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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Senior Insights Analyst 
Senior Insights Analyst
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
AnalyticsHealthcare Industry KnowledgeData VisualizationStatistical AnalysisPython (Programming Language)SQL (Programming Language)
PT Care Manager Behavioral Health - After Hours - Remote US
PT Care Manager Behavioral Health - After Hours - Remote US
30+ days ago
VetJobs
- Remote: United States
- Part time
- Mid-level (2-5 years)
- 58 - 93K
Hospital ExperienceDischarge PlanningCare CoordinationUtilization ManagementCrisis InterventionCommunity Mental Health
CARE NAVIGATOR
CARE NAVIGATOR
30+ days ago
Covenant Health
- Remote: United States, Tennessee (USA)
- Full time
- Mid-level (2-5 years)
Care CoordinationChronic CareClinical AssessmentsIntegrated ReportingUtilization ManagementHealth Care Risk Management
Clinical Solutions Specialist - Rehab & Fall Prevention
Clinical Solutions Specialist - Rehab & Fall Prevention
30+ days ago
Medline Industries, LP
- Remote: United States, California (USA)
- Senior (5-10 years)
- 93 - 135K
AnalyticsCustomer DevelopmentPresentation TrainingClinical ConsultingActivities Of Daily Living (ADLs)Utilization Management
Nurse Liaison - Post Acute Care - Ocean County, NJ
Nurse Liaison - Post Acute Care - Ocean County, NJ
30+ days ago
CareCentrix
- Remote: United States, New Jersey (USA)
- Full time
Utilization ManagementNursingCare CoordinationResource ManagementUtilization ManagementClinical Assessments
Clinical Psychologist
Clinical Psychologist
30+ days ago
Sentara Healthcare
- Remote: United States, Virginia (USA)
- Full time
- Senior (5-10 years)
Quality AssessmentBehavioral HealthClinical PsychologyUtilization ManagementManaged CareMedicaid
Nurse Liaison - Post Acute Care - New Brunswick, NJ
Nurse Liaison - Post Acute Care - New Brunswick, NJ
30+ days ago
CareCentrix
- Remote: United States, New Jersey (USA)
- Full time
- 80 - 100K
Care CoordinationUtilization ManagementHealthcare Industry KnowledgeNurse Licensure CompactElderly CareSocial Influences
Physician Reviewer, Utilization Management
Physician Reviewer, Utilization Management
30+ days ago
Oscar Health
- Remote: United States
- Junior (1-2 years)
- 211 - 277K
Evidence-Based PracticeClinical AssessmentsMedical NecessityUtilization ManagementManaged CareClinical Practices
Medical Director - Medicare/Medicaid - Utilization Management
Medical Director - Medicare/Medicaid - Utilization Management
30+ days ago
Dane Street, LLC
- Remote: United States
- Full time
Project CollaborationQualification Protocols (IQ/OQ/PQ)Strategic LeadershipClinical AuditingUtilization ManagementMedicare
Associate Medical Director
Associate Medical Director
30+ days ago
Blue Cross NC
- Remote: United States, Georgia (country), Arizona (USA), Arkansas (USA), Florida (USA), Indiana (USA), Kansas (USA), Kentucky (USA), Missouri (USA), North Carolina (USA), Oklahoma (USA), Pennsylvania (USA), South Carolina (USA), Tennessee (USA), Utah (USA)
- Full time
- Senior (5-10 years)
- 146 - 278K
Healthcare StrategyMedical LawPublic HealthClinical ConsultingData ManagementReimbursement Regulations
Medical Director - Florida
Medical Director - Florida
10 day ago
Humana
- Remote: United States
- Full time
Utilization ManagementTreatment PlanningHome Health CareDischarge PlanningMedical GuidelineManaged Care
Clinical Reviewer - LPN
Clinical Reviewer - LPN
30+ days ago
TriWest Healthcare Alliance
- Remote: United States, Azerbaijan, Arizona (USA)
- Senior (5-10 years)
- 58 - 74K
Managed CareClinical NursingMedical NecessityUtilization ManagementMedical GuidelineClinic Management Systems
Care Coordinator, Licensed
Care Coordinator, Licensed
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
Outcome InterpretationUtilization ManagementCost Benefit Analysis
Research Analyst- Family Health Advocate
Research Analyst- Family Health Advocate
6 day ago
Sharecare
- Remote: United States
- Full time
Utilization ManagementGrievance ArbitrationClaims And Litigation ManagementDigital CommunicationsOffice Management
Medicare Grievances and Appeals Corporate Medical Director
Medicare Grievances and Appeals Corporate Medical Director
30+ days ago
Conviva Care Solutions
- Remote: United States
- Full time
- Senior (5-10 years)
- 246 - 344K
Medical Practice ExperienceHealthcare Industry KnowledgeDischarge PlanningRehabilitationHome Health CareMedical Licensing (Health Law)
Remote Medical Director
Remote Medical Director
6 day ago
Centene Corporation
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementClinical AssessmentsQuality AssessmentHealth AdministrationMedical Management
Field Care Coordinator RN, Franklin County, OH and Surrounding Areas - Remote
Field Care Coordinator RN, Franklin County, OH and Surrounding Areas - Remote
30+ days ago
UnitedHealthcare
- Remote: United States, Ireland, Texas (USA)
- Mid-level (2-5 years)
- 54 - 107K
Care ManagementNursingClinical AssessmentsCommunity DesignCare CoordinationCase Management Systems
UM Clinical Team Lead
UM Clinical Team Lead
30+ days ago
Lifelancer
- Remote: United States, New York (USA)
- Full time
- Mid-level (2-5 years)
- 84 - 94K
Medical Insurance ClaimsInterQual CriteriaUtilization ManagementPerformance ImprovementRegulatory ComplianceCustomer Centricity
Part-Time Weekend Medical Director (Remote)
Part-Time Weekend Medical Director (Remote)
30+ days ago
Highmark Health
- Remote: United States, Kansas (USA)
- Part time
- Junior (1-2 years)
- 19 - 342K
Utilization ManagementMedical ManagementManaged CareClinical ConsultingOnline CommunicationMedical Software
Manager, Clinical Care Management (New Mexico - Active RN License)
Manager, Clinical Care Management (New Mexico - Active RN License)
30+ days ago
Comagine Health
- Remote: United States
- Senior (5-10 years)
- 85 - 107K
Financial ManagementNurse Licensure CompactUtilization ManagementBudget ManagementClinical ConsultingCommercial Insurances
Medical Director - Pediatric Infectious Disease - EviCore
Medical Director - Pediatric Infectious Disease - EviCore
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticePediatric Diseases And DisordersHealth LawsMedical Licensing (Health Law)Utilization ManagementClinical Assessments
Clinical Admissions Therapist (Michigan)
Clinical Admissions Therapist (Michigan)
10 day ago
Charlie Health
- Remote: United States
- Full time
TelehealthBehavioral HealthMental Health AssessmentsUtilization ManagementPsychosocial AssessmentsElectronic Medical Record
Pre-Service Utilization Management LVN
Pre-Service Utilization Management LVN
7 day ago
CommonSpirit Health
- Remote: United States
- Full time
Utilization ManagementClinical InformaticsMedical NecessityICD 503Benefits AdministrationMedical Abbreviations
Telephonic Case Manager I
Telephonic Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, Pennsylvania (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Utilization ManagementNeurologyMedical HumanitiesProject AssessmentsPhysical Medicine And RehabilitationCost Containment
Remote Care Management Nurse (Future Opportunities)
Remote Care Management Nurse (Future Opportunities)
30+ days ago
Cambia Health Solutions
- Remote: United States, District of Columbia (USA), Idaho (USA), Iowa (USA), Maine (USA), Massachusetts (USA), Oregon (USA), Utah (USA), Washington (USA)
- Freelance
- Mid-level (2-5 years)
- 64 - 105K
Documentation GenerationHealthcare Industry KnowledgeCare ManagementOrganizational StructureUtilization ManagementNursing
Enterprise PHCO - Medicare & Duals - Lead
Enterprise PHCO - Medicare & Duals - Lead
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Care ManagementMedical ManagementUtilization ManagementContinuous Improvement ProcessProject ManagementClinical Informatics
Senior Healthcare Analyst, Actuarial
Senior Healthcare Analyst, Actuarial
20 day ago
Cohere Health
- Remote: United States
- Full time
AnalyticsCost ManagementCustomer EngagementActuarial SciencePython (Programming Language)SQL (Programming Language)
Senior Manager, Resource Management
Senior Manager, Resource Management
27 day ago
Wpromote
- Remote: United States
- Full time
Utilization ManagementStaff PlanningResource ManagementAnalyticsGT-SUITE (Simulation Software)Project Management
Provider Engagement Account Manager
Provider Engagement Account Manager
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- 55 - 99K
Provider ModelAccount ManagementNetwork Performance ManagementUtilization ManagementProject ManagementQuality Assessment
Consulting Team Lead - Microsoft Fabric & Power BI at Collectiv
Consulting Team Lead - Microsoft Fabric & Power BI at Collectiv
30+ days ago
Collectiv
- Remote: United States, Illinois (USA)
- Full time
- Senior (5-10 years)
Power BIMicrosoft AzureUtilization ManagementCustomer Relationship Management
Neurologist Needed for Utilization Review work - Remote 1099
Neurologist Needed for Utilization Review work - Remote 1099
20 day ago
Medical Review Institute
- Remote: United States
- Freelance
Utilization ManagementMedical Licensing (Health Law)NeurologyBasic Patient CareMedical Licensing (Health Law)Global Positioning Systems
Pharmacy Coordinator
Pharmacy Coordinator
12 day ago
Centene Corporation
- Remote: United States
- Full time
Pharmacy ExperiencePrior AuthorizationUtilization ManagementClient EducationPharmacy ExperienceProcess Improvement
Care manager (LMFT or LCSW) - Remote
Care manager (LMFT or LCSW) - Remote
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
Discharge PlanningUtilization ManagementClinical Data Analysis
Clinical Formulary Pharmacist - Government Programs
Clinical Formulary Pharmacist - Government Programs
30+ days ago
Maxor National Pharmacy Services, LLC
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Utilization ManagementCompliance ManagementPharmacy ExperienceDrug Utilization ReviewClinical PracticesPolicy Development
Virtual Utilization Review Specialist
Virtual Utilization Review Specialist
12 day ago
Ensemble Health Partners
- Remote: United States
- Full time
Utilization ManagementClinical AssessmentsMedical NecessityResource ManagementRegulatory ComplianceBasic Patient Care
UR Case Manager II
UR Case Manager II
30+ days ago
CorVel Corporation
- Remote: United States, Texas (USA)
- Full time
- Mid-level (2-5 years)
- 63 - 96K
Utilization ManagementWorkers' Compensation ClaimsCPT CodingICD Coding (ICD-9/ICD-10)OrthopedicsClinical Assessments
Obstetrics/Newborn/Pediatrics Clinical Documentation Specialist PRN
Obstetrics/Newborn/Pediatrics Clinical Documentation Specialist PRN
30+ days ago
Wellstar Health System
- Remote: United States
- Part time
- Senior (5-10 years)
Coding TheoryLine ChartDiagnosis-Related GroupClinical DocumentationCoding TheoryMedical Abbreviations
Career Opportunities: Utilization Management Medical Director - Remote in US (28039)
Career Opportunities: Utilization Management Medical Director - Remote in US (28039)
30+ days ago
Gainwell Technologies LLC
- Remote: United States
- Senior (5-10 years)
- 100 - 150K
InterQual CriteriaUtilization ManagementManaged CareAnalyticsAuditing
Medical Director, Children's Services (SafetyNet & Behavioral Health)
Medical Director, Children's Services (SafetyNet & Behavioral Health)
30+ days ago
Univera Healthcare
- Remote: United States, Massachusetts (USA), New York (USA), Virginia (USA)
- Full time
- Expert & Leadership (>10 years)
Behavioral HealthChild And Adolescent PsychiatryClinical AuditingIntegrated CareEvidence-Based PracticeCommunications Systems
Medical Director -Pediatric Cardiology
Medical Director -Pediatric Cardiology
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
CardiologyClinical AssessmentsEvidence-Based PracticeMedical Record ManagementComputer SystemsUtilization Management
Remote Child & Adolescent Behavioral Medical Director - Washington
Remote Child & Adolescent Behavioral Medical Director - Washington
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Utilization ManagementHealth AdministrationInsurance PoliciesClinical ConsultingPerformance ImprovementCost Containment
Clinical Product Consultant - UM
Clinical Product Consultant - UM
30+ days ago
Iodine Software
- Remote: United States
- Freelance
- Senior (5-10 years)
Utilization ManagementClinical AssessmentsProject ManagementRegulatory ComplianceCare ManagementGoogle Sites
Mental Health Therapist (RMHCI, RCSWI)
Mental Health Therapist (RMHCI, RCSWI)
30+ days ago
Discovery Behavioral Health
- Remote: United States, Florida (USA)
- Full time
- Entry-level / graduate
- 52 - 65K
Patient SafetyClinical DocumentationClinical AssessmentsFamily TherapyProject CollaborationUtilization Management
Physician Advisor
Physician Advisor
30+ days ago
Ensemble Health Partners
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Project ManagementBudget ManagementContinuing Medical EducationExecutive ConversationsUtilization Management
Medical Director - EviCore - Cardiology
Medical Director - EviCore - Cardiology
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 196 - 328K
Evidence-Based PracticeCardiologyMedical ManagementLegal KnowledgeMedical Licensing (Health Law)Utilization Management
Clinical Support Coordinator - Part-Time
Clinical Support Coordinator - Part-Time
26 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Part time
Data ProcessingCare ManagementTeleconferencingUtilization ManagementAdobe Creative Cloud
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
30+ days ago
Magellan Health
- Remote: United States, California (USA)
- Full time
- Mid-level (2-5 years)
- 58 - 93K
Behavioral HealthDischarge PlanningUtilization ManagementCrisis InterventionInpatient CareMental Health And Recovery Services
Medical Director Utilization Management
Medical Director Utilization Management
30+ days ago
AmeriHealth Caritas
- Remote: United States
- Expert & Leadership (>10 years)
Medical DirectionClinical PracticesUtilization ManagementQuality AssessmentBehavioral HealthEvidence-Based Practice
Remote Behavioral Medical Director - western region
Remote Behavioral Medical Director - western region
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Cost ContainmentUtilization ManagementRegulatory ComplianceClinical ConsultingPerformance ImprovementProvider Network Management
LPN/LVN Utilization Management Reviewer
LPN/LVN Utilization Management Reviewer
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityUtilization ManagementService ReviewClinical DocumentationInterQual CriteriaEvaluation Of Care
