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
359 jobs
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Nurse Practitioner (Ocean, New Jersey)
Nurse Practitioner (Ocean, New Jersey)
28 day ago
CareCentrix
- Remote: New Jersey (USA)
- Full time
Utilization ManagementAcute Care NursingClinical AuditingBasic Patient Care
Clinical Nurse Case Manager – USRN
Clinical Nurse Case Manager – USRN
18 day ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
Medical ManagementClinical Assessments
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 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 ManagementNursing
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
30+ days ago
Morgan Stephens
- Remote: Kentucky (USA)
- Full time
Utilization ManagementMedical GuidelineClinical Assessments
Resource Management Coordinator
Resource Management Coordinator
12 day ago
GuidePoint Security
- Remote: United States
- Full time
Identity And Access ManagementProject ManagementResource Management
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
9 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Utilization ManagementClinical AssessmentsMedical Necessity
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 CompactUtilization Management
Staff Dentist
Staff Dentist
3 day ago
LIBERTY Dental Plan
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementQuality Assessment
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 Scanning
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 Authorization
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
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 Management
Payment Integrity Manager
Payment Integrity Manager
30+ days ago
CorVel Corporation
- Remote: United States, Texas (USA)
- Senior (5-10 years)
- 5 - 121K
Auditing
Clinical Care Reviewer, Pediatric Shift Care, RN
Clinical Care Reviewer, Pediatric Shift Care, RN
25 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Utilization ManagementNursingPediatricsClinical Assessments
Senior Mainframe Systems Programmer - zOS 
Senior Mainframe Systems Programmer - zOS
30+ days ago
Ensono
- Remote: India
- Senior (5-10 years)
z/OSDisaster Recovery
Senior Business Analyst – Clinical Operations Support
Senior Business Analyst – Clinical Operations Support
10 day ago
UST HealthProof
- Remote: United States
- Full time
AnalyticsBusiness AnalysisProject ManagementHealthcare Industry Knowledge
RN Reviewer 
RN Reviewer
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
Utilization ManagementNursing
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 Management
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
Nurse Registry
Utilization Review Nurse - LPN (Remote)
Utilization Review Nurse - LPN (Remote)
30+ days ago
Morgan Stephens
- Remote: Florida (USA)
- Full time
Utilization ManagementUsage TrackingRegulatory Compliance
Medicaid Provider Materials Lead
Medicaid Provider Materials Lead
16 day ago
Humana
- Remote: United States
- Full time
Content CreationInstructional DesignProject Management
RN I
RN I
30+ days ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: New Jersey (USA)
- Full time
Utilization ManagementCare ManagementClinical AssessmentsPatient Education And Counseling
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
30+ days ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
Gastroenterology
RN 1
RN 1
1 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: United States
- Full time
Nurse Licensure Compact
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 Management
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
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 Assessments
CDI Specialist
CDI Specialist
14 day ago
UPMC
- Remote: United States
- Full time
Diagnosis-Related GroupProspective Payment SystemsClinical DocumentationMedical Coding
Supervisor PA & UM Programs
Supervisor PA & UM Programs
29 day ago
MedImpact Healthcare Systems, Inc.
- Remote: California (USA)
- Full time
Clinical InvestigationsPrior AuthorizationPharmacy Operations
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 Management
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 Authorization
Utilization review Nurse
Utilization review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: Michigan (USA)
Discharge PlanningCare Coordination
Care Coordinator- CISC
Care Coordinator- CISC
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 50 - 75K
Director, Care & Case Management - Government Programs
Director, Care & Case Management - Government Programs
1 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: United States
- Full time
Medical ManagementCare ManagementDisease ManagementUtilization Management
Utilization Management Nurse Analyst (Remote)
Utilization Management Nurse Analyst (Remote)
2 day ago
Availity
- Remote: United States
- Part time
Natural Language Processing (NLP)Utilization ManagementArtificial Intelligence
Utilization Management Coordinator (Home-Based) - Prior Authorization
Utilization Management Coordinator (Home-Based) - Prior Authorization
12 day ago
Sanford Health
- Remote: United States
- Full time
Authorization (Computing)Utilization ManagementCoding TheoryHealth Reimbursement Arrangement
Clinician, C365
Clinician, C365
8 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Utilization ManagementProcess ManagementMental Health Counseling
Clinical Operations Manager (Internal Only)
Clinical Operations Manager (Internal Only)
13 day ago
NOCD
- Remote: United States
- Full time
Medical 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
Registered Nurse Utilization Management Specialist
Registered Nurse Utilization Management Specialist
28 day ago
UnityPoint Health
- Remote: United States
- Full time
Utilization ManagementNursing
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 ManagementNeurology
Registered Nurse Advocate, Proactive Care Management
Registered Nurse Advocate, Proactive Care Management
29 day ago
EPIC Insurance Brokers & Consultants
- Remote: United States
- Full time
Care ManagementUtilization ManagementClinical Auditing
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 Management
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 Management
Senior Complex Bill Reviewer 2
Senior Complex Bill Reviewer 2
21 day ago
Mitchell International
- Remote: United States
- Full time
Clinical ConsultingMedical Coding
Clinical Product Consultant - UM
Clinical Product Consultant - UM
30+ days ago
Iodine Software
- Remote: United States
- Freelance
- Senior (5-10 years)
Project ManagementUtilization Management
Board Certified Medical Toxicology Physician Advisor, Disability Peer Review
Board Certified Medical Toxicology Physician Advisor, Disability Peer Review
13 day ago
Dane Street, LLC
- Remote: United States
- Freelance
Toxicology
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 Management
Medical Director - Post-Acute Care - Evernorth Home-based Care - Remote
Medical Director - Post-Acute Care - Evernorth Home-based Care - Remote
8 day ago
The Cigna Group
- Remote: United States
- Full time
Discharge PlanningUtilization ManagementClinical Assessments
