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- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
- ...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 States2 days 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
NurseRemotely
United States12 hours 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
New York, NY4 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
New York, NY4 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
United States2 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...Remote workNurseRemotely
United States12 hours 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, IL2 days ago $40k - $50k
...Job Type Full-time 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...Remote workFull timePart timeWork at officeWeekend workThe Joint Commission
Fort Lauderdale, FL1 day 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
NurseRemotely
New York, NY2 days ago - Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented Utilization Review (UR) Specialist to support our behavioral health programs in a hybrid/remote setup in Chadds Ford, PA. You will manage authorizations and eligibility verification across clinical...Remote job
$24 - $26 per hour
...Academy (AWA) and Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for... ...and authorization software. Ability to work independently in a remote setting. Eligibility for DCF and AHCA Level 2 background screening...Remote workFull timeMonday to FridayAdolescent Wellness Academy
New York, NY18 hours 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 Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced...Remote workFull timeMonday to FridayFlexible hours
Diversified Treatment Alternative Centers (DTAC)
Wyomissing, PA4 days ago $62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health‑sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health, Inc.
New York, NY3 days ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health Outreach
United States3 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
Jacksonville, FL4 days ago- ...Corporation is seeking a licensed clinician to review ABA services and health status across... ...reviews, data analysis to improve utilization, and collaboration with BH providers. Time... ...MST, or CST is required, with flexible remote/hybrid options. #J-18808-Ljbffr Centene...Remote workFlexible hours
$60k - $75k
...alternative application process. Full Time Office/Clerical Remote, Birmingham, AL, US 14 days ago Requisition ID: 5907... ...communities 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, AL1 day ago- Optum is seeking a Behavioral Health Utilization Review Specialist to support case management and care coordination remotely. You will review cases, determine levels of care, and coordinate transitions between inpatient and outpatient settings. You will collaborate with...Remote jobMonday to Friday
- 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... ...for diverse populations. The position emphasizes utilization review, documentation, and collaboration with stakeholders...Remote jobWork from home
- ...Remote DUR Pharmacist Safe & Cost-Effective Medication Use Work From Home Analyze medication use patterns, apply clinical guidelines... ...collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical...Remote jobWork from home
- ...is seeking a licensed nurse to perform concurrent reviews for Ambetter members in Georgia. This fully remote role follows a Monday-Friday schedule 8am-5pm ET... ...and 2+ years acute care experience; knowledge of utilization management is preferred. This role offers remote...Remote jobMonday to Friday
- ...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, MA5 days ago - ...Apply Refer a Friend Back Remote Work from Home Share This Page Share on Facebook Share on... ...Friday, the core business hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD1 day ago - ...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
United States2 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, NY1 day ago - ...Job Description Job Description Utilization Review Manager - KVC Missouri Admissions Location: Remote (Statewide - Missouri) KVC Missouri is seeking a dedicated and detail-oriented Utilization Review Manager (URM) to serve as a vital link between our treatment...Remote work
KVC Health Systems
Kansas City, MO12 days ago $92.4k - $138.6k
...of redefining the possible in healthcare. The Manager for Utilization Review is responsible for the leadership and management of the centralized... ..., experimentation, and application of AI. This is a remote position; however, candidates must be willing and able to travel...Remote workTemporary workWork at officeLocal area- ...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 States4 days ago - ...Centene Corp. is seeking a Utilization Review Clinician - Behavioral Health for a remote role focused on clinical reviews and prior authorization of mental health and substance use services. The role emphasizes ensuring appropriate levels of care and educating providers...Remote work
Centene Corporation
United States2 days ago
