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  • Regional Utilization Review Documentation Specialist (RN)

    $78.54k - $121.72k

     ...Regional Utilization Review Documentation Specialist (RN) at TrinityHealth summary: The Regional Utilization Review Documentation Specialist...  ...Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team including physicians, staff... 
    Suggested
    Full time
    Work at office
    Local area
    Shift work
    Day shift

    TrinityHealth

    Maywood, IL
    2 days ago

  • Utilization Reviewer 2

    $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 home
    Full time
    Part time
    Local area
    Remote work
    Flexible hours

    Enlyte

    Arlington, TX
    17 hours ago

  • Utilization Review RN

     ...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 home
    Temporary work
    Work at office
    Remote work
    Monday to Friday
    Flexible hours

    Hines & Associates Inc

    Freeport, IL
    2 days ago

  • Senior Utilization Review Coordinator II (PT)

     ...Senior Utilization Review Coordinator II (PT) at Kaiser Permanente summary: The Senior Utilization...  ...monitors progress and results. Develops work plans to meet business priorities and...  ...Oakland Reg - 1950 Franklin - Rgnl Hosp-Home Health/Hospice - 0201 Pay Range: $ -... 
    Suggested
    Full time
    Work experience placement
    Local area
    Flexible hours
    Shift work

    Kaiser Permanente

    Pleasanton, CA
    1 day ago

  • Cardiologist Needed for Remote 1099 Utilization Review Work

    Overview Cardiologist Needed for Remote 1099 Utilization Review Work at Medical Review Institute of America (MRIoA). What You’ll Do Provide expert...  ...Independent contractor role (1099) Remote, work-from-home position—anywhere in the U.S. within regulatory constraints... 
    Work from home
    Remote job
    For contractors
    Flexible hours

    Medical Review Institute of America

    Dallas, TX
    1 day ago

  • Utilization Review Specialist (in-office only)

    $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... 
    Suggested
    Full time
    Work at office
    Remote work

    Quadrant Health Group

    Boca Raton, FL
    5 days ago

  • Utilization Management Nurse, Senior (Behavioral Health Post-Service Review)

     ...The Commercial Post Service Review team is responsible for clinically...  ...IOP). The RNs perform reviews utilizing the Blue Shield of California...  .... Responsibilities Your Work In this role, you will:...  ...physical offices and work from home office/deskwork - Activity level... 
    Work from home
    Full time
    Part time
    Work at office
    Local area
    Remote work
    Home office
    1 day per week

    Blue Shield Of California

    Rancho Cordova, CA
    17 hours ago

  • Document Reviewer (McLean)

    $28 per hour

     ...jurisdiction and desire an engaging work environment where they are...  ...an ongoing need for Document Reviewers. Document Reviewers will...  ...Details ~ Remote work-from-home opportunity ~ Pay rate: $2...  .... ~ Proficiency in utilizing modern technology, especially... 
    Work from home
    Temporary work
    Part time
    Remote work
    Home office
    Monday to Thursday
    Flexible hours

    KLDiscovery

    McLean, VA
    1 day ago

  • staff - Registered Nurse (RN) - Case Manager, Utilization Review - $45-62 perhour

     ...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 home
    Full time
    Immediate start
    Shift work

    Medical Solutions Direct Hire

    White Plains, NY
    2 days ago

  • Senior Utilization Review Coordinator I (LVN)

     ...Senior Utilization Review Coordinator I (LVN) at Kaiser Permanente summary: The Senior Utilization...  ...flexibility in approaches to work; champions change and helps others adapt...  ...Oakland Reg - 1950 Franklin - Rgnl Hosp-Home Health/Hospice - 0201 Pay Range: $ -... 
    Suggested
    Full time
    Work experience placement
    Local area
    Flexible hours
    Shift work

    Kaiser Permanente

    Oakland, CA
    2 days ago

  • After Hours Behavioral Health Utilization Management Reviewer

     ...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.... 
    Suggested
    Remote work
    Flexible hours
    Saturday

    AmeriHealth Caritas

    Newtown Square, PA
    17 hours ago

  • Pediatric Utilization Management Reviewer

     ...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.... 
    Suggested
    Contract work
    Remote work
    Monday to Friday
    Flexible hours
    Shift work

    AmeriHealth Caritas

    Newtown Square, PA
    2 days ago

  • Utilization Management Reviewer

     ...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... 
    Suggested
    Remote work
    Monday to Friday
    Flexible hours
    Afternoon shift

    AmeriHealth Caritas

    Newtown Square, PA
    1 day ago

  • Long Term Services & Support Reviewer Utilization Management

     ...(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... 
    Suggested
    Remote work
    Flexible hours

    AmeriHealth Caritas

    Newtown Square, PA
    17 hours ago

  • Utilization Review Nurse

     ...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 home
    Full time
    Local area
    Remote work

    VillageCare

    New York, NY
    4 days ago

  • Utilization Review Nurse- Remote

    $65k - $78k

     ...challenges. Join us and put your expertise to work in ways you never imagined possible. We...  ...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization,...  ...What you should expect in this role Home-based position. High-speed internet... 
    Work from home
    Full time
    Contract work
    Work at office
    Remote work
    Flexible hours

    Gainwell Technologies

    Wilmington, NC
    17 hours ago

  • RN Utilization Management Reviewer

    $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... 
    Hourly pay
    Work at office
    Remote work
    Flexible hours
    Shift work

    Blue Cross Blue Shield of Massachusetts

    Hingham, MA
    1 day ago

  • Work From Home - Clinical Pharmacist Reviewer - $57/hour (MA Only)

    $57 per hour

     ...Work From Home - Clinical Pharmacist Reviewer - $57/hour (MA Only) ~ Fully remote position with a leading pharmacy team ~$57/hour pay rate + professional...  ...role won't last! There are no costs for candidates utilizing our services as our clients pay for all related... 
    Work from home
    Hourly pay
    Second job
    Remote work

    Professional Staffing Group

    Hingham, MA
    1 day ago

  • Utilization Review Coordinator

    Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our...  ...apply. Website: Benefit Highlights Challenging and rewarding work environment Competitive Compensation & Generous Paid Time... 
    Full time
    Local area

    UHS

    Brookline, MA
    4 days ago

  • Utilization Review Coordinator

    Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our...  ...individuals to apply. Website: Benefits Challenging and rewarding work environment Competitive Compensation & Generous Paid Time... 
    Full time

    Clive Behavioral

    Brookline, MA
    4 days ago

  • Utilization Review Coordinator

    Join to apply for the Utilization Review Coordinator role at HRI Hospital Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital...  ...development. Benefit Highlights Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off... 
    Full time

    HRI Hospital

    Brookline, MA
    4 days ago

  • Quality Utilization Reviewer I

     ...Job Summary The UR Reviewer 1 is responsible for performing inpatient admission...  ...accredited School of Nursing or Social Work. ~ Experience ~2 years experience...  ...related field (i.e. 3rd party payer) ~ Utilization review experience preferred.... 

    Children's of Alabama

    Birmingham, AL
    4 days ago

  • Utilization Reviewer

    $40.61 - $60.96 per hour

     ...Under general supervision, provides utilization review and denials management for an assigned patient...  ...the general nature and level of work being performed by staff assigned to this...  ...CPUR) preferred. Additional experience in home health, ambulatory care, and/or occupational... 
    Relocation package

    University of Maryland Medical System

    Upper Marlboro, MD
    4 days ago

  • UTILIZATION REVIEW COORDINATOR (Orlando)

     ...reimbursement, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting. This...  ...and payer expectations for patient acuity and appropriate utilization. Works collectively with hospital operations (social services,... 
    Part time
    Work at office
    Local area
    Shift work
    Day shift

    Universal Health Services, Inc.

    Orlando, FL
    7 days ago

  • Utilization Review Coordinator - PRN (West Columbia)

     ...of 300+ high quality employees describe working here as " family atmosphere," "supportive...  ...incoming patients. Coordinates the utilization management functions of a patient caseload...  ...treatment team and performance of reviews, with external review organizations/managed... 
    Daily paid
    Part time
    Relief
    Local area
    Day shift

    Universal Health Services, Inc.

    West Columbia, SC
    7 days ago

  • Utilization Review Coordinator - Behavioral Health - PRN (Savannah)

     ...Responsibilities Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per Diem To coordinate and direct  Utilization...  .... Benefit Highlights: ~ Challenging and rewarding work environment ~ Competitive compensation, Paid Time Off ~ Excellent... 
    Daily paid
    Temporary work
    Part time
    Relief
    Local area

    Universal Health Services, Inc.

    Savannah, GA
    7 days ago

  • RN Utilization Review Part- time Day

    $56.44 - $87.63 per hour

     ...prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical...  ...Nurse License. ~2 years Experience working in a remote UR environment or working...  ...outreach programs, and hospice and home care, and even our own Providence High... 
    Part time
    Local area
    Remote work
    Shift work

    Providence Health and Services

    Santa Clarita, CA
    17 hours ago

  • Travel Nurse Manager RN - Utilization Review - $2,200 per week

     ...Rang Healthcare is seeking a travel nurse RN Utilization Review Manager for a travel nursing job in Madison, Wisconsin. Job Description &...  .... Ensuring that patients have transport to and from their homes and all pertinent healthcare facilities. Meeting with members... 
    Weekly pay
    Contract work
    For contractors
    Local area
    Shift work

    Rang Healthcare

    Madison, WI
    8 hours agonew

  • Travel Nurse Manager RN - Utilization Review - $3,088 per week

     ...Rang Healthcare is seeking a travel nurse RN Utilization Review Manager for a travel nursing job in Albuquerque, New Mexico. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 11/03/2025 ~ Duration: 13 weeks ~40... 
    Weekly pay
    Contract work
    For contractors
    Local area
    Shift work
    Day shift

    Rang Healthcare

    Albuquerque, NM
    1 day ago

  • Travel RN Case Manager (Utilization Review) - $3,336 per week

    $8 per hour

     ...Travel RN Case Manager (Utilization Review) - $3,336 per week at Host Healthcare summary: The Travel RN Case Manager (Utilization Review) provides specialized nursing care focused on case management for a 13-week travel assignment in Bakersfield, California. This role... 
    Full time
    Shift work

    Host Healthcare

    Bakersfield, CA
    5 days ago