Remote Utilization Management Jobs
Remote from:
Software Development 17838B2B Sales & Account Management 10968CRM & Direct Marketing 10917Product 9303Back-End Development 9223Management and Leadership 8423Data and Analytics 8147finance 8094IT & Engineering 6553Enterprise Sales 6500Project & Program Management 5958Customer Support & Service 5958Sustainability & CSR 5474Sales Leadership & Strategy 5011DevOps & Infrastructure 4737Growth & Performance 3338Front-End Development 2857
364 jobs
Sort by:
Manager, Clinical Pharmacy Operations (Medicare Part D)
Manager, Clinical Pharmacy Operations (Medicare Part D)
1 day ago
Centene Corporation
- Remote: Alabama (USA), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Connecticut (USA), Delaware (USA), District of Columbia (USA), Florida (USA), Georgia (USA), Idaho (USA), Illinois (USA), Indiana (USA), Iowa (USA), Kansas (USA)
- Full time
General SurgeryMedicare Part DPharmacy OperationsIndividual Financial GoalsStep TherapyPerformance Management
Utilization Review Clinician (RN, PT, OT) - Oregon
Utilization Review Clinician (RN, PT, OT) - Oregon
1 day ago
WellSky
- Remote: Oregon (USA)
- Full time
Care CoordinationUtilization ManagementMedical GuidelineNursingInterQual CriteriaMedical Software
Career Opportunities: RN Clinical Systems Trainer (24913)
Career Opportunities: RN Clinical Systems Trainer (24913)
1 day ago
CareOregon
- Remote: Arizona (USA), Idaho (USA), Montana (USA), Nevada (USA), Oregon (USA), Texas (USA), Utah (USA), Washington (USA), Wisconsin (USA)
- Full time
Medical GuidelineNursingUtilization ManagementClinical Data ManagementInterQual CriteriaChange Management
Care Management Social Worker
Care Management Social Worker
1 day ago
Cambia Health Solutions
- Remote: Idaho (USA), Oregon (USA), Utah (USA), Washington (USA)
- Full time
Care ManagementBehavioral HealthCare ManagementHealthcare Industry KnowledgeCare CoordinationOrganizational Structure
Utilization Review Specialist
Utilization Review Specialist
1 day ago
Bradford Health Services
- Remote: Alabama (USA), Mississippi (USA)
- Freelance
Insurance LawUtilization ManagementClinical DocumentationQuality AssessmentOffice Equipment
Resource Management Coordinator
Resource Management Coordinator
1 day ago
GuidePoint Security
- Remote: United States
- Full time
Identity And Access ManagementProject ManagementResource ManagementSalesforceProfessional Services AutomationGeneral Security
Medical Director
Medical Director
1 day ago
Highmark Health
- Remote: Alabama (USA), Alaska (USA), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Connecticut (USA), Delaware (USA), District of Columbia (USA), Florida (USA), Georgia (USA), Hawaii (USA), Idaho (USA), Illinois (USA), Indiana (USA)
- Full time
Utilization ManagementMedical ManagementManaged CareClinical ConsultingOnline CommunicationMedical Software
Utilization Management Coordinator (Home-Based) - Prior Authorization
Utilization Management Coordinator (Home-Based) - Prior Authorization
1 day ago
Sanford Health
- Remote: United States
- Full time
Authorization (Computing)Utilization ManagementCoding TheoryHealth Reimbursement ArrangementData ManagementInternal Communications
Utilization Review Clinician (RN, PT, OT) - Remote
Utilization Review Clinician (RN, PT, OT) - Remote
1 day ago
WellSky
- Remote: United States
- Full time
Care CoordinationUtilization ManagementMedical GuidelineMedical NecessityInterQual CriteriaCare Management
Physician Utilization Reviewer (Medical Director)
Physician Utilization Reviewer (Medical Director)
2 day ago
Medical Review Institute
- Remote: Utah (USA)
- Full time
Clinical Data AnalysisUtilization ManagementClinical MedicineCommunity AdvocacyFamily MedicineHospital Experience
Career Opportunities: Help Desk Representative - Healthcare - Remote US (29667)
Career Opportunities: Help Desk Representative - Healthcare - Remote US (29667)
1 day ago
Gainwell Technologies LLC
- Remote: United States
- Full time
Problem ManagementIncident ManagementHealth Care IndustryOffice ManagementUtilization ManagementComputer Systems
Speech Therapist /Clinical Reviewer - eviCore - Work at Home
Speech Therapist /Clinical Reviewer - eviCore - Work at Home
1 day ago
The Cigna Group
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementMedical GuidelineSpeech TherapyPediatricsGeriatrics
Clinical Appeals Nurse (PRN)
Clinical Appeals Nurse (PRN)
1 day ago
Netsmart
- Remote: United States
- Part time
AppealsMedical Record ManagementNurse Licensure CompactHealth PoliciesMedicareHuman Interface Guidelines
Clinical Review Pharmacist (Remote)
Clinical Review Pharmacist (Remote)
3 day ago
Medical Review Institute
- Remote: Utah (USA)
- Full time
Utilization ManagementClinical Quality ManagementPeer ReviewQualification Protocols (IQ/OQ/PQ)Regulatory CompliancePharmacy Benefit Management
Utilization Management Nursing
Utilization Management Nursing
2 day ago
Humana
- Remote: Florida (USA)
- Full time
Utilization ManagementClinical NursingNurse Licensure CompactClinical AssessmentsManaged CareCall Center Experience
Clinical Integration Liaison - Licensed/Remote in CA
Clinical Integration Liaison - Licensed/Remote in CA
5 day ago
Magellan Health
- Remote: California (USA)
- Full time
Clinical Data ExchangeUtilization ManagementProject ManagementMental Health EducationAddiction CounselingMental Health Counseling
Medical Management Specialist Sr
Medical Management Specialist Sr
1 day ago
Elevance Health
- Remote: Indiana (USA), Virginia (USA)
- Full time
Utilization ManagementMedical ManagementCare ManagementQuality AssessmentMedicaidMedicare
Clinical Admissions Therapist (New Hampshire)
Clinical Admissions Therapist (New Hampshire)
3 day ago
Charlie Health
- Remote: New Hampshire (USA)
- Full time
TelehealthPsychosocial AssessmentsMental Health AssessmentsMental Health AssessmentsUtilization ManagementElectronic Medical Record
Physician Utilization Reviewer (Medical Director)
Physician Utilization Reviewer (Medical Director)
2 day ago
Medical Review Institute
- Remote: California (USA)
- Full time
Utilization ManagementClinical MedicineBasic Patient CareAdjudicationFamily MedicineMedical Licensing (Health Law)
Grievance and Appeals Nurse Specialist
Grievance and Appeals Nurse Specialist
3 day ago
Partnership HealthPlan of California
- Remote: California (USA)
- Full time
Care ManagementGrievance ArbitrationUtilization ManagementClinical AssessmentsDocumentation GenerationNurse Licensure Compact
Utilization Management Coord
Utilization Management Coord
3 day ago
Health Care Service Corporation
- Remote: Texas (USA)
- Full time
Utilization ManagementNursingClinical AssessmentsMedical AbbreviationsCare CoordinationData Collection
Utilization Review Clinician - ABA
Utilization Review Clinician - ABA
2 day ago
Centene Corporation
- Remote: Florida (USA)
- Full time
Utilization ManagementBehavioral HealthApplied Behavior AnalysisNurse Licensure CompactBehavioral HealthHospital Experience
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
2 day ago
Bright Health
- Remote: California (USA)
- Full time
Utilization ManagementMedical GuidelineElectronic Health Record ApplicationsMedical NecessityInterQual CriteriaCare Management
Medical Director - Medical Oncology - eviCore - Remote
Medical Director - Medical Oncology - eviCore - Remote
7 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
Evidence-Based PracticeClinical AssessmentsMedical OncologyCare ManagementMedical Licensing (Health Law)Utilization Management
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
2 day ago
NeueHealth
- Remote: California (USA)
- Full time
Utilization ManagementMedical GuidelineMedical NecessityElectronic Health Record ApplicationsCare ManagementUtilization Management
Telecommute Medical Review Stream Physician
Telecommute Medical Review Stream Physician
20 day ago
Concentra
- Remote: New Mexico (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Business NegotiationAnesthesiologyNeurosurgery
Utilization Management Nurse (MLTC Focus) - Remote
Utilization Management Nurse (MLTC Focus) - Remote
8 day ago
Morgan Stephens
- Remote: New York (USA)
- Part time
MedicaidUtilization ManagementNurse Licensure CompactClinical Data AnalysisInpatient CareCare Management
Supervisor, Clinical Review
Supervisor, Clinical Review
30+ days ago
Comagine Health
- Remote: United Kingdom
- Senior (5-10 years)
- 81 - 113K
Medical ManagementMedicaid Management Information Systems (MMIS)Recruitment StrategiesUtilization ManagementInterQual CriteriaOrganizational Structure
National Medical Director
National Medical Director
30+ days ago
CorVel Corporation
- Remote: Virginia (USA)
- Part time
- Expert & Leadership (>10 years)
Regulatory ComplianceUtilization ManagementOnline CommunicationCPT CodingProject CollaborationClinical Documentation
Payment Integrity Clinician - (Remote)
Payment Integrity Clinician - (Remote)
9 day ago
Highmark Health
- Remote: Pennsylvania (USA)
- Full time
Coding TheoryInsurance ReviewsClinical AssessmentsAnalyticsClient EducationMedical Record Management
Utilization Management Nurse (MLTC Focus) - Remote
Utilization Management Nurse (MLTC Focus) - Remote
8 day ago
Morgan Stephens
- Remote: New York (USA)
- Part time
MedicaidUtilization ManagementNurse Licensure CompactClinical Data AnalysisInpatient CareCare Management
Utilization Management Nurse (MLTC Focus) - Remote
Utilization Management Nurse (MLTC Focus) - Remote
21 day ago
Morgan Stephens
- Remote: New York (USA)
- Part time
Clinical Data AnalysisUtilization ManagementMedicaidNurse Licensure CompactCare ManagementLead Time Reduction
UM Administration Coordinator
UM Administration Coordinator
3 day ago
Humana
- Remote: Kentucky (USA)
- Full time
Medical AbbreviationsUtilization ManagementHelp Desk SupportBasic Patient CareICD Coding (ICD-9/ICD-10)Help Desk Support
Clinical Appeals Consultant
Clinical Appeals Consultant
5 day ago
Intermountain Health
- Remote: Utah (USA)
- Full time
AppealsUtilization ManagementRegulatory ComplianceClinical AssessmentsHealth PoliciesInsurance Reviews
Registered Nurse-Access Care- UMC-Remote Work-36 Hours-Midnights-Detroit
Registered Nurse-Access Care- UMC-Remote Work-36 Hours-Midnights-Detroit
30+ days ago
Henry Ford Health
- Remote: Michigan (USA)
- Full time
Utilization ManagementNursingCare ManagementClinical AssessmentsEvidence-Based PracticeRegulatory Compliance
Utilization Review Nurse
Utilization Review Nurse
22 day ago
Sidecar Health
- Remote: Florida (USA), Georgia (USA), Kentucky (USA), Ohio (USA)
- Full time
Utilization ManagementMedical GuidelineNursingMedical NecessityOnline CommunicationPrior Authorization
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: Michigan (USA)
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
USRN
USRN
30+ days ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
- Junior (1-2 years)
Utilization ManagementWorkers' Compensation Claims
Clinical Specialist - Performance Improvement
Clinical Specialist - Performance Improvement
5 day ago
Detroit Wayne Integrated Health Network
- Remote: Michigan (USA)
- Full time
Utilization ManagementProject ManagementQuality AssessmentBehavioral HealthEducational AssessmentQualification Protocols (IQ/OQ/PQ)
Registered Nurse
Registered Nurse
30+ days ago
US Tech Solutions
- Remote: Louisiana (USA)
- Full time
- Mid-level (2-5 years)
Utilization ManagementPrior Authorization
Strategy & Business Development Analyst II
Strategy & Business Development Analyst II
3 day ago
Essentia Health
- Remote: North Dakota (USA)
- Full time
AnalyticsMarket AnalysisBusiness IntelligencePerformance AnalyticsQualitative Data AnalysisDatabase Management
Licensed Vocational Nurse
Licensed Vocational Nurse
30+ days ago
US Tech Solutions
- Remote: Georgia (USA)
- Full time
- Mid-level (2-5 years)
Utilization ManagementPrior Authorization
Clinical Facilitator, RN or SW
Clinical Facilitator, RN or SW
21 day ago
Healthfirst
- Remote: New York (USA)
- Full time
Support EngineeringAdult Learning PrinciplesClinical PracticesCurriculum DevelopmentOnline CommunicationEvidence-Based Practice
USRN (Utilization Review)
USRN (Utilization Review)
30+ days ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
- Junior (1-2 years)
Utilization ManagementMedical Insurance ClaimsMedical Record Management
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: Michigan (USA)
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
Healthcare Data Entry! UR Index Intake Coordinator - REMOTE! Mon- Fri 10am - 7pm PST
Healthcare Data Entry! UR Index Intake Coordinator - REMOTE! Mon- Fri 10am - 7pm PST
18 day ago
EK Health Services Inc.
- Remote: Idaho (USA)
- Full time
Case Management SystemsData EntryUtilization ManagementLaser ScanningMedical AbbreviationsOrganizational Structure
Director, Utilization Management
Director, Utilization Management
9 day ago
Centene Corporation
- Remote: Ohio (USA)
- Full time
Performance ImprovementUtilization ManagementBudget ManagementPolicy DevelopmentAnalyticsRegulatory Compliance
Clinical Operations Manager (Internal Only)
Clinical Operations Manager (Internal Only)
2 day ago
NOCD
- Remote: United States
- Full time
Medical ManagementOrganisational PoliciesUtilization ManagementCerner EHRClinical AssessmentsTelehealth
Utilization Review Nurse - LPN (Remote)
Utilization Review Nurse - LPN (Remote)
8 day ago
Morgan Stephens
- Remote: Georgia (USA)
- Full time
Utilization ManagementUsage TrackingProcess ImprovementCare ManagementNursingRegulatory Compliance
Manager Medical Policy and Corporate Coding
Manager Medical Policy and Corporate Coding
17 day ago
Capital Blue Cross
- Remote: Pennsylvania (USA)
- Full time
Clinical GovernanceHealth PoliciesRegulatory ComplianceCoding TheoryCross-Functional CollaborationRegulatory Compliance
