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
335 jobs
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Neurologist Telecommute Medical Review Stream
Neurologist Telecommute Medical Review Stream
22 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
Medical Licensing (Health Law)Clinical AssessmentsNeurologyMedical NecessityUtilization ManagementCredential Manager
Nurse Practitioner (Ocean, New Jersey)
Nurse Practitioner (Ocean, New Jersey)
19 day ago
CareCentrix
- Remote: New Jersey (USA)
- Full time
Utilization ManagementAcute Care NursingClinical AuditingBasic Patient CareMedical Record ManagementInterQual Criteria
Utilization Management Registered Nurse, Indiana - Remote
Utilization Management Registered Nurse, Indiana - Remote
22 day ago
McLaren Health Care
- Remote: Indiana (USA)
- Full time
Utilization ManagementClinical NursingManaged CareCare ManagementNurse Licensure CompactBehavioral Change Theories
Full-Time RN Case Manager (UR Focused) | Texas
Full-Time RN Case Manager (UR Focused) | Texas
28 day ago
Beam Healthcare
- Remote: Texas (USA)
- Full time
Care CoordinationCare ManagementDischarge PlanningUtilization ManagementInterQual CriteriaInpatient Care
Clinical Care Reviewer, Pediatric Shift Care, RN
Clinical Care Reviewer, Pediatric Shift Care, RN
16 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Utilization ManagementNursingPediatricsClinical AssessmentsClinical InformaticsInterQual Criteria
US Registered Nurse
US Registered Nurse
27 day ago
Cognizant
- Remote: Philippines
- Full time
Utilization ManagementCall Center ExperienceClinical AssessmentsCall Center Experience
Medical Field Case Manager
Medical Field Case Manager
22 day ago
Genex Services
- Remote: Illinois (USA)
- Full time
Care ManagementNursingWorkers' CompensationBasic Patient CareTreatment PlanningClinical Practices
Supervisor-Utilization Review/Full Time/Remote
Supervisor-Utilization Review/Full Time/Remote
13 day ago
Henry Ford Health
- Remote: Michigan (USA)
- Full time
Utilization ManagementRevenue ManagementFinancial ManagementProject ManagementAnalytical DashboardKPI Management
Medicaid Provider Materials Lead
Medicaid Provider Materials Lead
7 day ago
Humana
- Remote: United States
- Full time
Content CreationInstructional DesignProject ManagementDigital File ManagementManaged CarePolicy Development
Medical Director -Pediatric Surgery
Medical Director -Pediatric Surgery
27 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
Pediatric SurgeryEvidence-Based PracticeComputer SystemsUtilization ManagementClinical AssessmentsHealth Laws
Program Director - Eating Disorder, Residential
Program Director - Eating Disorder, Residential
30+ days ago
Discovery Behavioral Health
- Remote: United States, California (USA)
- Full time
- Expert & Leadership (>10 years)
- 77 - 95K
TelehealthUtilization ManagementGroup TherapyClinical SupervisionEducational AssessmentEmployee Monitoring
Neurosurgeon Telecommute Medical Review Stream
Neurosurgeon Telecommute Medical Review Stream
22 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
NeurosurgeryUtilization ManagementClinical AssessmentsMedical NecessityInsurance ReviewsManaged Care
USRN
USRN
30+ days ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
- Mid-level (2-5 years)
Utilization ManagementInternational Laws
Telecommute Medical Review Stream Physician
Telecommute Medical Review Stream Physician
22 day ago
Concentra
- Remote: Colorado (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Managed CareMedical Necessity
Medical Director - Kansas
Medical Director - Kansas
30+ days ago
Centene Corporation
- Remote: United States, Kansas (USA)
- Full time
- Expert & Leadership (>10 years)
- 221 - 420K
Clinical GovernanceUtilization ManagementClinical AssessmentsClinical Quality ManagementCost ContainmentRegulatory Compliance
Care Manager, SCO
Care Manager, SCO
30+ days ago
Saviance Technologies Pvt. Ltd.
- Remote: Kentucky (USA), Massachusetts (USA)
Care CoordinationUtilization Management
Mental Health Therapist - Outpatient
Mental Health Therapist - Outpatient
30+ days ago
Discovery Behavioral Health
- Remote: United States, District of Columbia (USA), Washington (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Clinical DocumentationFamily TherapyProject CollaborationCrisis ManagementGroup TherapyPatient Evaluation
Medical Case Management WC/UR Supervisor
Medical Case Management WC/UR Supervisor
30+ days ago
TRISTAR Insurance Group
- Remote: United States, South Carolina (USA)
- Full time
- Mid-level (2-5 years)
- 19 - 192K
Utilization ManagementRegulatory ComplianceHuman Resource ManagementWorkers' Compensation ClaimsCare Management
Supervisor PA & UM Programs
Supervisor PA & UM Programs
20 day ago
MedImpact Healthcare Systems, Inc.
- Remote: California (USA)
- Full time
Clinical InvestigationsPrior AuthorizationPharmacy OperationsQuality AssessmentUtilization ManagementCompliance Management
VP, PHCO Utilization Management - Medicare & Duals
VP, PHCO Utilization Management - Medicare & Duals
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 182 - 345K
Utilization ManagementCompliance ManagementNursingPrior AuthorizationCorporate ForecastingRisk Management
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
23 day ago
Morgan Stephens
- Remote: Kentucky (USA)
- Full time
Utilization ManagementMedical GuidelineClinical AssessmentsHealth Management Information SystemsMedicareInternal Documentation
Utilization Clinical Reviewer
Utilization Clinical Reviewer
30+ days ago
TriWest Healthcare Alliance
- Remote: United States, Arizona (USA)
- Full time
- Mid-level (2-5 years)
- 73 - 93K
Nurse Licensure CompactOnline CommunicationUtilization ManagementTri-careMedical Practice ExperienceBehavioral Health
Speech Therapist /Clinical Reviewer - eviCore - Work at Home
Speech Therapist /Clinical Reviewer - eviCore - Work at Home
3 day ago
The Cigna Group
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementMedical GuidelineSpeech TherapyPediatricsGeriatrics
DSNP RN/SW Supervisor-Atlantic County, NJ
DSNP RN/SW Supervisor-Atlantic County, NJ
5 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: United States
- Full time
Care ManagementUtilization ManagementCare ManagementBudget ManagementPerformance ManagementRegulatory Compliance
UR Index Intake Coordinator - REMOTE! Mon- Fri 8:30am - 5:30pm PST
UR Index Intake Coordinator - REMOTE! Mon- Fri 8:30am - 5:30pm PST
30+ days ago
EK Health Services Inc.
- Remote: United States
- Expert & Leadership (>10 years)
- 30 - 32K
Case Management SystemsUtilization ManagementData EntryLaser ScanningEmail SoftwareMedical Abbreviations
Neurologist Medical Review Stream
Neurologist Medical Review Stream
22 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsNeurologyManaged CareMedical Licensing (Health Law)
Field Reimbursement Manager, Pulmonology and Gastroenterology - Denver, CO
Field Reimbursement Manager, Pulmonology and Gastroenterology - Denver, CO
30+ days ago
Sanofi
- Remote: United States, New Mexico (USA)
- Full time
- 122 - 175K
Medical AssistanceActivities Of Daily Living (ADLs)Reimbursement RegulationsPrior AuthorizationDirect Market AccessBiopharmaceuticals
Senior Medical Director, Behavioral Health - New Mexico
Senior Medical Director, Behavioral Health - New Mexico
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Senior (5-10 years)
- 222 - 422K
Stakeholder EngagementCost Benefit AnalysisContinuous Quality Improvement (CQI)Care ManagementClinical AuditingHealth Policies
New Mexico Manager, Clinical Care Management (New Mexico - Active RN License)
New Mexico Manager, Clinical Care Management (New Mexico - Active RN License)
30+ days ago
Comagine Health
- Remote: United States
- Senior (5-10 years)
- 85 - 107K
Utilization ManagementNurse Licensure CompactFinancial ManagementTotal Quality ManagementCommercial InsurancesMedicaid
Payment Integrity Manager
Payment Integrity Manager
30+ days ago
CorVel Corporation
- Remote: United States, Texas (USA)
- Senior (5-10 years)
- 5 - 121K
AuditingICD Coding (ICD-9/ICD-10)Benefits Realization ManagementUtilization ManagementWorkers' Compensation ClaimsProject Management
Senior Mainframe Systems Programmer - zOS 
Senior Mainframe Systems Programmer - zOS
30+ days ago
Ensono
- Remote: India
- Senior (5-10 years)
z/OSDisaster RecoveryPerformance AnalysisSystem MonitoringSecurity ManagementDatabase Management
Business Analyst III - Risk Adjustment
Business Analyst III - Risk Adjustment
14 day ago
UPMC
- Remote: United States
- Full time
Financial AnalysisSQL (Programming Language)Risk ControlClaims And Litigation ManagementAnalyticsUtilization Management
RN Reviewer 
RN Reviewer
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
Utilization ManagementNursingInpatient CareQualification Protocols (IQ/OQ/PQ)Prior AuthorizationWeb Standards
Registered Nurse Utilization Management Specialist
Registered Nurse Utilization Management Specialist
19 day ago
UnityPoint Health
- Remote: United States
- Full time
Utilization ManagementNursingUtilization ManagementMedicareCustomer Centricity
RN Compliance Auditor
RN Compliance Auditor
30+ days ago
Conviva Care Solutions
- Remote: United States, Georgia (country), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Connecticut (USA), Delaware (USA), District of Columbia (USA), Florida (USA), Idaho (USA), Illinois (USA), Indiana (USA), Iowa (USA), Kansas (USA)
- Full time
- 3 - 97K
Nurse Licensure CompactUtilization ManagementProcess ImprovementInternal CommunicationsClinical AssessmentsAnalytics
Medical Case Manager I (RN)
Medical Case Manager I (RN)
30+ days ago
CorVel Corporation
- Remote: United States, Missouri (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Utilization ManagementNeurologyPhysical Medicine And RehabilitationCost ContainmentOrthopedicsNurse Registry
Utilization Review Nurse - LPN (Remote)
Utilization Review Nurse - LPN (Remote)
23 day ago
Morgan Stephens
- Remote: Florida (USA)
- Full time
Utilization ManagementUsage TrackingRegulatory ComplianceCode Of Federal RegulationsMedicaidMedicare
RN I
RN I
29 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: New Jersey (USA)
- Full time
Utilization ManagementCare ManagementClinical AssessmentsPatient Education And CounselingOnline CommunicationForward Planning
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
22 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
GastroenterologyUtilization ManagementComputer SystemsClinical AssessmentsClinical AssessmentsHealth Laws
CISC Care Coordinator, Licensed
CISC Care Coordinator, Licensed
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 58 - 93K
Clinical AssessmentsUtilization ManagementCare PlanningAnalytics
Registered Nurse Advocate, Proactive Care Management
Registered Nurse Advocate, Proactive Care Management
20 day ago
EPIC Insurance Brokers & Consultants
- Remote: United States
- Full time
Care ManagementUtilization ManagementClinical AuditingHispanic And Latino Culture
Utilization Review Case Manager - SUD
Utilization Review Case Manager - SUD
30+ days ago
Discovery Behavioral Health
- Remote: United States, California (USA)
- Full time
- Mid-level (2-5 years)
- 74 - 74K
DimensioningMental Health EducationDiagnosis CodesUtilization Management
Telephonic Medical Case Manager (Workers' compensation)
Telephonic Medical Case Manager (Workers' compensation)
30+ days ago
TRISTAR Insurance Group
- Remote: United States, South Carolina (USA)
- Full time
- 19 - 192K
Clinical AssessmentsNurse Licensure CompactDischarge PlanningConflict ResolutionWorkers' CompensationManaged Care
Business Development Director (Clinical Documentation and Coding)
Business Development Director (Clinical Documentation and Coding)
6 day ago
R1 RCM
- Remote: United States
- Full time
Coding TheoryRevenue ManagementClinical DocumentationStaff PlanningUtilization ManagementSoftware Systems
Medical Director - Pediatric Pulmonology - EviCore - Remote
Medical Director - Pediatric Pulmonology - EviCore - Remote
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticePulmonologyClinical AssessmentsCase Management ToolsMedical Licensing (Health Law)Utilization Management
Medical Director- Radiation Oncology - EviCore
Medical Director- Radiation Oncology - EviCore
30+ days ago
eviCore healthcare
- Remote: United States
- Senior (5-10 years)
- 203 - 338K
Radiation OncologyEvidence-Based PracticeUtilization ManagementCase Management ToolsHealth LawsMedical Licensing (Health Law)
Senior Complex Bill Reviewer 2
Senior Complex Bill Reviewer 2
12 day ago
Mitchell International
- Remote: United States
- Full time
Clinical ConsultingMedical CodingMedical Insurance ClaimsICD 503Liability InsuranceOrthopedics
UM Administration Coordinator
UM Administration Coordinator
30+ days ago
Conviva Care Solutions
- Remote: United States, Florida (USA)
- Full time
- Junior (1-2 years)
- 40 - 52K
Utilization ManagementPrior AuthorizationClient ServicesSoftware DocumentationICD Coding (ICD-9/ICD-10)Transitional Bilingual Education
Client Solutions Manager- CM & UM
Client Solutions Manager- CM & UM
10 day ago
Abacus Insights
- Remote: United States
- Full time
Utilization ManagementCare ManagementHealthcare AnalyticsCustomer Requirements AnalysisMRO SoftwareUser Acceptance Testing (UAT)
Utilization review Nurse
Utilization review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: Michigan (USA)
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
