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- 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
- 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
$31 - $61 per hour
...Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in New York, New York. Job Description &... ...Staff Pre-Authorization RN Pre-Authorization RN Remote after training which is a hybrid schedule 2 days onsite, 3...Remote workHourly payPermanent employmentWork at officeRelocation packagePerm Staff Jobs
New York, NY2 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 States1 day ago - 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 job
- 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 job
- A healthcare solutions provider is seeking a Clinical Review Clinician for a remote position. The candidate will have responsibilities such as reviewing... ...RN or LPN license, is required, along with experience in Utilization Management or Appeals. Knowledge of Medicare regulations...Remote jobFlexible hours
- ...pharmacy benefits manager is seeking a Physician Clinical Reviewer specialized in Dermatology for a remote role. This position involves reviewing clinical... .... This is an opportunity to contribute to effective utilization management processes while working within a...Remote job
- A health services provider is seeking a Utilization Review Specialist in Malibu, CA. This part-time remote role requires effective communication skills and knowledge of medical terminology. Responsibilities include managing cases for clients in treatment and ensuring compliance...Remote jobPart time
- ...Physician Reviewer – Utilization Management (Remote)-Full Time Overview We are seeking a Board-Certified Physician to support utilization management activities by reviewing clinical documentation and determining the medical appropriateness of inpatient, outpatient, and...Remote workFull timeLocal areaWeekend work
Medix
New York, NY5 days ago - A recognized Independent Review Organization is seeking Board-Certified Orthopedic Spine Surgeons for a remote Physician Reviewer role. This non-clinical position focuses on conducting utilization reviews without direct patient interaction. Responsibilities include reviewing...Remote jobExtra incomeFlexible hours
- ...to make a difference, consider applying for the position of Utilization Review Nurse. As a Utilization Review Nurse, you will leverage a... ...is mandatory. Working Conditions: ~ Position is remote. Join us at PCG and be part of our mission to improve...Remote work
Public Consulting Group
Atlanta, GA3 days ago - A healthcare safety-net provider in Houston is seeking a Utilization Management Review Nurse. This position involves evaluating the necessity of medical services and collaborating with various healthcare teams to ensure quality and efficiency. Candidates should have a Bachelor...Remote jobFlexible hours
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract... ...Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This...Remote workFull timeContract work
- Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled... ...pharmacy. Flexibility: Many DUR roles offer hybrid or fully remote schedules. Rewards: Competitive salary, benefits, and career...Remote work
- ...Job Title: Utilization Management RN Location: Remote – must reside within the PA/NJ/DE tri-state area for potential conversion to full-time License... ...’ clinical conditions through detailed medical record review to determine medical necessity for services. Using...Remote workFull time
IntePros
Philadelphia, PA1 day ago $28 per hour
...respected. We have an ongoing need for Document Reviewers. Document Reviewers will review... ...litigation! Position Details ~ Remote work-from-home opportunity ~ Pay rate... ...later is required. ~ Proficiency in utilizing modern technology, especially computers...Remote workHourly payTemporary workWork from homeHome officeMonday to ThursdayFlexible hoursDiversityJobs Inc
Sioux Falls, SD9 hours ago$28 per hour
...respected. We have an ongoing need for Document Reviewers. Document Reviewers will review... ...litigation! Position Details ~ Remote work-from-home opportunity ~ Pay rate... ...later is required. ~ Proficiency in utilizing modern technology, especially computers...Remote workHourly payTemporary workWork from homeHome officeMonday to ThursdayFlexible hoursDiversityJobs Inc
Eden Prairie, MN9 hours ago$60.2k - $107.4k
...Care Advocate you will be responsible for case management and utilization review of behavioral health and substance abuse cases. You'll have... ..., anywhere. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaUnitedHealth Group
Latham, NY3 days ago$39.32 - $48.06 per hour
...healthcare? Bring your true colors to blue. The Role The RN Utilization Management Reviewer is responsible for facilitating care for members who may... ..., and Resident personas. This position can be fully remote with an in-office requirement to work 1-3x/month at our...Remote workHourly payWork at officeFlexible hoursShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA3 days ago$20 - $22 per hour
...Employment Type: Full-Time Work Options: Remote / Work from Home in the US #LI-Remote... ...J. J. Keller has a REMOTE - Document Review Specialist opening in one of our fastest... ...For meetings and internal interaction we utilize MS Teams for video communication. Benefits...Remote workFull timeWork at officeLocal areaWork from homeHome officeMonday to FridayJ. J. Keller
Neenah, WI2 days ago$55 per hour
...Fri, 8:00am-5:00pm EST Work Location- REMOTE No call, holiday, or weekend There... ...direct patient care; this is a medical review position only. $55/hr Responsibilities... ...and/or rehabilitative facilities. The Utilization Nurse (UN) actively monitors the...Remote workTemporary workLocal areaShift workWeekend workJohns Hopkins Medical Management Corporation
Baltimore, MD2 days ago$30 - $45 per hour
...for a talented Operations Specialist III – Medicaid / Medi-Cal (Epic + Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Long Beach , CA(Remote). Please review the job description below and contact me ASAP if you...Remote workContract workLocal areaImmediate startPyramid Consulting, Inc
Long Beach, CA27 days ago$76k - $85k
...sector. To learn more, visit . PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for... ...utilization management RN required Working Conditions ~ Remote The above is intended to describe the general contents and...Remote workFor contractorsH1bWork at officeLocal areaPublic Consulting Group
Columbus, OH2 days ago- ...and Supports (LTSS) Supervisor, the LTSS Reviewer is responsible for completing care and... ...request was received, nature of the request, utilization determination (and events leading up to... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workFlexible hours
AmeriHealth Caritas
Newtown Square, PA2 days ago $15 per hour
A utility services company is looking for a Digital Technician to work from home in Las Vegas. You will review locate requests and assess conflicts while using mapping applications. Ideal candidates will demonstrate strong analytical skills, a solid work ethic, and proficiency...Remote jobHourly payFull timeSeasonal workWork at officeWork from homeShift work$25.67 - $37.26 per hour
...Utilization Reviewer Job Class: Management Analyst 2 Agency: Direct Care and Treatment Location: Vadnais Heights Telework Eligible: Yes Full/Part Time: Full-Time Regular/Temporary: Unlimited Who May Apply: Open to all qualified job seekers Date...Remote workHourly payFull timeTemporary workPart timeWork experience placementLocal areaMonday to FridayShift workDay shift- ...Opportunity For Nurses In Michigan This position is a remote role for nurses in Michigan. Candidates should have a valid MI RN license and utilization management experience. Experience completing post-acute reviews for the inpatient rehab, skilled nursing facility...Remote work
LanceSoft
Detroit, MI4 days ago $41 per hour
...Medical Review Nurse (RN) Remote position, however, candidates must reside in the State of TX or State Of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care industry using medically accepted criteria...Remote workContract workHireOps Staffing LLC
United States8 days ago$22 - $29 per hour
...used for offers in exceptionally rare cases. We do not extend offers above the posted maximum. A day in the life The Utilization Review Technician is responsible for providing support for care coordination, network, referrals, and other pre- and post-service...Hourly pay16 hoursContract workWork at officeLocal areaImmediate startFlexible hoursBlue Cross Blue Shield of North Dakota
Fargo, ND2 days ago
