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- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically... ...RN license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate degree...Remote workWork from homeMonday to FridayWeekend work
CVS Health
Jackson, MS2 days ago - ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...Remote work
Northpoint-Recovery-Holdings,-LL
United States18 hours ago - ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Remote workPart timeWeekend work
Recovery Unplugged
United States2 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
United States3 days ago - ...and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support medical necessity criteria while working remotely. Key responsibilities Verify insurance benefits, eligibility,...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...Remote workFull time
Virtual Vocations Inc
United States5 days ago - ...Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for... ...and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter. #J-18808-Ljbffr...Remote work
MnAdultTeenChallenge
Minneapolis, MN2 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- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials... ...appropriate levels of care and timely approvals. This remote role requires PA RN licensure (or multi-state eNLC), a care-management...Remote work
Highmark Health
United States2 days ago - ...Bradford Health Services seeks an experienced Utilization Review Specialist to join our Birmingham-based team. You will evaluate patient records, treatment plans, and clinical data to determine medical necessity and appropriate level of care while ensuring regulatory...Remote work
Addiction And Mental Health Services
United States3 days ago - ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented...Remote workFull timeMonday to FridayFlexible hours
Diversified Treatment Alternative Centers
Wyomissing, PA5 days ago - ...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, IL3 days ago - ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Remote workWork at office
HealthHelp
United States18 hours ago $24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...Remote workFull timeMonday to FridayPrinciples Recovery Center
United States1 day ago- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
Cleveland Clinic
United States4 days ago - ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Remote workWork at office
CCF
New York, NY3 days ago $69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote workFull timeCincinnati Children's
United States1 day ago- ...Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas... ...diverse populations. The position emphasizes utilization review, documentation, and collaboration with stakeholders...Remote workWork from home
Comagine Health
United States2 days ago - ...Utilization Review Specialist – Join a Top 1% Workplace Are you looking for a fast-paced clinical role where your contributions are truly valued... .... 2 days in office at our Olathe corporate office, 3 days remote. What You Will Do Act as the primary point of contact...Remote workWork at office
KVC Missouri
Olathe, KS5 days ago $40k - $50k
...Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply. Job Details...Remote workFull timePart timeWork at officeWeekend workRecovery Unplugged
Fort Lauderdale, FL4 days ago$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
United States3 days ago$30 - $35 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $30-35/hour Northpoint Recovery Holdings, LLC began... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for...Remote workFull timeTemporary workFor contractorsWork at officeMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID5 days ago$60k - $70k
...alternative application process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range: $60,000.00 To $70,000.00... ...for every stage of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization Review...Remote workFull timePart timeWork at officeBradford Health Services
Birmingham, AL2 days ago- ...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
- ...provide operational supervision of clinical staff performing utilization reviews and specialty reviews using InterQual criteria. You will... ...internal and external stakeholders. This role supports a flexible remote work model with occasional on-site collaboration, based out...Remote workFlexible hours
Comagine Health
United States3 days ago - ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for...Remote jobWork from home
- ...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, MA1 day ago $34.82k - $55.99k
...The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and... ...CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assess care for mental health and substance use. This remote role supports clinicians across the continuum of care while collaborating with providers to determine appropriate...Remote work
IntelliResume
United States1 day ago - ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity...Remote work
Medix
United States2 days ago
