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- ...is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant...Remote workWork from home
Guidehealth
Peoria, IL1 day ago - ...A leading healthcare solutions company seeks a skilled Utilization Review Nurse to conduct vital reviews for medical necessity and appropriateness. The ideal candidate will have an active RN license, 3+ years of inpatient clinical experience, and strong written communication...Remote workWork from homeFlexible hours
Gainwell Technologies
Juneau, AK1 day ago - ...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 workFull timeWork at officeWork from home
Berkshire Hathaway Homestate Companies
Omaha, NE4 days ago - ...A healthcare organization is looking for a Utilization Management RN in Mission Hills, California, to provide prospective, retrospective, and concurrent reviews for ministries. Candidates should have strong clinical skills, a nursing degree, and California RN license....Remote work
Providence Service
Mission Hills, CA4 days ago $57.28 - $88.92 per hour
...healthcare organization in California is seeking a Utilization Management RN to conduct clinical reviews and manage utilization reviews for their Southern CA... ...background, California RN License, and experience in a remote UR environment or as an acute hospital case manager....Remote workHourly payProvidence Health & Service
Mission Hills, CA4 days ago- 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
$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 workContract workActalent
Austin, TX4 days ago- A leading healthcare organization in California is seeking an RN Utilization Review professional for a full-time remote role. The position entails conducting utilization reviews and managing a varied workload in a fast-paced environment. Required qualifications include...Remote jobFull time
$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- 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
- ...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
- ...high-quality care through efficient medical resource utilization. Key responsibilities include reviewing medical records and collaborating with healthcare... ...areas and utilization review. The role supports both remote work and in-person collaboration, ensuring exceptional...Remote job
- ...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
- A healthcare organization is seeking an experienced RN Case Manager with a strong background in UAS assessments and utilization review. This fully remote position emphasizes data-driven decision-making to ensure appropriate care. Responsibilities include reviewing UAS assessments...Remote job
- ...emphasizes high-quality patient-centered care through detailed Utilization Review. Responsibilities include managing healthcare service... ...and over 5 years of relevant experience. The position is fully remote, offering competitive benefits including medical, dental, and...Remote job
$76k - $85k
...A leading public sector solutions firm is seeking a Utilization Review Nurse to perform medical reviews and ensure healthcare cost compliance... ...authorizations and working closely with healthcare providers. This is a remote position offering competitive compensation ranging from $76,0...Remote workPublic Consulting Group
Montpelier, VT1 day ago- ...healthcare provider in Los Angeles is seeking a Utilization Management RN responsible for conducting clinical reviews and overseeing medical records for admission. Candidates... ...RN license, and two years of experience in a remote utilization review environment or as an acute...Remote work
Providence Health Plan Group
Los Angeles, CA4 days ago $76k - $85k
...A public sector solutions firm is seeking a remote Utilization Review Nurse to handle prior authorizations and reviews. Responsibilities include recording determinations regarding healthcare costs and identifying quality issues. Candidates must be a graduate of an accredited...Remote workPublic Consulting Group
Charleston, WV1 day ago$76k - $85k
...A leading public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization and medical reviews in a remote environment. The role requires at least 2 years of clinical nursing experience and an RN license. Responsibilities include using...Remote workPublic Consulting Group
Helena, MT4 days ago- A national medical review organization is seeking Board-Certified physicians in Neurosurgery to conduct independent Utilization Reviews. This flexible, fully remote opportunity requires only 1-2 hours per week with no minimum commitment. Candidates must hold a current medical...Remote workFlexible hours
Medical Review Institute
Dallas, TX4 days ago - ...Manager to advance high-quality, patient-centered care through Utilization Review. The ideal candidate will have an active RN license in... ...healthcare services and coordinating care effectively. This fully remote position offers flexibility, competitive pay, and comprehensive...Remote job
- ...A leading healthcare organization is seeking a Physician Clinical Reviewer specializing in cardiology to join the utilization management team remotely. This role involves providing medical review of service requests and ensuring compliance with necessary guidelines. Candidates...Remote work
Prime Therapeutics
Ewing, NJ1 day ago $76k - $85k
...A public sector solutions firm is seeking a Utilization Review Nurse to perform prior authorization and clinical reviews. Candidates should... ...effective communication, and attention to detail while working remotely. Compensation ranges from $76,000 to $85,000, with...Remote workPublic Consulting Group
Albany, NY4 days ago- ...A healthcare facility in Gibson City, Illinois, is seeking a Utilization Review/Case Management Nurse. The role involves reviewing patient admissions... ...a hybrid work model, balancing in-person meetings with remote collaboration, aiming to enhance patient outcomes and...Remote work
Gibson Area Hospital
Gibson City, IL4 days ago $76k - $85k
...A leading public sector solutions firm is seeking a Utilization Review Nurse to work remotely. This role involves conducting prior authorizations, performing reviews, and using medical management software. The ideal candidate will have a nursing degree, at least 2 years...Remote workPublic Consulting Group
Madison, WI1 day ago- ...organization in California seeks a full-time Registered Nurse for Utilization Review. The ideal candidate will perform reviews for Southern CA... ...and a California RN License, with 2 years of relevant remote experience. Join our team to thrive in a supportive culture focused...Remote workFull timeDay shift
Providence Service
Irvine, CA3 days ago - ...A healthcare company is seeking a remote Physician Clinical Reviewer specializing in Nephrology. The ideal candidate will have over 5 years of experience in utilization management, performing medical reviews, and providing clinical rationale for appeals. Responsibilities...Remote work
Prime Therapeutics
Denver, CO1 day ago - ...A healthcare organization is seeking Board-Certified physicians in Oncology for a flexible, remote utilization review role. This position requires a Medical Degree (MD or DO) with a current license in Florida, Minnesota, or Oregon, and an active Board Certification in...Remote workFlexible hours
Medical Review Institute
Dallas, TX1 day ago - ...A leading healthcare company is seeking a Physician Clinical Reviewer - Cardiology to join its utilization management team. This remote role involves reviewing medical service requests and collaborating with healthcare professionals to ensure compliance with medical guidelines...Remote work
Prime Therapeutics
Hartford, CT1 day ago
