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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Remote Medical Director (PRN) - Missouri
Remote Medical Director (PRN) - Missouri
28 day ago
Centene Corporation
- Remote: United States
- Full time
Cost ContainmentUtilization ManagementClinical AssessmentsQuality AssessmentCredential ManagerPerformance Improvement
Field Medical Director, Interventional Cardiology (Remote)
Field Medical Director, Interventional Cardiology (Remote)
30+ days ago
Evolent Health
- Remote: United States
- Part time
- Senior (5-10 years)
Utilization ManagementMedical Licensing (Health Law)CardiologyContinuous TrainingCardiovascular DiseaseClinical Data Analysis
VP, Payer Analytics
VP, Payer Analytics
30+ days ago
Trinity Health
- Remote: United States, Michigan (USA)
- Full time
- Expert & Leadership (>10 years)
Financial AnalysisCost ManagementUtilization ManagementRisk ModelingTrading StrategyCost Benefit Analysis
Sales Executive - Payer
Sales Executive - Payer
30+ days ago
Notable
- Remote: United States, California (USA)
- Full time
- Senior (5-10 years)
Healthcare Industry KnowledgeEnterprise SalesValue-Based CareMarket AnalysisHEDIS (Healthcare Effectiveness Data And Information Set)Risk Control
RN Senior Medical Reviewer - CGS
RN Senior Medical Reviewer - CGS
30+ days ago
CGS Administrators, LLC
- Remote: United States, South Carolina (USA), Tennessee (USA)
- Full time
- Senior (5-10 years)
Utilization ManagementNurse Licensure CompactClinical AssessmentsClinical AssessmentsHealthcare Delivery ModelsManaged Care
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: United States
- Full time
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
Residential Mental Health Therapist
Residential Mental Health Therapist
30+ days ago
Discovery Behavioral Health
- Remote: United States, California (USA)
- Full time
- Mid-level (2-5 years)
- 67 - 84K
Microsoft NetworkingClinical DocumentationFamily TherapyUtilization ManagementProject CollaborationCrisis Management
C&S Plan Associate Medical Director - Georgia Foster Care - Remote
C&S Plan Associate Medical Director - Georgia Foster Care - Remote
30+ days ago
UnitedHealthcare
- Remote: United States, Georgia (country), Georgia (USA)
- Senior (5-10 years)
- 269 - 425K
Clinical GovernanceUtilization ManagementProvider ModelQuality AssessmentMedicaidState Children's Health Insurance Programs
Customer Service Representative - Remote
Customer Service Representative - Remote
30+ days ago
Easy Recruiter Solutions
- Remote: United States
- Full time
Utilization Management
Senior Clinical Documentation Specialist (CDS)
Senior Clinical Documentation Specialist (CDS)
8 day ago
UPMC
- Remote: United States
- Full time
Diagnosis-Related GroupMedical Record ManagementClinical DocumentationTeam NursingBasic Patient CareClinical Assessments
PRN RN Utilization Review Audit Specialist
PRN RN Utilization Review Audit Specialist
30+ days ago
University of Maryland Medical System
- Remote: United States, Maryland (USA)
- Full time
- Mid-level (2-5 years)
- 7 - 19K
Database ManagementClinical AssessmentsUtilization ManagementNursingBusiness NegotiationCare Management
RN Medical Case Manager I
RN Medical Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, New Mexico (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Utilization ManagementNeurologyPhysical Medicine And RehabilitationOrthopedicsNurse RegistryManaged 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 ManagementClinic Management SystemsInterQual Criteria
Utilization Review Nurse 
Utilization Review Nurse
30+ days ago
US Tech Solutions
- Remote: United States, Illinois (USA)
- Mid-level (2-5 years)
Assurance ServicesMedicaid Management Information Systems (MMIS)Prior AuthorizationUtilization ManagementMediTouchManaged Care
Medical Director - Pediatric Pulmonology - EviCore - Remote
Medical Director - Pediatric Pulmonology - EviCore - Remote
30+ days ago
eviCore healthcare
- Remote: United States
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticePulmonologyClinical AssessmentsCase Management ToolsComputer SystemsUtilization Management
Group Health Operations Manager (RN/LPN)
Group Health Operations Manager (RN/LPN)
12 day ago
Dane Street, LLC
- Remote: United States
- Full time
Business OperationsUtilization ManagementPerformance ManagementFinancial AnalysisStaff PlanningInsurance Law
Medical Director
Medical Director
8 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementRegulatory ComplianceMedical LawProject ManagementMedical Direction
Behavioral Health Clinical Care Manager, BSN/LMSW/LCSW
Behavioral Health Clinical Care Manager, BSN/LMSW/LCSW
30+ days ago
AmeriHealth Caritas
- Remote: United States, Michigan (USA)
Differential DiagnosisCare ManagementUtilization ManagementMental HealthMedicareBehavioral Health
Physician Advisor, Utilization Review Management
Physician Advisor, Utilization Review Management
12 day ago
Sutter Health
- Remote: United States
- Full time
Utilization ManagementHealthcare Delivery ModelsCare ManagementClinical DocumentationHealth Reimbursement ArrangementMedical Necessity
Medical Director
Medical Director
30+ days ago
Samaritan Health Services
- Remote: United States
- Part time
- Senior (5-10 years)
Clinical Quality ManagementMedical ManagementUtilization ManagementMedicareManaged CareHealth Policies
Actuarial Manager
Actuarial Manager
30+ days ago
Pediatric Associates Family of Companies
- Remote: United States
- Full time
- Senior (5-10 years)
Utilization ManagementStatistical AnalysisReimbursement RegulationsActuarial SciencePresentation TrainingData Validation
CA Telephonic Case Manager II - RN
CA Telephonic Case Manager II - RN
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- Mid-level (2-5 years)
- 58 - 89K
Educational EvaluationMedical HumanitiesUtilization ManagementRehabilitationCost ContainmentOrthopedics
Medical Economics Manager
Medical Economics Manager
19 day ago
Healthmap Solutions
- Remote: United States
- Full time
Data MiningEconomicsSQL (Programming Language)Actuarial ScienceUtilization ManagementIndustry Trend Analysis
Registered Nurse
Registered Nurse
30+ days ago
US Tech Solutions
- Remote: United States, Kansas (USA)
- Fixed term
- Mid-level (2-5 years)
Managed CareUtilization ManagementPrior AuthorizationInpatient CareMedicareMedicaid
Intake Coordinator
Intake Coordinator
30+ days ago
Highmark Health
- Remote: United States, Sudan, Laos, China, Tunisia, Norway, Italy, Colombia, Alaska (USA), Illinois (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Maryland (USA), Mississippi (USA)
- Full time
- Junior (1-2 years)
- 19 - 96K
Utilization ManagementData EntryAdministrative LawHealth Care IndustryOnline Communication
Virtual Primary Therapist - East
Virtual Primary Therapist - East
28 day ago
Monte Nido & Affiliates
- Remote: United States
- Full time
Psychosocial AssessmentsGroup TherapyFamily TherapyDischarge PlanningPsychosocial AssessmentsTreatment Planning
Medical Director- Radiation Oncology - EviCore
Medical Director- Radiation Oncology - EviCore
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Radiation OncologyUtilization ManagementMedical Licensing (Health Law)Health LawsClinical AssessmentsClinical Assessments
Payer Strategy Director
Payer Strategy Director
30+ days ago
Cohere Health
- Remote: United States
- Senior (5-10 years)
- 28 - 28K
Utilization ManagementHealthcare StrategySales StrategyBusiness AnalysisProject ManagementSystems Design
CA Utilization Review Case Manager I
CA Utilization Review Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- Mid-level (2-5 years)
- 56 - 83K
ICD Coding (ICD-9/ICD-10)CPT CodingUtilization ManagementOrthopedicsWorkers' Compensation ClaimsAnalytics
Medical Director--Claims Management
Medical Director--Claims Management
10 day ago
Humana
- Remote: United States
- Full time
Clinical Data AnalysisLanguage InterpretationRegulatory ComplianceUtilization ManagementMedical Licensing (Health Law)Utilization Management
Medical Director - Care Plus
Medical Director - Care Plus
26 day ago
Humana
- Remote: United States
- Full time
Language InterpretationClinical InformaticsRegulatory ComplianceUtilization ManagementOnline CommunicationMedical Licensing (Health Law)
Clinical Pharmacist.
Clinical Pharmacist.
30+ days ago
Lifelancer
- Remote: United States, Hawaii (USA)
- Full time
- Mid-level (2-5 years)
- 103 - 191K
Pharmacist AssistanceMedication Therapy ManagementPharmacotherapyPrior AuthorizationPharmacy Benefit ManagementMedication Inventory
Medical Director - Mid West Region
Medical Director - Mid West Region
28 day ago
Humana
- Remote: United States
- Full time
Language InterpretationRegulatory ComplianceUtilization ManagementClinical DocumentationBasic Patient CareUtilization Management
Manager Utilization Management
Manager Utilization Management
30+ days ago
Spectrum Health
- Remote: United States
- Full time
- Senior (5-10 years)
Process ImprovementProject CollaborationQuickbaseUtilization ManagementData EntryCompliance Management
Medical Director - Neurology
Medical Director - Neurology
7 day ago
The Cigna Group
- Remote: United States
- Full time
Utilization ManagementMedical ManagementCare ManagementClinical AssessmentsBasic Patient CareProject Management
Senior Clinical Documentation Specialist (CDS)
Senior Clinical Documentation Specialist (CDS)
8 day ago
UPMC
- Remote: United States
- Full time
Diagnosis-Related GroupMedical Record ManagementClinical DocumentationTeam NursingBasic Patient CareClinical Assessments
Career Opportunities: Field Reimbursement Access Manager (Southern California) (16113)
Career Opportunities: Field Reimbursement Access Manager (Southern California) (16113)
30+ days ago
Bausch + Lomb
- Remote: United States
- 150 - 175K
Liability InsuranceReimbursement RegulationsProject ManagementMedical AssistanceBusiness PlanningUtilization Management
Board Certified-Texas Licensed Physician Reviewer-Multiple Specialties
Board Certified-Texas Licensed Physician Reviewer-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, Texas (USA)
- Full time
Medical Licensing (Health Law)Medical NecessityUtilization Management
Connecticut-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
Connecticut-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States
- Fixed term
Medical NecessityUtilization ManagementClinical AssessmentsCare Management
Physician Advisor
Physician Advisor
30+ days ago
Med-Metrix
- Remote: United States
- Full time
- Mid-level (2-5 years)
Patient SafetyUtilization ManagementEmergency Medical DispatchInterQual CriteriaMedical Licensing (Health Law)Physician Credentialing
Weekend Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote
Weekend Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote
30+ days ago
Healthfirst
- Remote: United States, Laos, Kansas (USA), Minnesota (USA), Wyoming (USA)
- Full time
- 71 - 116K
Utilization ManagementClinical InvestigationsCompliance ManagementHealthcare QualityDental HygieneAppeals
Central Denials Unit Coordinator
Central Denials Unit Coordinator
30+ days ago
Russell Tobin
- Remote: United States, California (USA)
- Fixed term
- Senior (5-10 years)
- 38 - 42K
Internal DocumentationCPT CodingUtilization ManagementMedical Licensing (Health Law)Electronic ReferralsICD Coding (ICD-9/ICD-10)
Financial Analyst (Remote)
Financial Analyst (Remote)
30+ days ago
HR Prospect
- Remote: United States, New Jersey (USA)
- Full time
- Junior (1-2 years)
Client ServicesCorporate Financial ReportingUtilization ManagementVendor ManagementGroup InsuranceAnalytics
Board Certified NC - Licensed Physician Reviewers - Multiple Specialties
Board Certified NC - Licensed Physician Reviewers - Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, North Carolina (USA)
Medical Licensing (Health Law)Medical NecessityUtilization ManagementOrthopedics
Medical Director- South Central
Medical Director- South Central
30+ days ago
Conviva Care Solutions
- Remote: United States
- Full time
- Senior (5-10 years)
- 223 - 313K
Utilization ManagementClinical AssessmentsRegulatory ComplianceMedical GuidelineMedical Practice ExperienceDischarge Planning
Medical Case Manager II - RN (Bilingual English-Spanish)
Medical Case Manager II - RN (Bilingual English-Spanish)
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- Mid-level (2-5 years)
- 58 - 89K
NursingOrthopedicsNeurologyRehabilitationManaged CareClinical Medicine
Program Manager, Utilization Management
Program Manager, Utilization Management
14 day ago
Curana Health
- Remote: United States
- Full time
Utilization ManagementCare ManagementAnalyticsProject ManagementICD Coding (ICD-9/ICD-10)CPT Coding
Clinical Operations Manager
Clinical Operations Manager
30+ days ago
Gravie
- Remote: United States
- Full time
General SurgeryHealthcare StrategyCost ContainmentUtilization ManagementData MiningTransitional Care
Staff Vice President PHCO UM Operations Support
Staff Vice President PHCO UM Operations Support
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Senior (5-10 years)
- 182 - 345K
Utilization ManagementRegulatory ComplianceBusiness OperationsBusiness DevelopmentStakeholder CommunicationsProduct Software Implementation Method
Autism Services Navigator, Case Manager, RN/LCSW
Autism Services Navigator, Case Manager, RN/LCSW
30+ days ago
TriWest Healthcare Alliance
- Remote: United States, Azerbaijan, Arizona (USA)
- Mid-level (2-5 years)
- 81 - 103K
Autism Spectrum DisordersBehavioral HealthMedical CodingHealth AdministrationTri-careHealth Care Finance Administration (HCFA) Regulations
