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  •  ...Utilization Management Nurse Reviewer The Utilization Management Nurse Reviewer plays a crucial role in healthcare...  ...PRN nurses will be required to work at least one weekend per month, one major...  ...and computer work. Work From Home Technical Requirements: Supply and... 
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    Dane Street

    Scranton, PA
    9 hours 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...  ...promote optimal health. This position is self-directed and works independently and collaboratively to facilitate care using... 
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    Blue Cross Blue Shield of Massachusetts

    Hingham, MA
    2 days ago
  •  .... We are currently seeking a dedicated Utilization Reviewer to join our dynamic team. Why Choose...  ...resources, strong EAP services, and a healthy work-life balance in a supportive...  ...CPUR) preferred. Additional experience in home health, ambulatory care, and/or occupational... 
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    University of Maryland Medical System

    Largo, MD
    8 days ago
  •  ...coordinating, integrating, and monitoring the utilization of behavioral health (BH) services...  ...cases to the Medical Director for review. Refer to and work closely with Case Management to...  ...of care. Collaborates with hospital, home care, care management, and other providers... 
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    Univera Healthcare

    Buffalo, NY
    9 hours ago
  • $19.5 - $26 per hour

     ...About the job Document Review and Data Entry Specialist Job details Salary...  ...pride ourselves on providing our employees a work experience built on family values. Our...  ...the following: Use TRAX program areas utilized for Maintenance personnel and perform setup... 
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    RemoteOnline

    San Francisco, CA
    5 days ago
  • Join to apply for the Utilization Review Appeals Specialist role at Michigan Medicine . Talent Acquisition...  ...The Audit and Appeals Specialist works in Revenue Cycle. They work closely with...  ...timeframe. Work Locations Work From Home position or Alternate: Onsite in Ann Arbor... 
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    Michigan Medicine

    Ann Arbor, MI
    2 days ago
  •  ...rewarding journey with GLC - a recruiter will connect quickly to review pay , start date , and assignment details so you can...  ...be determined. Posted job title: CA - RN Case Manager (Strong Utilization Review (InterQual) exp REQUIRED) M-F, no weekends - Rate...... 
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    GLC On-The-Go

    Greenbrae, CA
    7 days ago
  • $35 - $50 per hour

     ...Description JobTitle : Retro Claims Reviewer Location : West Hills/Canoga Park 91...  ...Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong...  ...and communication skills ~ Ability to work independently and prioritize tasks ~ Proficiency... 
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    TEKsystems

    Los Angeles, CA
    4 days ago
  • $20.38 - $31.81 per hour

     ...Job Description Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician...  ...and Care Coordination Additionally, the position works closely with the Care Coordination department to support... 
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    Guthrie

    Cortland, NY
    26 days ago
  •  ...levels of care (inpatient, Extended Hospital Outpatient and OBS). 3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group) • InterQual required, this is a Hardstop • Experience with HMOs,... 
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    Pacer Group

    Torrance, CA
    3 days ago
  •  ...Employment Type: Travel Description: RN-Case Manager/Utilization Review/CDI (clinical documentation improvement) Must have...  ...including hospitals, clinics, rehabilitation centers, old-age homes, schools, correctional facilities, and more. At HonorVet,... 
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    HonorVet Technologies

    Syracuse, NY
    26 days ago
  •  ...Wilshire Blvd, Beverly Hills, CA Required: * RN license in CA * 3 years of clinical experience in hospital or urgent care * Utilization review experience * Knowledge of ICD10, CPT, HCPC * Familiarity with HMO, PPO, POS Preferred: * Managed care experience * Knowledge... 
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    Zenex Partners

    Beverly Hills, CA
    4 days ago
  • $114k - $161k

     ...Principal Consultant - Utility Return on Equity & Cost of Capital Specialist Join to apply...  ..., we immerse our employees in a hard-working, collegial and cooperative culture with the...  ...hybrid model, with flexibility to work from home two days a week. Duties &... 
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    2 days per week

    Concentric Energy Advisors

    Washington DC
    2 hours ago
  • $2,312.8 - $2,407.8 per month

     ...GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Medford, Wisconsin. Job Description...  ...aligning with your goals, values, and the way you want to work. As an award-winning talent partner, we support healthcare... 
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    GQR Healthcare

    Medford, WI
    5 days ago
  • $3,579 per month

     ...GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Los Angeles, California. Job Description...  ...aligning with your goals, values, and the way you want to work. \n \nAs an award-winning talent partner, we support... 
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    GQR Healthcare

    Los Angeles, CA
    29 days ago
  • Hematology/Oncology Physician - Utilization Review Remote - Flexible Independent Contractor (1099) Opportunity...  ...complete No minimum case requirements - work as much or as little as you’d like Additional Details Remote, work‑from‑home position - work anywhere in the U.S.... 
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    Medical Review Institute of America

    Dallas, TX
    4 days ago
  •  ...About the job Work From Home Remote Data Entry Operator Description The Data...  ...Appropriate data in prescribed format, utilizing basic knowledge of computer software or...  ...for the Help Desk technicians to review. The data entry clerk will review each... 
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    Easy Recruiter

    United States
    1 day ago
  •  ...Title: EMS Billing - Special Utilities Group - Digitech - Remote Req...  ...(Insurance Biller) to work claims after theyve been submitted...  ...This role is a remote, work from home position. The Claims...  ...rejected by the clearinghouse. Review claims that have been put on hold... 
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    Monday to Friday

    Sarnova

    United States
    1 day ago
  •  ...awarded health system located north of Philadelphia, Pennsylvania, is seeking an Emergency Medicine physician to work in a non-clinical utilization review setting. Opportunity Highlights ~ Daytime Monday through Friday position. Potential to work remotely part of... 
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    Enterprisemed

    Abington, PA
    2 days ago
  • $1,099 per month

    Join to apply for the ENT - Utilization Review - Remote- 1099 Contractor role at Medical Review Institute...  ...and healthcare plan guidelines. Work remotely with flexible hours, as little...  ...office equipment. Role is remote (work-from-home). Legal and Privacy California... 
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    Medical Review Institute of America

    Dallas, TX
    5 days ago
  • $3,000 per month

     ...earn extra income from the comfort of your home? We are looking for motivated individuals...  ...online surveys, secret shopping, and product reviews. If you enjoy sharing your opinion and...  ...Choose Us? You have the flexibility to work either from home or in-person, with the option... 
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    Maxion Research

    Stow, OH
    3 days ago
  • $790 per week

     ...looking for temporary, remote, part-time work. The hours are flexible and no previous experience...  ...commute needed if you choose to work from home. No minimum hours. You can do this part...  ...feedback of their products. You get to review and use new products or services before... 
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    Maxion Research

    Graham County, KS
    1 day ago
  • $70 - $74 per hour

     ...Talent4Health is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Cambridge, Massachusetts. Job Description...  ...tool criteria experienceMust have acute care experienceMust work every other major holidayEMR Exp Required(or Preferred): EPIC... 
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    Local area
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    Monday to Friday
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    Talent4Health

    Cambridge, MA
    5 days ago
  •  ...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... 
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    Integrated Resources

    Long Beach, CA
    1 day 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.... 
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    IntePros

    Phoenix, AZ
    20 days ago
  • $20 per hour

     ...Job Description Laboratory Document Review and Data Analytics Specialist Title :...  ...inconsistencies, and errors in documentation and work collaboratively with laboratory personnel...  ...hire and executive search services. SRG utilizes an innovative approach to identify and... 
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    The Staffing Resource Group Inc

    Storrs, CT
    3 days ago
  • $8 per hour

     ...Description Job Opportunity: Registered Nurse - Utilization Review Facility: CSMN - 8714024 - MNS Quality Management Location: Los...  ...process improvement * BLS Preferred: * BSN * Prior work in an ambulatory healthcare setting * ACLS Primary... 
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    Zenex Partners

    Los Angeles, CA
    3 days ago
  •  ...Job Title: Utilization Management RN Location: Remote – must reside within the PA/NJ/DE tri-state area for potential conversion to...  ...members’ clinical conditions through detailed medical record review to determine medical necessity for services. Using advanced clinical... 
    Full time
    Part time
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    IntePros

    Philadelphia, PA
    4 days ago
  • $71.1k - $97.8k

     ...help us put health first The Utilization Management Nurse 2 utilizes...  ...Management Nurse 2 work assignments are varied and frequently...  ...management or related activities reviewing criteria to ensure...  ...Various Time Zones) Work-At-Home Requirements: To ensure Home... 
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    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
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    Home office
    Monday to Friday

    Humana

    Sacramento, CA
    3 days ago
  • $2,366 per week

     ...• Start Date: • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel Case Management and Utilization Review Discharge planning Shift: 4x10's (Fri, Sat, Sun, Mon) 8am - 6pm WEEKENDS REQUIRED No Call Minimum 4 yrs exp required. NO FIRST... 
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    Protouch Staffing

    Kinston, NC
    1 day ago