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- ...this dept is 100% remote, with a variety of service lines and levels of care (inpatient, Extended Hospital Outpatient and OBS).... ...3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group) • InterQual...Remote work
Pacer Group
Torrance, CA3 days 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 $8 per hour
...Description Job Opportunity: Registered Nurse - Utilization Review Facility: CSMN - 8714024 - MNS Quality Management Location: Los... ...% Holiday Pay: 1.5% Additional Information: ***Hybrid/Remote within a commutable distance to Beverly Hills/Los Angeles***...Remote workHourly payContract workShift workZenex Partners
Los Angeles, CA3 days ago- ...Job Description Position Title: Utilization Review Nurse Location: Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and...Remote workFlexible hoursWeekend work
IntePros
Phoenix, AZ20 days ago - ...Job Title: Care review Clinician | Utilization review nurse Location: 100% Remote in CA Duration: 06 months+ contract (Possibility of extension) Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri) Pay Rate - $47.14/hr on W2 Job Summary:...Remote workContract workWork at officeShift work
Integrated Resources
Long Beach, CA1 day ago - ...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 timePart time
IntePros
Philadelphia, PA4 days ago $85 - $90 per hour
...LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Poughkeepsie, New York. Job Description... ...TIMES: 08:00:00 AM - 04:30:00 PM - Every other weekend - REMOTE *REMOTE* Utilization Review Nurse Case Manager position...Remote workHourly payWeekly payLong term contractPermanent employmentFull timeContract workTemporary workWork at officeLocal areaShift workWeekend workLanceSoft
Poughkeepsie, NY16 hours ago- ...Utilization Review Nurse Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities... ...Certified (CMGT-BC) Expectations Comfortable with remote work arrangements and virtual collaboration tools Physical...Remote workFull timeWork at officeShift workWeekend workWeekday work
Netsmart
Winston Salem, NC9 hours ago $34 - $52.7 per hour
...Utilization Management Nurse Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility. This job is remote. Standard Hours: 35.00 Shift: Shift 1 Shift Details: 7/70 schedule (7... ..., PA moonlighter, for a second level review as needed. Facilitates communication...Remote workHourly payTemporary workShift workWeekend workFroedtert Memorial Lutheran Hospital
Albuquerque, NM3 days ago- ...find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees...Remote workWork at office
Portland Staffing
Portland, ME9 hours ago $56.44 - $87.63 per hour
...Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Full- time and will work... ...Registered Nurse License. ~2 years Experience working in a remote UR environment or working as an acute hospital case manager....Remote workFull timeShift workDay shiftProvidence Health & Service
Mission Hills, CA3 days ago$38.49 - $47.05 per hour
...RN Utilization Management Reviewer The RN Utilization Management Reviewer is responsible for facilitating care for members who may have complex... ...Mobile, and Resident personas. This position can be fully remote with an in-office requirement to work 1-3x/month at our...Remote workHourly payFull timeWork at officeFlexible hoursBlue Cross Blue Shield of Massachusetts
Hingham, MA2 days ago$72.48k - $108.72k
013650 CCA-Auth & Utilization Mgmt Position Summary: Reporting to the Manager Utilization... ..., the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely... ...environment This position is available to remote employees residing in Massachusetts....Remote workWork at officeLocal areaHome officeCommonwealth Care Alliance
Boston, MA4 days ago- ...PRN Clinical Review Nurse Children's is one of the nation's leading children's hospitals... ...applicable patients as stated in system utilization management plan. Oversees Clinical... ...days/week for 8-10 weeks. This role can be remote, including training but occasional...Remote workRelief3 days per week
Children's Healthcare of Atlanta
Atlanta, GA3 days ago - ...POSITION Customer Solutions Representative II Utilities Company Position Type: Temporary/Remote Schedule : M-F, 8:00 am - 5:00 pm (Shift may... ...and program databases (e.g., PV, SBP, MAR). Review submitted MSA applications for completeness and...Remote workTemporary workFor contractorsWork at officeShift work
Alura Workforce Solutions
Azusa, CA3 days ago $56.44 - $87.63 per hour
...Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work... ...Nurse License upon hire. ~2 years - Experience working in a remote UR environment or working as an acute hospital case manager....Remote workPart timeLocal areaShift workDay shiftProvidence Service
Mission Hills, CA4 days ago$75k - $85k
...Location Huntington Beach Office - Huntington Beach, CA Remote Type Fully Remote Position Type Full Time... ...celebrates diversity and innovation. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity...Remote workFull timeWeekend workClever Care Health Plan
Huntington Beach, CA4 days ago- ...Job Description Job Description Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient... ...answers first level calls in Utilization Review for HealthCheck360 participants. They will...Remote workFull timeWork at office
HealthCheck360
Dubuque, IA14 days ago $28.9 - $35.45 per hour
...$28.90- $35.45/hr based on experience We are seeking Virtual Utilization Review Specialists to join our team. Full-time and PRN jobs are available... ...Other Knowledge, Skills, and Abilities Required: This is a remote role which requires access to high speed internet Excellent...Remote jobFull timeReliefWork at officeWork from home- Join to apply for the Utilization Review Appeals Specialist role at Michigan Medicine . Talent Acquisition Consultant at Michigan Medicine Why... ...of Work Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work...Remote workFull timeWork at officeWork from homeMonday to Friday
- ..., is seeking an Emergency Medicine physician to work in a non-clinical utilization review setting. Opportunity Highlights ~ Daytime Monday through Friday position. Potential to work remotely part of the time. ~ Strong CDI Program ~ Salary and incentive of $2...Remote workPart timeMonday to Friday
Enterprisemed
Abington, PA2 days ago $35 - $50 per hour
...Job Description JobTitle : Retro Claims Reviewer Location : West Hills/Canoga Park 91304 Compensation : LVN $38-$40 hourly... ...(LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare...Hourly payContract workTemporary workTEKsystems
Los Angeles, CA4 days ago$70 - $74 per hour
...Talent4Health is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Cambridge, Massachusetts. Job... ...between Hospitals. Hybrid position: in person and remotely. MUST float between Hospitals.Hybrid position: in person...Remote workHourly payContract workLocal areaMonday to FridayShift workDay shiftTalent4Health
Cambridge, MA5 days ago- ...Description Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of... ...preferred) licensed in Mississippi to perform Utilization Reviews . This is a non-clinical, fully remote role designed to offer supplemental income with complete...Remote jobPrice workExtra incomeFor contractors
- ...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 remote or office/home hybrid position. Your Responsibilities:...Remote workFull timeWork at officeFlexible hours
$114k - $161k
...Principal Consultant - Utility Return on Equity & Cost of Capital Specialist Join to apply for the Principal Consultant - Utility Return... ...Washington, DC Position Type : Hybrid 3 days in office, 2 remote days per week 2025 Salary Range: $114,000 - $161,000 plus...Remote workFull timePart timeWork at officeWork from homeFlexible hours2 days per weekConcentric Energy Advisors
Washington DC2 hours ago$68k - $72k
Description Join Our Team as a Utilization Review Specialist (RN or Social Worker) Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help...Remote workTemporary workAllHealth Network
Watkins, CO1 day ago- ...Type: Full-Time Department: Clinical Operations / Utilization Management Reports To: Utilization Review Manager Position Summary We are seeking a detail-oriented... .... Work Environment Standard office setting or remote work, depending on location. Regular use of...Remote workFull timeWork at officeFlexible hours
$19.5 - $26 per hour
...About the job Document Review and Data Entry Specialist Job details Salary $ 19.50 to $ 26.00 per hour Job Type... ...but not be limited to the following: Use TRAX program areas utilized for Maintenance personnel and perform setup and data entry of log...Hourly payFull timeWork experience placementWork at officeRemoteOnline
San Francisco, CA5 days ago$72 - $76 per hour
...LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Cambridge, Massachusetts. Job Description... ...and Somerville Hospital. Hybrid position: in person and remotely. (Be sure your candidate is agreeable) MUST have...Remote workHourly payWeekly payLong term contractPermanent employmentContract workTemporary workWork at officeLocal areaMonday to FridayShift workLanceSoft
Cambridge, MA2 days ago
