa Barbara Cottage Hospital is seeking a Utilization Review Specialist (RN) for a remote position, specifically for candidates based in Florida. The ideal candidate will possess a valid Florida RN License and certifications in OASIS and coding. The role involves thorough...Remote workSanta Barbara Cottage Hospital
New York, NY4 days ago- ...Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit and medical...Remote work
Santa Barbara Cottage Hospital
New York, NY1 day ago - ...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, NY1 day ago $30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly payAstrana Health
California, MO4 days ago$23.76 - $51.49 per hour
...seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...offers a competitive hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly payMolina Healthcare
Nevada, IA17 hours ago$45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote workDane Street
New York, NY1 day 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, IL2 days 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, NY1 day ago - ...AHCCCS is seeking a Behavioral Health Prior Authorization Utilization Review Consultant to monitor and decide on medical and behavioral health... ..., and standards of care. The position supports AHCCCS’ remote-work options within Arizona, emphasizes collaboration with providers...Remote work
Arizona State Government
Phoenix, AZ6 hours agonew - ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical review and provider collaboration. The position requires an active RN license, 3+ years...Remote workFull time
Hispanic Alliance for Career Enhancement
Jefferson City, MO1 day ago $35 - $45.94 per hour
...Description Job Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role:... ...Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida;...Remote workHourly payFull timeWork from homeHome officeWeekend workOscar Health
Dallas, TX9 days ago
