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$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$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 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 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 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 leading independent review organization is seeking a Board-Certified Chiropractor for a flexible, fully remote opportunity involving independent Utilization Reviews. The role requires a Chiropractic Degree, a Missouri state license, and 5 years of clinical experience...Remote jobFlexible hours
- 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
$40 - $45 per hour
...seeking an ER/ICU RN in Austin, TX. This fully remote contract position requires 4+ years of RN experience in utilization management and a Compact RN license. Responsibilities include performing concurrent health reviews, evaluating care delivery for necessity, and assisting...Remote jobContract work- ...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 States1 day ago $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$29.95 - $44.77 per hour
A national risk management firm is seeking a Utilization Review Case Manager to analyze clinical information for patient admissions and treatment. This remote position requires strong CPT and ICD coding knowledge, along with effective organizational and communication skills...Remote jobHourly pay- ...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
- ...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 job
- ...ensure high-quality, patient-centered care through effective utilization review. The candidate will be responsible for evaluating healthcare... ...’ experience in various healthcare settings. The position is remote and offers a competitive benefits package. #J-18808-Ljbffr GuidehealthRemote job
$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, NY4 days ago- ...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, CA1 day 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 States3 days ago- A leading healthcare analytics firm is seeking a Registered Nurse for a remote role focused on utilization review and clinical determinations. The position requires strong communication skills, 5+ years of varied healthcare experience, and an active RN license in Illinois...Remote job
$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 States1 day 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, CA4 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 States1 day 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, MO3 days ago- Part-Time | Remote (U.S. Based) Medical Review Institute of America (MRIoA) is a nationally recognized leader in utilization management and clinical review services, delivering evidence-based solutions for more than Physician Advisor (Utilization Review) Part-Time | Remote...Remote workPart timeWork at officeWork from home10 hours per weekFlexible hoursShift workWeekend work
- ...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
$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, CO4 days ago- ...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 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 job
- ...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, CA4 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 jobContract work
