Get new jobs by email
$59.24k - $76k
...edge technology, or providing clinical services you'll work alongside dedicated professionals who share your... ...license is required We are seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers...Work from homeFull timePart timeLocal areaRemote workFlexible hoursEnlyte
Arlington, TX2 days ago$275k - $300k
...MediCare service line 100% administrative, non-clinical role Work from home, but candidate must be within reasonable driving distance... ...CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA...Work from homePermanent employmentFull timeRemote workMonday to FridayIntegrity Healthcare...
Sacramento, CA21 hours ago- ...looking for a change? Want to work no nights, no weekends, and no... ...holidays? Be able to work from home 50% of the time once trained?... ...DESCRIPTION: This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual interfaces with...Work from homeTemporary workPart timeWork at officeRemote workMonday to FridayFlexible hours
Hines & Associates Inc
Freeport, IL16 hours ago $78.54k - $121.72k
...Type: Full time Shift: Day Shift Description: Utilization Review- RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal... ...Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team including physicians, staff...SuggestedFull timeWork at officeLocal areaShift workDay shiftTrinity Health
Maywood, IL14 hours ago$60k - $75k
...Quadrant Health Group, i s seeking a passionate and dedicated Utilization Review Specialist to join our growing team. You will play a vital... ...professional development and growth. A supportive and collaborative work environment. A chance to make a meaningful impact on the...SuggestedFull timeWork at officeRemote workQuadrant Health Group
Boca Raton, FL2 days ago- ...Direct Hire is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in White Plains, New York. Job... ...career. At Medical Solutions, you’ll find a great place to work and a career home. We’ve received Best Places to Work awards, landed top industry...Work from homeFull timeImmediate startShift work
Medical Solutions Direct Hire
White Plains, NY4 days ago - ...Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non-traditional hours to provide access to medical necessity determinations for urgent and contractually required coverage requests 24/7, 365 days a year....SuggestedRemote workFlexible hoursSaturday
AmeriHealth Caritas
Newtown Square, PA2 days ago - ...services including skilled nursing and home health aide services, medical daycare... ...approved services are provided. Our Utilization Management Reviewers cultivate and maintain relationships... ...member reaches their 21st birthday. ; Work Arrangement:; Remote role....SuggestedContract workRemote workMonday to FridayFlexible hoursShift work
AmeriHealth Caritas
Newtown Square, PA4 days ago - ...(LTSS) Supervisor, the LTSS Reviewer is responsible for completing... ...inpatient and outpatient services, working closely with Service... ...Personal Assistance Services (PAS), home care (skilled) services,... ...received, nature of the request, utilization determination (and events...SuggestedRemote workFlexible hours
AmeriHealth Caritas
Newtown Square, PA2 days ago - ...Role Overview: Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient... ...;Utilization Management Reviewer must maintain a strong working knowledge of federal, state, and organizational regulations...SuggestedRemote workMonday to FridayFlexible hoursAfternoon shift
AmeriHealth Caritas
Newtown Square, PA3 days ago - ...RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside... ...Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY... ...position from the comfort of your own home as you will be responsible for the assessment...Work from homeFull timeLocal areaRemote work
VillageCare
New York, NY1 day ago $38.49 - $47.05 per hour
...healthcare? Bring your true colors to blue. The RoleThe Clinical Utilization Reviewer is responsible for facilitating care for members who may... ...optimal health. This position is self-directed and works independently and collaboratively to facilitate care using clinical...SuggestedHourly payWork at officeRemote workFlexible hoursShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA3 days ago- Job Summary: Conducts reviews of medical records and treatment plans to evaluate and... ...across the continuum of care. Identifies utilization trends, leads efforts for improvement initiatives... ...monitors progress and results. Develops work plans to meet business priorities and...SuggestedLocal area
Kaiser Permanente
Pleasanton, CA14 hours ago $45 - $62 per hour
...Direct Hire is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in White Plains, New York. Job... ...career. At Medical Solutions, you’ll find a great place to work and a career home. We’ve received Best Places to Work awards, landed top industry...Work from homeHourly payImmediate startShift workMedical Solutions Direct Hire
White Plains, NY2 days ago- ...Job Description Description: Conifer Park is looking for an Utilization Review Coordinator to join the Medical Records team at our site in... ...wages, benefits, and a pension plan in a supportive working environment. Background checks, pre-employment & drug screenings...Suggested
Conifer Park Inc.
Schenectady, NY10 days ago - ...Desk Review Specialist Kemper is one of the nations leading specialized... ...challenge, and a healthy work-life balance can be highly... ...most cost-effective parts were utilized within industry standards.... ...onsite with occasional work from home opportunities out of our local...Work from homeWork experience placementCasual workWork at officeLocal area
Kemper
Dallas, TX2 days ago - A Medical Bill Reviewer I will perform activities related to the accurate... .... Additionally, you’ll: Utilize knowledge of medical coding... ...preferred. ~1-3+ years of related work experience in a medical office... .... Monday and Friday work from home if you choose to, Tuesday...Work from homeWork experience placementWork at officeImmediate startHome officeMonday to Friday
Sentry Insurance
Stevens Point, WI14 hours ago - ...Shift 1st Shift (Days) Description Registered Nurse Utilization Reviewer At Bristol Health, we begin each day caring today for... ...The appropriate Nurse Utilization Reviewer will have a strong working knowledge of nationally recognized criteria sets including...Full timeShift workDay shift
BRISTOL HOSPITAL GROUP
Bristol, CT2 days ago - ...AHA Must-Have: Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with providers, social workers, and external agencies...Permanent employmentTemporary workFor contractorsZero hours contractImmediate startShift work
Prime Staffing
Quincy, CA3 days ago - ...tax-free stipend amount to be determined. Posted job title: RN:Utilization Review,07:00:00-19:00:00 About Voca Healthcare As a Voca... ...to support you. Voca’s experienced and dedicated travel team works in concert with you every step of the way. Our long-standing...Weekly payFor contractorsZero hours contractImmediate startShift work
Voca Healthcare
Quincy, CA2 days ago - ...tax-free stipend amount to be determined. Posted job title: Utilization Review Case Manager About Anders Group WHY ANDERS? Anders Group... ...our travelers are given the best customer service. Our team works hard to find the best jobs with the most aggressive rates!...For contractorsImmediate startShift work
Anders Group
Quincy, CA3 days ago - ...Type: Regular Time Type: Full time Work Shift: Day (United States of America)... ...The schedule is 5 8-hour shifts. The Utilization Analyst works with physicians, the payers... ...care. Using the concepts of utilization review, clinical documentation improvement and revenue...Full timeShift work
Beth Israel Lahey Health
Burlington, MA4 days ago $40 per hour
...Candidates must be based in TX. RN working in the insurance or managed care industry... ...responsible for performing initial, concurrent review activities; discharge care coordination... .... Provides information regarding utilization management requirements and operational...Full timeContract workWork at officeRemote workHireOps Staffing LLC
Dallas, TX14 hours ago- ...Job Description Position Title: Utilization Review Nurse Location: Fully Remote Position... ...cost-effective, and compliant delivery of home health care. This role monitors... ...Self-directed, flexible, and able to work independently with minimal supervision....Remote workFlexible hoursWeekend work
IntePros
Phoenix, AZ4 days ago - ...GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Los Angeles, California. Job Description... ...• Orientation every Monday • Local travelers welcome **Work Environment:** • Scrub Color: Royal/Navy Blue • PPE...Contract workFor contractorsLocal areaShift workSundayDay shift
GQR Healthcare
Los Angeles, CA4 days ago - ...tax-free stipend amount to be determined. Posted job title: Utilization Review Case Manager About Anders Group WHY ANDERS? \n Anders Group... ...our travelers are given the best customer service. Our team works hard to find the best jobs with the most aggressive rates! \...Immediate startShift work
Anders Group
Quincy, CA4 days ago - ...contract position in Quincy California . This is a 7a-3p, 07:00:00-15:00:00, 8.00-5 position in the Critical Access Hospital RN, Utilization Review RN . The ideal candidate will possess a current state license as a RN and have at least 2 years of recent experience as a...Weekly payContract workZero hours contractImmediate startShift work
Assured Nursing
Quincy, CA4 days ago - ...Job Description Job Description Utilization Review Nurse (LVN, LPN, RN Compact licenses are accepted for this position) Location - Remote "Work from Home" but must live in the state of Florida or Texas Job Purpose: Review Workers Compensation requests submitted...Work from homeLive inRemote work
- ...Job Title: Care review Clinician | Utilization review nurse Location: 100% Remote in CA Duration: 06 months+ contract (Possibility of extension... ...inpatient authorizations, Pediatrics, CCS and UM Works with the Utilization Management team primarily responsible...Contract workWork at officeRemote workShift work
Integrated Resources
Long Beach, CA14 hours ago $26.5 - $47.59 per hour
...for this role have the flexibility to work remotely from their home anywhere in the Eastern time zone.... ...rotating basis. Previous concurrent review experience is highly preferred.... ...health management systems according to utilization management policies and guidelines...Work from homeHourly payFull timePart timeWork at officeRemote workMonday to FridayFlexible hoursCentene Corporation
Richmond, VA3 days ago
