Average salary: $126,960 /yearly
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- OverviewTitle: Clinical Review Nurse - Prior Authorization ReviewLocation: Fully Remote (PST Time Zone - WA/OR Resident)Duration: 1... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent and...SuggestedRemote work
- We are seeking a DC licensed RN to perform utilization management reviews, ensuring healthcare services are medically necessary and meet quality standards. The role involves reviewing treatment plans, consulting with providers, documenting decisions, and supporting care...Suggested
$2,256.4 per month
Job Overview Our Client is currently seeking Utilization Review for positions in Washington, DC for a 5×8 Days shift. The ideal candidate will possess a current DC license or Compact license depending on the state. You must have a license and at least 1 year of recent...SuggestedShift workDay shift- Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical...SuggestedRemote workMonday to FridayFlexible hoursWeekend work
$81k - $110k
Avalon Health Care Management is now hiring a Case Manager of Utilization Management and Authorizations to join our team! Avalon Health... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of care...SuggestedFull timeContract workTemporary workImmediate start$90.87 - $154.33 per hour
A health services company is seeking a remote Physician Clinical Reviewer specializing in dermatology. The ideal candidate will provide medical review of service requests, discuss cases with physicians, and ensure proper documentation of communications. This role requires...SuggestedRemote job- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...SuggestedRemote jobFor contractorsMonday to FridayFlexible hours
- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records, and collaborating with healthcare providers to optimize care. Candidates must have a valid nursing...SuggestedRemote job
- A leading healthcare solutions provider is seeking a Clinical Care Reviewer to evaluate medical necessity for inpatient and outpatient services. This role involves reviewing provider requests, making determinations based on clinical guidelines, and collaborating with healthcare...SuggestedRemote job
$223.8k - $313.1k
...clinical determinations and uphold compliance with national guidelines. In this remote position, you will utilize your MD or DO degree and medical expertise to review care requests while collaborating with healthcare teams. A minimum of 5 years of patient care experience...SuggestedRemote job$2,256.4 per month
Specialty Professional Services, Corp. is seeking a Utilization Review professional in Washington, DC. Ideal candidates will have a current DC or Compact license and at least 1 year of experience in utilization review. The position offers a 5×8 days shift and includes...SuggestedDay shift$90k - $100k
...nonprofit treatment provider in Washington D.C. seeks a Clinical Review Clinician to oversee the clinical review process for substance... ...’s degree, active DC licensure, and extensive experience in utilization management. This full-time position offers competitive...SuggestedFull time- A healthcare organization in Washington D.C. is seeking a Clinical Utilization Review Nurse (RN) for a remote position. This full-time PRN role involves assessing medical necessity and quality of healthcare services through utilization reviews. The ideal candidate will...SuggestedRemote jobFull timeReliefWeekend workAfternoon shift
$60.63k - $107.49k
...is seeking a Care Management Coordinator to support comprehensive, quality cost-effective care. This role requires 1-2 years utilization review experience and an active DC LPN license. Key responsibilities include identifying potential case management candidates and maintaining...Suggested$2,331 - $2,561 per month
A healthcare staffing agency has an immediate opening for a Utilization Review Registered Nurse in Washington, DC. This role requires at least 1 year of experience and prefers candidates with previous charge nurse experience. The position offers competitive weekly pay...SuggestedWeekly payImmediate start- A health management firm is seeking a DC licensed RN to perform utilization management reviews. Responsibilities include reviewing treatment plans, consulting with providers, and ensuring healthcare services are necessary and meet quality standards. The ideal candidate...
$2,115 per week
Job Description & Requirements TNAA TotalMed RN is seeking a travel nurse RN Case Management for a travel nursing job in Washington, District of Columbia. Specialty: Case Management Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment...Weekly payTemporary workImmediate startShift work- ...Certified Orthopaedic Spine Surgeon, Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Work's Compensation experience is preferred but not required. This telework opportunity provides the ability to customize your...For contractorsRemote workMonday to Friday
- Position Overview We are seeking PRN Clinical Utilization Review Nurses (RN) to assess the medical necessity and quality of healthcare services through prospective, concurrent, and retrospective utilization management reviews. This full-time, remote position supports high...Full timeContract workReliefWork at officeRemote workWork from homeWeekend workAfternoon shift
$55k - $65k
...recommendations. Strategically assess business processes and procedures to improve day to day operations. Continuously developing and reviewing internal program procedures for program efficiencies and compliance. Perform test work (either individually or as a team) to...Work experience placementWork at officeRemote workUniversal Service Administrative Company
Washington DC9 days ago- Hmong Chinese Language Document Reviewer Employment Type: Full Time, Mid-Level Department: Legal As a CGS Hmong Chinese Document Reviewer... ...; Produces a variety of written documents and materials utilizing a wide range of office software applications; Establishes and...Full timeWork at officeFlexible hours
$90k - $100k
...Meaningful Work Picture Yourself at Gaudenzia as a Clinical Review Clinician at our R.A.P. Program located in Washington D.C.! We... ...master's level, licensed, clinician, with documented experience in utilization review, management, and quality assurance skills! Are you...Full timeFlexible hoursWeekend work- Lead Clinical Reviewer DC Medicaid Contract The Clinical Review Lead is responsible for designing, implementing, and evaluating reviews... ...strategic decision‑making. Skills The Clinical Reviewer Lead utilizes strong clinical knowledge and analytical skills daily to assess...Contract work
$50 - $60 per hour
We are looking for a Clinical Reviewer to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. Physicians & Advanced Practice Clinicians Physicians of all...Hourly payFull timeContract workPart timeRemote work- Join our Team as a Utility Engineer! Are you ready to play a critical role in large, exciting projects critical to improving infrastructure... ...in the District of Columbia. The role combines technical review, practical field perspective, coordination, and process tracking...Full timeFor contractorsH1bWork at office
$210k - $260k
...an alternative application process. Director - Internal Credit Review Full-time Regular Director District of Columbia, Washington, DC... ...operating segment (Farm & Ranch, Corporate AgFinance, Power & Utilities, Broadband Infrastructure, and Renewable Energy). Oversee design...Full timeContract workWork at officeFlexible hours- ...Operations Education: Professional Travel: Responsibilities The Reviewer will be trained to conduct declassification reviews in support... ...different types of documentation assigned. The Reviewer will utilize analytical skills to make determinations on documents for...Full time
- Required Qualification The contractor shall provide attorney services at the GS-9/10 or equivalent level primarily to review documents for e.g., responsiveness, issue coding, confidentiality and privilege. Other related services may include, but are not limited to, drafting...For contractorsLocal area
$60.8k - $64k
...related updates.On a quarterly basis, schedule and conduct a "state of the state" meeting with the Contractor Program Managers, Medical Review leadership team, and Contractor's small business liaison to discuss progress and necessary changes.Performance Measures /...For contractorsRemote workWork from home- Permits & Utilities Coordinator Maryland | Full-Time About Schaefer Homes At Schaefer Homes, we don’t just build houses we build homes... ...Coordinate directly with utility providers to ensure timelines are met Review plans and drawings to confirm scope and alignment Track...Full timeRelocation
