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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
    11 hours ago
  • $35 - $41 per hour

    Job Title: Utilization Review - FULLY REMOTE Job Description This role involves performing precertification...  ...review experience is a plus. Work Environment The position requires an initial...  ...person. The role is primarily work-from-home, ideally located within 2 hours of the... 
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    Actalent

    Atlanta, GA
    8 days 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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    Relocation package

    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...  ...care. Collaborates with hospital, home care, care management, and other providers... 
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    Excellus Health Plan

    Rochester, NY
    11 hours ago
  •  ...Commercial Documentation Review Specialist I Join Mercantile Bank as a Full-Time Commercial...  ...90 days, there is an opportunity to work from home 1-2 days per week) offers an opportunity...  ...a new challenge, allowing you to utilize your analytical skills in a fast-paced,... 
    Work from home
    Full time
    Flexible hours
    2 days per week
    1 day per week

    Mercantile Bank

    Grand Rapids, MI
    1 day 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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    Full time
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    Immediate start
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    GLC On-The-Go

    Greenbrae, CA
    7 days ago
  •  ...manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The...  ...motivated, detail-oriented and interested in working in a cohesive and rewarding environment. This is a remote or office/home hybrid position. Your Responsibilities... 
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    Spectrum Billing Solutions

    Skokie, IL
    24 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
  • $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
  • $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
  • $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
  •  ...Street, a nationally recognized Independent Review Organization (IRO), is expanding its...  ...Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-...  ...supplemental income Fully remote – work from anywhere You control volume and... 
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    Dane Street, LLC

    New York, NY
    more than 2 months 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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    Full time
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    Guthrie

    Cortland, NY
    26 days ago
  •  ...Dane Street: Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our...  ...supplemental income through non-traditional clinical work. Position Overview: We are currently seeking... 
    Extra income
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    Dane Street, LLC

    New York, NY
    more than 2 months ago
  •  ...Street, a nationally recognized Independent Review Organization (IRO), is expanding its...  ...preferred) licensed in Mississippi to perform Utilization Reviews . This is a non-clinical,...  ...– predictable, supplemental income Work remotely from anywhere you choose... 
    Price work
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    For contractors
    Remote work

    Dane Street, LLC

    Parchman, MS
    more than 2 months 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,... 
    Remote work

    Pacer Group

    Torrance, CA
    3 days ago
  •  ...SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for...  ...Management Reviewer must maintain a strong working knowledge of federal, state, and organizational...  ..., or Long-Term Acute Care (LTAC), home health care, or medical office... 
    Remote work
    Relocation package
    Monday to Friday
    Flexible hours
    Afternoon shift

    AmeriHealth Caritas

    Washington DC
    2 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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    Part time
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    2 days per week

    Concentric Energy Advisors

    Washington DC
    5 hours ago
  •  ...Dane Street, a nationally recognized Independent Review Organization (IRO) and a leading provider of Utilization Review (UR) services, is expanding our panel of expert...  ...New York medical license (Required) Work Location: Fully Remote / Telehealth Compensation... 
    Extra income
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    Dane Street, LLC

    New York, NY
    9 days ago
  • $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 and... 
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    Gainwell Technologies LLC

    North Carolina
    16 hours 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... 
    Local area
    Remote work
    Weekend work

    Zenex Partners

    Beverly Hills, CA
    4 days ago
  • $55 - $57 per hour

     ...Work From Home – Clinical Pharmacist Reviewer – $55 - $57/hr (MA Only) Fully remote position with a leading pharmacy team Competitive pay + professional...  ...won’t last! There are no costs for candidates utilizing our services as our clients pay for all related... 
    Work from home
    Full time
    Second job
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    ProPivotal Staffing

    Hingham, MA
    9 days ago
  •  ...Behavioral of Springfield has an immediate opening for a Full-Time Utilization Review Coordinator.  We are seeking individuals who are committed...  ...responsibilities include the following: Within two working days of admission, obtains initial certification based on established... 
    Full time
    Immediate start
    Monday to Friday
    Flexible hours
    Shift work

    Perimeter Healthcare

    Springfield, MO
    8 hours ago
  • **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials...  ...or GED required + Bachelor's Degree preferred + 0-2 years of work experience in utilization review, hospital admissions or... 
    Work experience placement
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    Local area

    Community Health Systems

    Franklin, TN
    3 days ago
  •  ...Responsibilities Utilization Review Coordinator The Carolina Center for Behavioral Health is currently hiring utilization review coordinators...  .... Benefit Highlights: Challenging and rewarding work environment • Career development opportunities • Competitive... 
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    The Carolina Center for Behavioral Health

    Greer, SC
    more than 2 months ago
  •  ...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
    Relief
    Local area

    Coastal Harbor Treatment Center

    Savannah, GA
    more than 2 months ago
  • Job Summary: Conducts reviews of medical records and treatment plans to evaluate and consult...  ...independently. Observes and identifies utilization trends and learns about addressing...  ...demonstrates flexibility in approaches to work. Assesses and responds to the needs of others... 
    Local area

    Kaiser Permanente

    Walnut Creek, CA
    7 days ago
  •  ...preferred Experience: Must have one (1) year experience in the Utilization Review process and/or two (2) years’ clinical experience in a...  ...skills, communication skills and ability to perform detailed work.  Ability to use the English language and medical terminology... 
    Full time
    Work at office
    Local area
    Immediate start
    Flexible hours

    Perimeter Healthcare

    Jackson, TN
    19 days ago