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  •  ...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... 
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    Monday to Friday
    Flexible hours

    JobTarget

    Freeport, IL
    1 day ago
  • $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
    3 days 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... 
    Suggested
    Full time
    Work at office
    Local area
    Shift work
    Day shift

    Trinity Health

    Maywood, IL
    1 day 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 home
    Full time
    Immediate start
    Shift work

    Medical Solutions Direct Hire

    White Plains, NY
    5 days 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... 
    Suggested
    Full time
    Part time
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    Quadrant Health Group

    Boca Raton, FL
    6 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.... 
    Suggested
    Remote work
    Flexible hours
    Saturday

    AmeriHealth Caritas

    Newtown Square, PA
    3 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.... 
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    Contract work
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    Monday to Friday
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    AmeriHealth Caritas

    Newtown Square, PA
    5 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... 
    Suggested
    Remote work
    Monday to Friday
    Flexible hours
    Afternoon shift

    AmeriHealth Caritas

    Newtown Square, PA
    4 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... 
    Suggested
    Remote work
    Flexible hours

    AmeriHealth Caritas

    Newtown Square, PA
    3 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... 
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    Full time
    Local area
    Remote work

    VillageCare

    New York, NY
    2 days ago
  • $25 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...  ...required. ~ Proficiency in utilizing modern technology, especially... 
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    Hourly pay
    Temporary work
    Part time
    Remote work
    Home office
    Monday to Thursday
    Flexible hours

    KLDiscovery

    Memphis, TN
    4 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... 
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    Hourly pay
    Work at office
    Remote work
    Flexible hours
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    Blue Cross Blue Shield of Massachusetts

    Hingham, MA
    4 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... 
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    Kaiser Permanente

    Pleasanton, CA
    1 day 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... 
    Suggested
    Full time
    Part time
    Local area

    Universal Health Services, Inc.

    Brookline, MA
    3 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,... 
    Suggested
    Part time
    Work at office
    Local area
    Shift work
    Day shift

    Universal Health Services, Inc.

    Orlando, FL
    4 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... 

    Conifer Park Inc.

    Schenectady, NY
    11 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 paid
    Temporary work
    Part time
    Relief
    Local area

    Universal Health Services, Inc.

    Savannah, GA
    4 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 paid
    Part time
    Relief
    Local area
    Day shift

    Universal Health Services, Inc.

    West Columbia, SC
    4 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 home
    Work experience placement
    Casual work
    Work at office
    Local area

    Kemper

    Dallas, TX
    3 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 home
    Work experience placement
    Work at office
    Immediate start
    Home office
    Monday to Friday

    Sentry Insurance

    Stevens Point, WI
    1 day 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 time
    Shift work
    Day shift

    BRISTOL HOSPITAL GROUP

    Bristol, CT
    3 days ago
  •  ...Responsibilities Utilization Review Specialist Opportunity Emerald Coast Behavioral Hospital provides inpatient treatment services...  ...-ups on all appeals for resolution. Maintains denial log. Works within the organization's utilization management plan in... 
    Part time
    Local area

    Universal Health Services, Inc.

    Panama City, FL
    4 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 employment
    Temporary work
    For contractors
    Zero hours contract
    Immediate start
    Shift work

    Prime Staffing

    Quincy, CA
    3 days ago
  •  ...Responsibilities Utilization Review Specialist Rivendell Behavioral Health Services is an 80-bed full-service behavioral healthcare...  ...available options for patients. Maintains a good working relationship with referral sources as well as knowledge of community... 
    Full time
    Part time
    Local area
    Immediate start

    Universal Health Services, Inc.

    Benton, AR
    4 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 contractors
    Immediate start
    Shift work

    Anders Group

    Quincy, CA
    3 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 pay
    For contractors
    Zero hours contract
    Immediate start
    Shift work

    Voca Healthcare

    Quincy, CA
    3 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 work
    For contractors
    Local area
    Shift work
    Sunday
    Day shift

    GQR Healthcare

    Los Angeles, CA
    5 days ago
  •  ...Type: Per Diem Time Type: Part time Work Shift: Day (United States of America)...  ...Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers...  .... Using the concepts of utilization review, clinical documentation improvement and revenue... 
    Daily paid
    16 hours
    Part time
    Shift work
    Weekend work

    Beth Israel Lahey Health

    Burlington, MA
    4 days 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 work
    Flexible hours
    Weekend work

    IntePros

    Phoenix, AZ
    5 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 start
    Shift work

    Anders Group

    Quincy, CA
    5 days ago