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- ...The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. Responsible for obtaining and tracking approvals, denials, and additional information requests received from...Remote workPart timeShift work
Henry Ford Health System
Troy, MI2 days ago $275k - $300k
...Remote or hybrid Medical Director for MediCare service line 100% administrative, non-clinical role Work from home, but candidate... ...CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license...Remote workPermanent employmentFull timeWork from homeMonday to FridayIntegrity Healthcare
Sacramento, CA1 day ago- ...and nights! Paid Holidays Work-life balance. Remote/hybrid setting (once trained) ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication skills... ...individual will defer decision to a second level reviewer. This individual interfaces with case...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
Hines & Associates Inc
Freeport, IL1 day ago - Registered Nurse (RN) | Utilization Review Location: Apple Valley, CA Agency: TechLink Systems, Inc. Pay: Competitive weekly pay (inquire for... ...Title: Registered Nurse - Utilization Review Location (On-site, Remote, or Hybrid?): Apple Valley, CA, (onsite) Contract Duration: 1...Remote workWeekly payContract workImmediate startShift workWeekend work
TechLink Systems, Inc.
Apple Valley, CA2 days ago - ...behavioral health and substance abuse case management through utilization reviews and care coordination. While not a member facing role, you'... ...the right level of care at the right time. This is a fully remote position with a Monday-Friday schedule during standard business...Remote workMonday to Friday
Optum
Sedona, Yavapai County, AZ4 days ago - ...coordinating, integrating, and monitoring the utilization of physical health (PH) medical and... ...cases to the Medical Director for review. Refer to and work closely with Case Management... .... Please note: The opportunity for remote work may be possible for all jobs posted...Remote workContract workLive inWork at office
Univera Healthcare
Rochester, NY2 days ago - ...RN Utilization Review By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your daily...Remote workWork experience placement
Tennessee Staffing
Knoxville, TN3 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, AZ4 days ago $56.44 - $87.63 per hour
...RN Utilization Review Part- time Day at Providence Health and Services summary: This part-time RN Utilization Review role involves conducting... ...-centered care and operates primarily during day shifts with remote work flexibility. Description RN Utilization Review...Remote workMinimum wageFull timePart timeLocal areaShift workDay shiftProvidence Health and Services
Glendale, CA4 days ago- ...Utilization Review RN The Utilization Review RN is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review. This position functions as a part of a multidisciplinary team, including physicians, social workers...Remote workFlexible hours
VCU Health
United States3 days 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
Virginia Beach, VA4 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, MA1 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 workTemporary workWork from homeHome officeMonday to ThursdayFlexible hoursKLDiscovery
Eden Prairie, MN3 days ago$56.44 - $87.63 per hour
...Description RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical...Remote workMinimum wageFull timeShift workDay shiftProvidence Service
Irvine, CA3 days ago- ...Great Place to Work" since 2015. Position Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, organizational determinations/ disputes, and auditing/training of...Remote workWork at office
Martins Point Health Care
Portland, ME1 day ago - ...Caritas Long Term Services And Supports Reviewer Your career starts now. We are looking... ...was received, nature of the request, utilization determination (and events leading up to... ...Package Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workFlexible hours
AmeriHealth Caritas
Augusta, GA3 days ago $18 - $21 per hour
...Tax Documentation Reviewer Cherry Bekaert is gearing up for tax busy season! We are seeking multiple temporary, remote Tax Documentation Reviewers to support our Validation Center... ...deadlines. In this role you will: Utilizing your keen attention to detail to...Remote workHourly payTemporary workWork experience placementSeasonal workMonday to FridayNashville Staffing
Nashville, TN6 hours agonew- ...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
- ...Hmong Document Reviewer Washington, DC / Remote / Arlington, VA eDiscovery Document Review Full Time Remote As a CGS Hmong Chinese Document... ...Produces a variety of written documents and materials utilizing a wide range of office software applications;...Remote workFull timeWork at officeFlexible hours
Contact Government Services LLC
Fresno, CA4 days ago $269.5k - $425.5k
...quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects... ...situations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some...Remote workMinimum wageFull timeWork experience placementLocal areaWeekend workUnitedHealth Group
Indianapolis, IN4 hours agonew- ...Company : Skyway Behavioral Health Title : Utilization Review Specialist (URS) FLSA Status : Exempt Location : Remote Skyway Behavioral Health is an innovative center that goes beyond the treatment of mood, anxiety, and eating disorders to address underlying...Remote workTemporary workLocal area
- ...A facility in Englewood, CO is seeking its next amazing Social Worker to work in Case Management (Utilization Review). Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you...
Medical Solutions
Omaha, NE4 days ago - ...your future. Apple equipment and a media stipend are provided for remote workspace. About Dane Street A fast-paced, Inc. 500... ...Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical...Remote workFull timeTemporary workWork from home
Dane Street
Washington DC2 days ago - ...Nurse Position This position will be a remote role for nurses in Michigan. Should have a valid MI RN license. Should have utilization management experience. Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings...Remote work
LanceSoft
Detroit, MI4 days ago - ...Behavioral Health Utilization Management Specialist Location: Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health... ...What You’ll Do Champion patient care by reviewing medical records and clinical documentation to...Remote workFull timeWork at office
Ampian HR
Sandy, UT3 days ago - ...organization is seeking a RN Coordinator for Utilization Management in Wisconsin. This full-time position involves reviewing authorization requests for medical necessity... ...of clinical experience. The role allows for remote work but requires occasional travel to the Menasha...Remote workFull timeWork at office
Network Health Plan (Wisconsin)
United States1 day ago - ...our continued success. Overview The Utility Analyst II works with utility data on a... ...accuracy, and storage tools. Develop and review energy consumption baselines and... ...ID 2025-8886 Category Energy Position Type Full-Time Remote No...Remote workFull timeFor contractors
ENFRA
Charlotte, NC4 hours agonew $38 - $40 per hour
...Job Title : Retro Claims Reviewer Location : West Hills/Canoga Park 91305 Compensation : LVN $38-$40 hourly RN $45-$50... ...Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare...Hourly payContract workTemporary workTEKsystems
Canoga Park, CA4 days ago$80k - $85k
...as the internal subject matter expert to review, approve, and finalize all marketing materials... ...the target audience.Content Management: Utilize content management systems (CMS) and... ...30 a.m. to 4:30 p.m., 5 days a week). No remote or hybrid flexibility is currently offered...Remote workTemporary workWork experience placementCella
Fort Lauderdale, FL3 days ago$71.87k - $114.8k
...KYC REVIEW ANALYST SENIOR- OPS WHAT IS THE OPPORTUNITY? Conduct Enhanced Due Diligence... ...loan borrowers and prospect reviews utilizing a variety of internal bank systems and external... .... Unless otherwise indicated as fully remote, reporting into a designated City...Remote workWork at officeCity National Bank
Phoenix, AZ2 days ago
