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- A health care organization is seeking a Utilization Management Specialist for a remote position. This role utilizes clinical expertise to improve patient... ...effective management practices. Key responsibilities include reviewing admissions, collaborating with interdisciplinary...Remote jobFlexible hours
- ...of a partner company. We are currently looking for a Utilization Management Specialist - REMOTE. In this role, you will leverage your clinical expertise... ...management practices. This position involves reviewing patient admissions and collaborating with multidisciplinary...Remote jobFlexible hours
- A leading healthcare provider is searching for a Medical Director to support the Medical Management staff with utilization reviews, appeals, and pharmacy oversight. This role requires an MD or DO with at least 3-5 years of clinical experience and a current medical license...Remote jobFull timeWork from home
- ...Job Title: Utilization Review Nurse Job Location: 100% Remote Job Duration: 06+ Months (Possibility of extension) remote within one of our plan states, IL, TX, NM, OK, MT or TN Hourly pay Rate - $41.45 - $45/Hr. on w2 Job Description: · Not a Case Management or Member...Remote workHourly payFull timeWork from home
Careers Integrated Resources Inc
Atlanta, GA4 days ago - A healthcare management company is seeking a full-time Utilization Review Specialist for a remote position. The role focuses on efficiently processing Utilization Management and Independent Review requests, reviewing case requests, maintaining compliance, and delivering...Remote jobFull timeWork at office
- ...insurance firm in Warwick seeks a UM Specialist to handle medical review decisions, balancing clinical standards with excellent... ...Responsibilities include reviewing medical services and conducting utilization reviews. Ideal candidates have an Associate's degree and three...Remote jobFlexible hours
$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 jobPermanent employmentFull timeWork from homeMonday to Friday- ...Denials Specialist - Utilization Review(RN) At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network... ...Location: Tampa or St Petersburg for up to first 6 months and then Remote Status: Full time, 40 hours per week Schedule: Monday -...Remote workFull timeWork at officeMonday to FridayWeekend work
BayCare
Tampa, FL4 days ago - 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
- A healthcare organization is seeking a Utilization Management Specialist to work remotely. The role involves reviewing patient admissions, assessing documentation, and collaborating with multidisciplinary teams to ensure appropriate care levels. Candidates must have a current...Remote job
$18 - $22 per hour
Our Ethos Medical Management Team is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and timely processing of Utilization Management and Independent Review requests for our clients. This role involves reviewing...Remote workHourly payFull timeWork at office$108k
...Experienced Utilization Review Nurse UW Medical Center has an outstanding opportunity for an experienced Utilization Review Nurse to join our team. Work schedule includes fully remote/work from home, availability to work day shifts during Pacific Standard Time, and...Remote workFull timeWork experience placementWork from homeShift workDay shift1 day per weekIntelyCare
Seattle, WA1 day ago$55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental...Remote workWork at officeFlexible hours- 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
- ...Care Manager to advance patient-centered care through precise Utilization Review. The role involves evaluating healthcare services, ensuring... ...experience in healthcare settings. This position supports a remote work model, allowing for flexibility while ensuring impactful...Remote job
- ...ensure high-quality, patient-centered care through effective utilization review. The candidate will be responsible for evaluating healthcare... ...’ experience in various healthcare settings. The position is remote and offers a competitive benefits package. #J-18808-Ljbffr GuidehealthRemote job
$40 per hour
Clinical Support Manager (temporary) Utilization Review RN/LPN Job Category : Advisory Services Requisition Number : CONSU005289 Posted : November 25, 2025 Full-Time Remote Locations Showing 1 location Remote United States Description About Sound Physicians: Headquartered...Remote workHourly payFull timeTemporary workPart timeWork at officeLocal areaWork from homeShift workWeekend work- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...case requirements Additional Details Remote, work‑from‑home position—work anywhere...Remote workFor contractorsWork from homeFlexible hours
$211.2k - $277.2k
...Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance... ...Director, Utilization Management. Work Location: This is a remote position, open to candidates who reside in: Arizona;...Remote workFull timeLocal areaWork from homeHome officeWeekend workOscar Health
Tampa, FL13 days ago- ...emphasizes high-quality patient-centered care through detailed Utilization Review. Responsibilities include managing healthcare service... ...and over 5 years of relevant experience. The position is fully remote, offering competitive benefits including medical, dental, and...Remote job
- A leading risk management company in Massachusetts seeks a Utilization Review Case Manager for a hybrid position. The role involves gathering clinical information, certifying medical necessity, and analyzing treatment data. Candidates should have a nursing degree, active...Remote job
$29.95 - $44.77 per hour
A national risk management firm is seeking a remote Utilization Review Case Manager to handle the certification of medical necessity and monitor patient admissions. The candidate should possess thorough knowledge of CPT and ICD coding, a nursing degree, and at least 4 years...Remote jobHourly pay- ...work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position... ...performing care for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity...Remote workFull timeReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO15 hours ago $29.95 - $44.77 per hour
A national risk management company is seeking a Utilization Review Case Manager responsible for gathering clinical information and certifying medical necessity. This fully remote position requires strong knowledge of CPT and ICD coding, excellent communication skills,...Remote jobHourly pay- ...Immediate need for a talented RN Case Manager – Utilization Review - Onsite-Santa Clara, CA. This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote) . Please review the job description below and contact me ASAP if you are interested...Remote workContract workLocal areaImmediate start
Pyramid Consulting
Atlanta, GA3 days ago $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, NY23 hours ago$35 - $45.94 per hour
...Description Job Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. Oscar is the... ...Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Texas, Georgia, Arizona...Remote workHourly payFull timeWork from homeHome officeOscar Health
Dallas, TX8 days ago- ...Medicine physicians to support our clinical review services. In this role, you’ll evaluate... ...a leading provider of technology-driven utilization management and clinical review services.... ...your medical expertise while working remotely from home. Reduce or step away from hands...Remote workFor contractorsReliefWork at officeWork from homeFlexible hours2 days per week1 day per week
- ...prominent health organization is seeking a Family Medicine physician for a daytime position in a non-clinical utilization review setting. The role may allow for partial remote work and offers a competitive salary and incentives starting at $250K, alongside comprehensive...Remote work
Council Of State and Territorial Epidemiologists
Los Angeles, CA23 hours 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 States4 days ago
