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$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, TX4 days 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 workWork at officeRemote workMonday to FridayFlexible hours
Hines & Associates Inc
Freeport, IL1 day ago - 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 homeRemote jobFor contractorsFlexible hours
$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, FL4 days ago- ...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 homeFull timePart timeWork at officeLocal areaRemote workHome office1 day per week
Blue Shield Of California
Rancho Cordova, CA4 days ago $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 homeTemporary workPart timeRemote workHome officeMonday to ThursdayFlexible hoursKLDiscovery
McLean, VA3 hours agonew$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, IL2 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, NY1 day 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, PA4 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, PA1 day 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, PA14 hours 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, PA4 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, NY3 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
$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... ...role won't last! There are no costs for candidates utilizing our services as our clients pay for all related...Work from homeSecond jobRemote work$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 homeFull timeContract workWork at officeRemote workFlexible hoursGainwell Technologies
Wilmington, NC4 days 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...Hourly payWork at officeRemote workFlexible hoursShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA14 hours ago$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 packageUniversity of Maryland Medical System
Upper Marlboro, MD3 days ago- ...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, AL3 days ago - ...Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join... ...: Benefit Highlights ~ Challenging and rewarding work environment ~ Competitive Compensation & Generous Paid Time...Full timePart timeLocal area
Universal Health Services, Inc.
Brookline, MA4 days ago - ...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 timeWork at officeLocal areaShift workDay shift
Universal Health Services, Inc.
Orlando, FL5 days ago - ...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 paidPart timeReliefLocal areaDay shift
Universal Health Services, Inc.
West Columbia, SC5 days 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 paidTemporary workPart timeReliefLocal area
Universal Health Services, Inc.
Savannah, GA5 days ago - ...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 payContract workFor contractorsLocal areaShift workDay shift
Rang Healthcare
Albuquerque, NM2 hours agonew - ...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 homePart timeWork experience placementCasual workWork at officeLocal area
Kemper
Dallas, TX2 hours agonew - ...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, CA5 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, CA5 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, CA4 days ago $23.2 per hour
Utilization Review Specialist - Full Time, Days (Hollywood) Utilization Review Specialist - Full Time... ...systems. Clears all providers, such as home health, LTACH, SNF, board and care,... ...Knowledge of utilization management 2 years works experience Must demonstrate customer service...Full timeWork experience placementWork at office- ...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, CA6 days ago
