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$65.5k - $96.89k
...The Utilization Review Specialist will be part of our Physician Advisory Team providing first level initial admission and continued stay case reviews. The Utilization Review Specialist will determine the appropriate cases for review, utilizing client specific guidelines...Remote workLocal areaNight shiftWeekend workDay shiftAfternoon shiftR1 RCM
Boise, ID2 days ago- ...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, IL3 days 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, AK3 days ago - ...Essential Duties and Responsibilities Performs utilization review in accordance with all state mandated regulations Analyzes insurance, governmental and accrediting standards to determine criteria concerning admissions, treatment, and length of stay Assures compliance...Remote workWeekly payContract workWork at officeLocal area
Amergis
Baltimore, MD19 hours ago - ...The Council of State and Territorial Epidemiologists seeks a Clinical Utilization Review Nurse (RN) for a full-time remote role assessing healthcare service necessity and quality. This position requires an active RN license in Alabama and a BA/BS in Nursing, along with...Remote workFull time
Council Of State and Territorial Epidemiologists
Albuquerque, NM2 days ago $275k - $300k
...~ Remote or hybrid Medical Director for MediCare service line ~100% administrative, non-clinical role ~ Work from home, but... ..., PTO ~ Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license...Remote workFull timeImmediate startWork from homeMonday to FridayInspire Healthcare
United States1 day ago$23.15 - $30.03 per hour
...members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization review... ...will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The...Remote workFull timeWork at officeLocal areaShift workPrime Healthcare
Ontario, CA2 days ago- ...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 work
Guidehealth
Chicago, IL3 days ago - ...Unrestricted MINNESOTA or TEXAS medical License Required Medical Review Institute of America, LLC (MRIoA), a national Independent... ...the appropriateness of treatments, known as Peer Review or Utilization Review. Key Benefits: Stay informed on the latest...Remote jobFor contractorsVisa sponsorshipFlexible hours
Medical Review Institute of America, LLC
West Valley, UT4 days ago - ...Job Description JOB POSTING Spend only 1-2 hours a week and provide your expertise in Gastroenterology by conducting Utilization Reviews in the Utilization Management/Peer Review process. A current Indiana medical license is required (or current Letter of Qualification...Remote jobFor contractorsVisa sponsorship
Medical Review Institute of America, LLC
West Valley, UT4 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 work
Guidehealth
Chicago, IL8 days ago - ...nights! * Paid Holidays * Work-life balance. * Remote/hybrid setting (once trained) ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication skills... ...will defer decision to a second level reviewer. This individual interfaces with case managers...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
Hines and Associates
Rockford, IL1 day ago $65k - $78k
...career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and...Remote workFull timeContract workWork at officeWork from homeFlexible hoursGainwell Technologies
Juneau, AK3 days ago- ...experienced Registered Nurse for a clinical role focusing on utilization review and care coordination. The ideal candidate will have 5+ years... ...processes, and be proficient in Microsoft 365. This role offers remote work and a comprehensive benefits package including medical,...Remote work
Guidehealth
Rockford, IL3 days ago - ...Flexible Independent Contractor (1099) Remote Opportunity Oregon Medical License Required... ...MRIoA Founded in 1983, Medical Review Institute of America (MRIoA)is a nationally... ...(IRO) specializing in technology-driven utilization management and clinical medical review...Remote jobContract workFor contractorsFlexible hours
Medical Review Institute of America, LLC
West Valley, UT29 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
Medical Review Institute
Salt Lake City, UT3 days ago - ...Registered Nurse Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Position Overview: This is a fully remote...Remote work
3B Healthcare, Inc.
Torrance, CA2 days ago - ...A healthcare administration company seeks a Utilization Management Nurse to perform medical necessity reviews while working remotely. The ideal candidate will be an active Licensed Practical Nurse (LPN) with strong proficiency in the Utilization Review process. Responsibilities...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC3 days ago - ...A major healthcare organization is seeking a registered nurse for a remote position focused on utilization review. Candidates should have 2 years of experience in a hospital setting and expertise in evaluating medical necessity. Responsibilities include assessing care...Remote work
BJC HealthCare
Kansas City, MO4 days ago $85.99k - $105.34k
...A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams....Remote workFull timeUmpqua Health
Roseburg, OR3 days ago- ...The Council of State and Territorial Epidemiologists is seeking a Clinical Utilization Review Nurse (RN) for a remote position focused on assessing healthcare services for medical necessity. Candidates must hold an active RN license in Alabama and have at least 3 years...Remote work
Council Of State and Territorial Epidemiologists
Sacramento, CA1 day ago - ...Case Management Senior Analyst Location: Remote Schedule: 8am to 5pm (M-F) Description Delivers... ...with the physician treatment plan. Utilizes clinical skills to assess, plan, implement... ..., concurrent, and retrospective reviews for inpatient acute care, rehabilitation,...Remote workImmediate start
w3r Consulting
Nashville, TN3 days ago - ...A healthcare organization is seeking a Physician Clinical Reviewer for a remote opportunity. In this role, you will be a key member of the utilization management team, performing medical reviews of service requests and collaborating with physicians to ensure compliance...Remote work
Prime Therapeutics
Carson City, NV3 days ago $42 - $43 per hour
...Description # Home # Search Jobs # Job Description Utilization Review RN (KY/Compact License) Remote: Louisville, Kentucky, US Salary Range: 42.00 - 43.00 | Per Hour Job Code: 369242 End Date: 2026-06-07 Days Left: 28 days, 3...Remote workHourly payCollabera Technologies
Louisville, KY2 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...Remote workFlexible hours
Medical Review Institute
Dallas, TX6 days ago - ...The Association of California Nurse Leaders is seeking Clinical Utilization Review Nurses (RNs) for a remote position focusing on assessing medical necessity and quality of healthcare services. Applicants must possess a BA/BS in Nursing, an active Alabama RN license,...Remote work
Association of California Nurse Leaders
Las Vegas, NV3 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
New York, NY8 days ago - ...COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workFull time
COMAGINE HEALTH
Seattle, WA3 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 workContract work
IntePros
Phoenix, AZ3 days ago
