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- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
ExamWorks
United States4 days ago - ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist... ...working in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities Review...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL1 day ago - ...To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with...Remote workFull time
Virtual Vocations Inc
United States1 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 workHourly payContract workPyramid Consulting
Long Beach, CA2 days ago$50k
...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 workNurseRemotely
United States2 days ago- ...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
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA2 days ago - ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to... ...Management Team is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and...Remote workFull timeWork at office
Ethos Risk Services
United States11 hours ago - Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas... ...for diverse populations. The position emphasizes utilization review, documentation, and collaboration with stakeholders...Remote jobWork from home
$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health Outreach
United States11 hours ago- ...Remote DUR Pharmacist Safe & Cost-Effective Medication Use Work From Home Analyze medication use patterns, apply clinical guidelines... ...collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical...Remote jobWork from home
$35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 2009 as Ashwood... ...SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for...Remote workFull timeTemporary workWork at officeMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID1 day ago$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At 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...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
Jacksonville, FL1 day ago- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
Mass Digital Health
United States2 days ago $62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...a timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health‑sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal area- ...Registered Nurse (RN) | Utilization Review Location: Pennsylvania Agency: Pyramid Consulting, Inc. Pay: Competitive weekly pay... ...ASAP About the Position Key Responsibilities ~100% REMOTE role but candidate has to be in (PA, NJ or DE) ~ Equipment will...Remote workWeekly payFull timeImmediate start
Pyramid Consulting, Inc.
Pennsylvania15 days ago - ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
United States4 days ago - ...Apply Refer a Friend Back Remote Work from Home Share This Page Share on Facebook Share on... ...Friday, the core business hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD3 days ago $71.1k - $97.8k
...Hong Kong Study Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a minimum...Remote workWork from homeHong Kong Study Skills Research Institute
Juneau, AK1 day 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, LLC
United States3 days ago $45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $45 to $50 per hour Shift Information... ...Management Location: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/19/2026 Hours: 40 hours/...Remote workHourly payFull timeContract workWork experience placementImmediate startMonday to FridayShift workWeekend workLancesoft Inc
Fort Myers, FL5 days ago- ...posting to physicians and working with members, providers, and facilities to ensure high-quality care in a remote environment, with rotating weekend utilization review coverage. The candidate should have 1-2 years in utilization management, 3-5 years clinical experience,...Remote job
- ...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely discharges, and refer members to appropriate resources while working remotely. Key responsibilities Assist in building and implementing...Remote workFull time
Virtual Vocations Inc
United States11 hours ago - ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity reviews for inpatient and outpatient... ...nursing or social work credentials, experience in utilization management, and the ability to work remotely within the US; remote options and weekday schedule...Remote workWeekday work
IntelliResume
Louisiana, MO3 days ago - ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
IntePros
United States4 days ago - ...Patient Chart ReviewerIn this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded... ....Minimum 3-5 years of clinical experience preferred.Previous utilization management or case management experience preferred....Remote workFull timeMonday to Friday
Henry Ford Health System
Troy, MI1 day ago - ...Centene Corporation is seeking a Behavioral Health Utilization Review clinician to evaluate and authorize BH services, ensure appropriate levels of care, and collaborate with providers and medical leadership. This role emphasizes quality improvement, case presentations...Remote work
Centene Corporation
Louisiana, MO2 days ago $38 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $38 to $45 per hour Shift Information... ...Position Travel Registered Nurse – Utilization Review (Remote) Location: Fort Myers, Florida Facility: Lee Health –...Remote workHourly payFull timeContract workWork experience placementMonday to FridayShift workWeekend workLancesoft Inc
Fort Myers, FL8 days ago$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart timeSanta Barbara Cottage Hospital
United States2 days ago- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
United States11 hours ago - A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
Insight Global
United States4 days ago
