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
370 jobs
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Government Appeals Manager
Government Appeals Manager
3 day ago
Intermountain Health
- Remote: United States
- Full time
AppealsClinical Data AnalysisRevenue ManagementUtilization ManagementHealth PoliciesRegulatory Compliance
RN Utilization Review
RN Utilization Review
5 day ago
EFI Global
- Remote: United States
- Full time
Utilization ManagementClinical PracticesInsurance LawEvidence-Based PracticeCompetency AssessmentClaims And Litigation Management
Primary Therapist - Virtual - (East Coast - NY license)
Primary Therapist - Virtual - (East Coast - NY license)
23 day ago
Monte Nido
- Remote: New York (USA)
- Full time
Group TherapyFamily TherapyEating Disorder TreatmentUtilization ManagementDischarge PlanningNutrition Intervention
USRN (Utilization Management)
USRN (Utilization Management)
30+ days ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
- Junior (1-2 years)
Utilization ManagementMedical Insurance ClaimsMedical Record Management
Customer Success Manager
Customer Success Manager
30+ days ago
Salsify
- Remote: Portugal
- 32 - 38K
Customer Success ManagementChange ManagementCustomer RetentionSalesforceCustomer Success ManagementBusiness Valuation
Clinical Product Consultant - UM
Clinical Product Consultant - UM
28 day ago
Iodine Software
- Remote: Texas (USA)
- Full time
Utilization ManagementProject ManagementClinical AssessmentsInterQual CriteriaCare ManagementChronic Care
IP Manager
IP Manager
11 day ago
Finning
- Remote: Chile
- Full time
Process OptimizationProject ManagementPerformance MetricCustomer Relationship ManagementAnalyticsProject Integration
Physician Utilization Reviewer (Medical Director)
Physician Utilization Reviewer (Medical Director)
9 day ago
Medical Review Institute
- Remote: California (USA)
- Full time
Utilization ManagementClinical MedicineBasic Patient CareAdjudicationFamily MedicineMedical Licensing (Health Law)
HRSN Specialist RN I
HRSN Specialist RN I
19 day ago
Samaritan Health Services
- Remote: Arizona (USA), Arkansas (USA), Connecticut (USA), Florida (USA), Georgia (USA), Idaho (USA), Indiana (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Louisiana (USA), Michigan (USA), Mississippi (USA), Missouri (USA), Montana (USA)
- Full time
MedicaidClinical NursingMedical AbbreviationsHealthcare Delivery ModelsDigital File ManagementICD Coding (ICD-9/ICD-10)
Strategy & Business Development Analyst II
Strategy & Business Development Analyst II
11 day ago
Essentia Health
- Remote: North Dakota (USA)
- Full time
AnalyticsMarket AnalysisBusiness IntelligencePerformance AnalyticsQualitative Data AnalysisDatabase Management
Field Medical Director, Radiology (Endocrinology)
Field Medical Director, Radiology (Endocrinology)
Today
New Century Health
- Remote: United States
- Full time
Utilization ManagementClinical AssessmentsClinical AssessmentsClinical PracticesMedical Licensing (Health Law)Internal Documentation
Utilization Review Clinician - ABA
Utilization Review Clinician - ABA
10 day ago
Centene Corporation
- Remote: Florida (USA)
- Full time
Utilization ManagementBehavioral HealthApplied Behavior AnalysisNurse Licensure CompactBehavioral HealthHospital Experience
PM&R Telecommute Medical Review Stream
PM&R Telecommute Medical Review Stream
27 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Credential ManagerManaged CareMedical Necessity
Medical Field Case Manager
Medical Field Case Manager
26 day ago
Genex Services
- Remote: Vermont (USA)
- Full time
Care ManagementPatient EvaluationTreatment PlanningWorkers' Compensation ClaimsClinical PracticesOnline Communication
Medical Field Case Manager
Medical Field Case Manager
30+ days ago
Genex Services
- Remote: Colorado (USA)
- Full time
Care ManagementNursingWorkers' CompensationClinical PracticesAcute Care NursingUtilization Management
VP, Clinical Operations
VP, Clinical Operations
26 day ago
TriWest Healthcare Alliance
- Remote: Arizona (USA)
- Full time
Clinical System OperationsMedicarePolicy DevelopmentPublic HealthAnalyticsMedical Management
Telecommute Medical Review Stream Physician
Telecommute Medical Review Stream Physician
27 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Plastic SurgeryRehabilitationPhysical Medicine And Rehabilitation
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
10 day ago
Bright Health
- Remote: California (USA)
- Full time
Utilization ManagementMedical GuidelineElectronic Health Record ApplicationsMedical NecessityInterQual CriteriaCare Management
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
5 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Utilization ManagementClinical AssessmentsMedical NecessityNurse Licensure CompactOrganizational StructureNursing Care
Intake Coordinator
Intake Coordinator
16 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 ManagementData EntryHealth Care IndustryTeleconferencingAdministrative Law
PM&R Telecommute Medical Review Stream
PM&R Telecommute Medical Review Stream
27 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Managed CareMedical Necessity
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 ManagementClinical MedicineRegulatory ComplianceCare ManagementEducational AssessmentBasic Patient Care
Quality Improvement Coordinator I
Quality Improvement Coordinator I
3 day ago
Centene Corporation
- Remote: United States
- Full time
Health Care Risk ManagementHEDIS (Healthcare Effectiveness Data And Information Set)Clinical Quality ManagementQuality AssessmentPerformance ManagementAuditing
Neurologist Telecommute Medical Review Stream
Neurologist Telecommute Medical Review Stream
27 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
Medical Licensing (Health Law)Clinical AssessmentsNeurologyMedical NecessityUtilization ManagementCredential Manager
Clinical Pharmacist, Utilization Management
Clinical Pharmacist, Utilization Management
3 day ago
Rightway
- Remote: United States
- Full time
Utilization ManagementPharmacy Benefit ManagementPharmacist AssistanceHealthcare StrategyHealth Policy DevelopmentPrior Authorization
Utilization Management Nurse
Utilization Management Nurse
17 day ago
Cambia Health Solutions
- Remote: Idaho (USA), Oregon (USA), Utah (USA), Washington (USA)
- Full time
Utilization ManagementChronic CareCare ManagementHealthcare Industry KnowledgeNurse Licensure CompactRetrospective Reviews
Utilization Management Registered Nurse, Indiana - Remote
Utilization Management Registered Nurse, Indiana - Remote
27 day ago
McLaren Health Care
- Remote: Indiana (USA)
- Full time
Utilization ManagementClinical NursingManaged CareCare ManagementNurse Licensure CompactBehavioral Change Theories
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
10 day ago
NeueHealth
- Remote: California (USA)
- Full time
Utilization ManagementMedical GuidelineMedical NecessityElectronic Health Record ApplicationsCare ManagementUtilization Management
Full-Time RN Case Manager (UR Focused) | Texas
Full-Time RN Case Manager (UR Focused) | Texas
30+ days ago
Beam Healthcare
- Remote: Texas (USA)
- Full time
Care CoordinationCare ManagementDischarge PlanningUtilization ManagementInterQual CriteriaInpatient Care
Medical Director - Pediatric Otolaryngology- EviCore
Medical Director - Pediatric Otolaryngology- EviCore
24 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
OtolaryngologyClinical AssessmentsEvidence-Based PracticeComputer SystemsUtilization ManagementMedical Necessity
Medical Field Case Manager
Medical Field Case Manager
27 day ago
Genex Services
- Remote: Illinois (USA)
- Full time
Care ManagementNursingWorkers' CompensationBasic Patient CareTreatment PlanningClinical Practices
Medical Director - Medical Oncology - eviCore - Remote
Medical Director - Medical Oncology - eviCore - Remote
14 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
Evidence-Based PracticeClinical AssessmentsMedical OncologyCare ManagementMedical Licensing (Health Law)Utilization Management
Physician Reviewer, Medical Managment
Physician Reviewer, Medical Managment
16 day ago
AltaMed Health Services
- Remote: California (USA)
- Full time
Authorization (Computing)Utilization ManagementMedical ManagementCase Management SystemsCare Coordination
Senior Business Analyst – Clinical Operations Support
Senior Business Analyst – Clinical Operations Support
6 day ago
UST HealthProof
- Remote: United States
- Full time
AnalyticsBusiness AnalysisProject ManagementHealthcare Industry KnowledgeEngineering DocumentationUser Acceptance Testing (UAT)
Clinical Care Reviewer, Pediatric Shift Care, RN
Clinical Care Reviewer, Pediatric Shift Care, RN
21 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Utilization ManagementNursingPediatricsClinical AssessmentsClinical InformaticsInterQual Criteria
Medical Director -Pediatric Surgery
Medical Director -Pediatric Surgery
30+ days 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
27 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
NeurosurgeryUtilization ManagementClinical AssessmentsMedical NecessityInsurance ReviewsManaged Care
Network Performance Advisor
Network Performance Advisor
25 day ago
Sunshine Health
- Remote: Florida (USA)
- Full time
Provider ModelPerformance Based ContractingNetwork AdministrationFinancial AnalysisUtilization ManagementQuality Assessment
Primary Therapist - Virtual - (East Coast - NY license)
Primary Therapist - Virtual - (East Coast - NY license)
23 day ago
Monte Nido & Affiliates
- Remote: New York (USA)
- Full time
Group TherapyFamily TherapyUtilization ManagementDischarge PlanningNutrition InterventionEmotional Disorders
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
27 day ago
Concentra
- Remote: Colorado (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)Managed CareMedical Necessity
Resource Management Coordinator
Resource Management Coordinator
9 day ago
GuidePoint Security
- Remote: United States
- Full time
Identity And Access ManagementProject ManagementResource ManagementSalesforceProfessional Services AutomationGeneral Security
Clinical Nurse Case Manager – USRN
Clinical Nurse Case Manager – USRN
14 day ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
Medical ManagementClinical AssessmentsUtilization ManagementMedical GuidelineCompliance ManagementInterQual Criteria
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
Supervisor-Utilization Review/Full Time/Remote
Supervisor-Utilization Review/Full Time/Remote
18 day ago
Henry Ford Health
- Remote: Michigan (USA)
- Full time
Utilization ManagementRevenue ManagementFinancial ManagementProject ManagementAnalytical DashboardKPI Management
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
Associate Director - Clinical Solutions - Care Management/Utilization Management
Associate Director - Clinical Solutions - Care Management/Utilization Management
3 day ago
Guidehouse
- Remote: United States
- Full time
Utilization ManagementCare ManagementClinical PracticesData MiningProject ManagementCustomer Relationship Management
Nurse Practitioner (Ocean, New Jersey)
Nurse Practitioner (Ocean, New Jersey)
25 day ago
CareCentrix
- Remote: New Jersey (USA)
- Full time
Utilization ManagementAcute Care NursingClinical AuditingBasic Patient CareMedical Record ManagementInterQual Criteria
