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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Medical Director
Medical Director
8 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementRegulatory ComplianceMedical LawProject ManagementMedical Direction
Care Coordinator- CISC
Care Coordinator- CISC
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 50 - 75K
Clinical Social WorkProject CollaborationCare CoordinationCost Benefit AnalysisOutcome InterpretationSocial Work
Primary Therapist - Virtual
Primary Therapist - Virtual
19 day ago
Monte Nido
- Remote: United States
- Freelance
PsychotherapyBasic Patient CareCounseling TechniquesEmotional DisordersDischarge PlanningUtilization Management
Medical Director (Behavioral Health) - Remote
Medical Director (Behavioral Health) - Remote
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 200 - 360K
Physical Medicine And RehabilitationCost Benefit AnalysisContinuous Quality Improvement (CQI)Commercial InsurancesUtilization ManagementCredential Manager
Field Medical Director, Radiology (Pulmonology Preferred)
Field Medical Director, Radiology (Pulmonology Preferred)
12 day ago
New Century Health
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementMedical GuidelineClinical PracticesPulmonologySecondary Research
RN Case Manager II
RN Case Manager II
30+ days ago
CorVel Corporation
- Remote: United States, Oregon (USA)
- Full time
- Mid-level (2-5 years)
- 63 - 96K
Nurse Licensure CompactUtilization ManagementNeurologyPhysical Medicine And RehabilitationCost ContainmentOrthopedics
Care Management Associate I (Appeals)
Care Management Associate I (Appeals)
30+ days ago
NYC Health + Hospitals
- Remote: United States, New York (USA)
- Mid-level (2-5 years)
ICD 503AppealsUtilization ManagementData EntryCppunitInternal Documentation
Remote Behavioral Medical Director
Remote Behavioral Medical Director
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Cost ContainmentUtilization ManagementClinical ConsultingProvider Network ManagementClinical Assessments
Senior Analyst, Client Analytics
Senior Analyst, Client Analytics
20 day ago
New Century Health
- Remote: United States
- Full time
SAS (Software)SQL (Programming Language)Data VisualizationBusiness Intelligence ToolsHealthcare AnalyticsValue-Based Care
Clinical Product Consultant - UM
Clinical Product Consultant - UM
30+ days ago
Iodine Software
- Remote: United States
- Freelance
- Senior (5-10 years)
Project ManagementUtilization ManagementClient ServicesCare ManagementReimbursement RegulationsProject Collaboration
VP, Regional CMO - West
VP, Regional CMO - West
30+ days ago
CenterWell Senior Primary Care
- Remote: United States, Texas (USA)
- Expert & Leadership (>10 years)
Clinical GovernanceValue-Based CareBasic Patient CareTeam NursingPublic HealthNetwork Administration
Career Opportunities: Field Reimbursement Access Manager (Georgia - Northern FL) (16111)
Career Opportunities: Field Reimbursement Access Manager (Georgia - Northern FL) (16111)
30+ days ago
Bausch + Lomb
- Remote: United States
- 150 - 175K
Liability InsuranceReimbursement RegulationsStakeholder EngagementProject ManagementMedical AssistanceBusiness Planning
Clinical Sales Pharmacist Consultant
Clinical Sales Pharmacist Consultant
30+ days ago
MedImpact Healthcare Systems, Inc.
- Remote: United States, California (USA)
- Freelance
- Mid-level (2-5 years)
Clinical ConsultingPharmacy Benefit ManagementUtilization ManagementSales StrategyEvidence-Based PracticeGovernment Rebates
Remote Beahvioral Medical Director - Kentucky
Remote Beahvioral Medical Director - Kentucky
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Clinical GovernanceUtilization ManagementClinical AssessmentsQuality AssessmentKey Performance Indicators (KPIs)Cost Containment
Medical Director - Gulf South
Medical Director - Gulf South
30+ days ago
Conviva Care Solutions
- Remote: United States
- Full time
- Senior (5-10 years)
- 199 - 274K
Utilization ManagementInpatient CareDischarge PlanningUtilization ManagementMedical GuidelineInternal Medicine
Senior Actuarial Analyst
Senior Actuarial Analyst
30+ days ago
Cohere Health
- Remote: United States
- Full time
Outcome InterpretationFinancial ModelingHealthcare AnalyticsCost Benefit AnalysisPython (Programming Language)Statistical Analysis
Utilization Clinical Reviewer - Appeals
Utilization Clinical Reviewer - Appeals
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
Registered Nurse-Review Analyst
Registered Nurse-Review Analyst
30+ days ago
Strategic Staffing Solutions
- Remote: United States, Michigan (USA)
- Junior (1-2 years)
Utilization ManagementCare CoordinationEducational AssessmentClinical Assessments
Clinical Reviewer WA L&I
Clinical Reviewer WA L&I
30+ days ago
Comagine Health
- Remote: United States
- Senior (5-10 years)
- 83 - 115K
Utilization ManagementNurse Licensure CompactHospital ExperienceClinical AssessmentsAnalyticsCare Management
Nurse, Utilization Management Reviewer.
Nurse, Utilization Management Reviewer.
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityUtilization ManagementMedicareHealth Services ResearchInterQual CriteriaInternal Documentation
Pre-Authorization Registered Nurse
Pre-Authorization Registered Nurse
30+ days ago
Conviva Care Solutions
- Remote: United States, Laos, Louisiana (USA)
- Full time
- Mid-level (2-5 years)
- 37 - 87K
Medical NecessityUtilization ManagementNursingHospital ExperienceRehabilitationNursing Care
RN Care Management Coordinator #36314
RN Care Management Coordinator #36314
30+ days ago
Contemporary Staffing Solutions
- Remote: United States
- 64 - 72K
Behavioral HealthUtilization ManagementHealth PoliciesMedical Management
Field Reimbursement Manager - Immunology - Newark, NJ
Field Reimbursement Manager - Immunology - Newark, NJ
8 day ago
Regeneron
- Remote: United States
- Full time
Reimbursement RegulationsMarket Access StrategyBiomedical SciencesPrior AuthorizationPharmaceuticalsUtilization Management
Utilization Review Specialist (Remote) 
Utilization Review Specialist (Remote)
30+ days ago
Coronis Health
- Remote: United States, Florida (USA), Michigan (USA), North Carolina (USA), South Carolina (USA)
- Full time
- Senior (5-10 years)
- 9 - 62K
Addiction TreatmentUtilization ManagementMedical AbbreviationsCare Management
Clinician, C365
Clinician, C365
9 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Utilization ManagementMental Health AssessmentsProcess ManagementChronic CareNurse Licensure CompactOnline Communication
Telephonic Case Manager
Telephonic Case Manager
21 day ago
Genex Services
- Remote: United States
- Full time
Care ManagementWorkers' CompensationClinical PracticesNurse RegistryNursingUtilization Management
Career Opportunities: Nurse Reviewer (Registered Nurse) - Remote in US (26772)
Career Opportunities: Nurse Reviewer (Registered Nurse) - Remote in US (26772)
30+ days ago
Gainwell Technologies LLC
- Remote: United States
- Senior (5-10 years)
- 3 - 75K
Utilization ManagementNurse Licensure CompactInterQual CriteriaClinical Data AnalysisMedical Record Management
Registered Nurse (RN), Utilization Review MediGold Health Plan - Remote
Registered Nurse (RN), Utilization Review MediGold Health Plan - Remote
30+ days ago
Trinity Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
Clinical AssessmentsUtilization ManagementNursingManaged CareCCURE (Security And Event Management System)Self-Directed Learning
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
Clinician, C365
Clinician, C365
9 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Utilization ManagementMental Health AssessmentsProcess ManagementChronic CareNurse Licensure CompactOnline Communication
Medical Director - Medical Oncology - eviCore - Remote
Medical Director - Medical Oncology - eviCore - Remote
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticeMedical OncologyComputer SystemsMedical ManagementHealth LawsMedical Licensing (Health Law)
Nursing - RN Level 1 RN Level 1
Nursing - RN Level 1 RN Level 1
30+ days ago
US Tech Solutions
- Remote: United States, New Jersey (USA)
- Fixed term
- Mid-level (2-5 years)
Nurse Licensure CompactHealth PoliciesUtilization ManagementOnline CommunicationCustomer CentricityClinical Assessments
Associate Medical Director
Associate Medical Director
30+ days ago
Lifelancer
- Remote: United States, North Carolina (USA)
- Full time
- Senior (5-10 years)
- 146 - 278K
Clinical ConsultingBusiness StrategiesMedical LawProject ManagementHealth PoliciesMedical Necessity
VP, Regional CMO - Central
VP, Regional CMO - Central
30+ days ago
CenterWell Senior Primary Care
- Remote: United States, Kentucky (USA)
- Expert & Leadership (>10 years)
Clinical GovernanceValue-Based CareBasic Patient CareTeam NursingPublic HealthNetwork Administration
Clinical Care Analyst
Clinical Care Analyst
30+ days ago
Lifelancer
- Remote: United States, District of Columbia (USA)
- Full time
- Senior (5-10 years)
Clinical AssessmentsElectronic Medical RecordCare ManagementHEDIS (Healthcare Effectiveness Data And Information Set)Utilization ManagementMedicare
Remote Medical Director
Remote Medical Director
6 day ago
Centene Corporation
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementClinical AssessmentsQuality AssessmentHealth AdministrationMedical Management
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
21 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Care CoordinationUtilization ManagementClinical AssessmentsMedical NecessityClinical Quality ManagementNurse Licensure Compact
Louisiana-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
Louisiana-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, Laos
- Full time
Institutional Review Board (IRB)Medical NecessityUtilization ManagementPsychiatryPsychologyDentistry
Primary Therapist - Virtual
Primary Therapist - Virtual
19 day ago
Monte Nido & Affiliates
- Remote: United States
- Freelance
PsychotherapyNutrition InterventionCounseling TechniquesEmotional DisordersDischarge PlanningCare Planning
UR Intake Specialist
UR Intake Specialist
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- 30 - 49K
Utilization ManagementOnline Communication
Remote Behavioral Medical Director – West Region
Remote Behavioral Medical Director – West Region
30+ days ago
Centene Corporation
- Remote: United States, Uganda
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Utilization ManagementPhysician CredentialingMedical ManagementRegulatory ComplianceClinical Research CoordinationClinical Assessments
Primary Therapist - Virtual - (East Coast license)
Primary Therapist - Virtual - (East Coast license)
11 day ago
Monte Nido & Affiliates
- Remote: United States
- Full time
PsychotherapyCounseling TechniquesEmotional DisordersClinical ConsultingDischarge PlanningUtilization Management
Physician Medical Director
Physician Medical Director
30+ days ago
relode
- Remote: United States
- Full time
Disease ManagementUtilization ManagementDrug Regulatory Affairs
Board Certified Pulmonologist Physician Advisor, Disability Peer Review
Board Certified Pulmonologist Physician Advisor, Disability Peer Review
30+ days ago
Dane Street, LLC
- Remote: United States
- Fixed term
Utilization ManagementClinical Consulting
OTA - Utilization Management Reviewer
OTA - Utilization Management Reviewer
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityUtilization ManagementService ReviewClinical DocumentationCare Management SoftwareInterQual Criteria
HMSA Intake Precert Care Manager - Remote Hawaii
HMSA Intake Precert Care Manager - Remote Hawaii
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 58 - 93K
Discharge PlanningUtilization ManagementCrisis InterventionQuality AssessmentAnalyticsMental Health
Utilization Review Nurse-Weekends-Remote
Utilization Review Nurse-Weekends-Remote
25 day ago
Sentara Healthcare
- Remote: United States
- Full time
Care CoordinationUtilization ManagementAcute CarePrior AuthorizationInterQual CriteriaNurse Licensure Compact
Senior Customer Success Technical Architect
Senior Customer Success Technical Architect
6 day ago
Confluent
- Remote: United States
- Full time
PLINK (Genetic Analysis Software)Apache KafkaData StreamingCloud ComputingPerformance Systems AnalysisAutomated Information Systems
Associate Director, Access Reimbursement Management- WI/MN/Northern OH
Associate Director, Access Reimbursement Management- WI/MN/Northern OH
7 day ago
Sage Therapeutics
- Remote: United States
- Full time
Health AdministrationActivities Of Daily Living (ADLs)Reimbursement RegulationsPayer MarketingBillingReimbursement Regulations
Member & Recipient Services Clinician (Remote M-F; 11am-8pm)
Member & Recipient Services Clinician (Remote M-F; 11am-8pm)
30+ days ago
Vaya Health
- Remote: United States, North Carolina (USA)
- Full time
- 19 - 19K
Addiction TreatmentMental Health AssessmentsCrisis InterventionTriageBehavioral HealthData Entry
