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- Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and... .... After a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide-ChildrenRemote jobWork at officeWork from home
- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
Alliance Health in
Morrisville, NC3 days ago - ...Compass Health Center is seeking a Remote Utilization Review Specialist to obtain insurance authorization for patients receiving Behavioral Health treatment at high levels of care. The UR Specialist serves as a liaison between the clinical team and insurers, helping patients...Remote work
COMPASS HEALTH CENTER, LLC.
Brooklyn, NY1 day ago - ...Prime Healthcare is seeking a Utilization Review Technician to coordinate UR and appeals within denial management. This role collaborates with... ...reviews (RAC, MAC, CERT, ADR) and audits, serve as SME to remote counterparts, and assist with Release of Information and discharge...Remote workWork at office
Prime Healthcare
Ontario, CA2 days ago - ...accredited college or university in Nursing, Social Work, Behavioral Health or related field required preferred.2-3 years of utilization review experience in behavioral health, addiction treatment, or managed care.Strong understanding of ASAM criteria, LOCUS, DSM-5, diagnostic...Remote workDaily paidFull time
The Florida House
Deerfield Beach, FL3 days ago - ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of...Remote work
Bradford Health Services
United States21 hours ago - ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities:Review patient...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL1 day ago $51 per hour
...Utilization Review Specialist (BCBA Licensee)Baltimore, MD (Remote – offsite) Contract To Hire $51/hr (W2) 100% Remote Must be Licensed in one of the 3 states: MD, VA or Washington D.C.Utilizing key principles of utilization management, the Utilization Review Specialist...Remote workContract workWork at officeWork from homeSystem One Holdings, LLC
Baltimore, MD2 days ago- ...Surgery Center in Addison, Texas, is seeking an experienced Utilization Review Specialist to join its team. The role requires the ability to... ...-paced environment. This is a hybrid position offering three remote days per week and onsite presence two days weekly in Addison....Remote job3 days per week
- Diversified Treatment Alternative Centers is looking for a Utilization Review Specialist in Chadds Ford, PA. This role supports behavioral health... ...or case management. This position offers flexible hybrid or remote work options and a comprehensive benefits package. #J-18808-...Remote jobFlexible hours
$50k
...the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote workAdvanced Recovery Systems LLC
New York, NY21 hours ago- ...week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient...Remote workPart time
ADDICTION AND MENTAL
United States1 day ago - Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
$24.65 - $30.03 per hour
...Utilization Review TechPrime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54... ...will also function as an SME to support the UR tech team and remote counterparts with the specific processes as applicable. The Utilization...Remote workWork at officeLocal areaPrime Healthcare
Ontario, CA21 hours ago- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing...Remote workTemporary work
Banyan Treatment Centers
Pompano Beach, FL1 day ago - FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance...Remote job
$70k - $100k
...part of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two days...Remote workPermanent employment2 days per weekTEKsystems
Addison, TX21 hours ago- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
$80 per hour
...healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization... ...healthcare operations.This role supports current and upcoming remote consulting opportunities focused on AI-assisted prior...Remote workHourly payPart timeFor contractorsWork at officeFlexible hours24-MAG LLC
New York, NY21 hours ago$45k - $55k
...below to learn more. If you are a current employee wanting to apply for a different position, clickhere . Back to jobs Utilization Review Specialist Remote Weekly outpatient therapy isn't always enough, and a trip to the ER isn't the only answer. Patients and their...Remote workWork at officeCOMPASS HEALTH CENTER, LLC.
Brooklyn, NY1 day ago$30 - $45 per hour
...and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure... ...accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various...Remote jobHourly payContract work$39.4 - $53 per hour
...Central Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job function... ...Other Knowledge, Skills, and Abilities Required: This is a remote role which requires access to high speed internet Excellent...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend workRemote Jobs
New York, NY3 days ago- ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for...Remote jobWork from home
- ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for...Remote jobWork from home
$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team.This role is ideal for an RN with strong experience in OASIS, coding, QA, and home health...Remote workMonday to FridayWeekend workConcierge Home Care
Jacksonville, FL1 day ago- ...Job Description Job Description Job Summary Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews... ...may occur outside of standard office hours. Hybrid (onsite/remote) work schedule available. The ideal candidate must be able...Remote workWork at office
Oakland Community Health Network
Troy, MI3 days ago - HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This... ..., and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr...Remote job
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR)...Remote workFull timeMonday to FridayFlexible hours
$51 per hour
Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote - offsite) Type: Contract To Hire Compensation: $51/hr (W2) Work Model: 100% Remote Must be Licensed in one of the 3 states: MD, VA or Washington D.C. Overview Utilizing key principles...Remote workContract workWork at officeLocal areaWork from home
