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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Enterprise Medical Director
Enterprise Medical Director
4 day ago
CareSource
- Remote: United States
- Full time
Medical DirectionMedical Record ManagementMedical Practice ExperienceClient EducationClinical Data AnalysisAnalytics
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
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
Business Development Director (Clinical Documentation and Coding)
Business Development Director (Clinical Documentation and Coding)
12 day ago
R1 RCM
- Remote: United States
- Full time
Coding TheoryRevenue ManagementClinical DocumentationStaff PlanningUtilization ManagementSoftware Systems
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
Primary Therapist - Virtual
Primary Therapist - Virtual
24 day ago
Monte Nido
- Remote: United States
- Freelance
PsychotherapyBasic Patient CareCounseling TechniquesEmotional DisordersDischarge PlanningUtilization Management
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
Career Opportunities: Help Desk Representative - Healthcare - Remote US (29667)
Career Opportunities: Help Desk Representative - Healthcare - Remote US (29667)
9 day ago
Gainwell Technologies LLC
- Remote: United States
- Full time
Problem ManagementIncident ManagementHealth Care IndustryOffice ManagementUtilization ManagementComputer Systems
Medical Director
Medical Director
13 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementRegulatory ComplianceMedical LawProject ManagementMedical Direction
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
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
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
Senior Analyst, Client Analytics
Senior Analyst, Client Analytics
26 day ago
New Century Health
- Remote: United States
- Full time
SAS (Software)SQL (Programming Language)Data VisualizationBusiness Intelligence ToolsHealthcare AnalyticsValue-Based Care
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
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
Director, Clinical Pharmacy
Director, Clinical Pharmacy
6 day ago
Humana
- Remote: United States
- Full time
Utilization ManagementClinical PharmacyPolicy DevelopmentDrug DevelopmentCross-Functional CollaborationPharmacist Assistance
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
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
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
Telephonic Case Manager
Telephonic Case Manager
26 day ago
Genex Services
- Remote: United States
- Full time
Care ManagementWorkers' CompensationClinical PracticesNurse RegistryNursingUtilization Management
Field Reimbursement Manager - Immunology - Newark, NJ
Field Reimbursement Manager - Immunology - Newark, NJ
14 day ago
Regeneron
- Remote: United States
- Full time
Reimbursement RegulationsMarket Access StrategyBiomedical SciencesPrior AuthorizationPharmaceuticalsUtilization Management
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
Clinician, C365
Clinician, C365
14 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Utilization ManagementMental Health AssessmentsProcess ManagementChronic CareNurse Licensure CompactOnline Communication
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
Primary Therapist - Virtual - (East Coast license)
Primary Therapist - Virtual - (East Coast license)
16 day ago
Monte Nido & Affiliates
- Remote: United States
- Full time
PsychotherapyCounseling TechniquesEmotional DisordersClinical ConsultingDischarge PlanningUtilization Management
Clinician, C365
Clinician, C365
14 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Utilization ManagementMental Health AssessmentsProcess ManagementChronic CareNurse Licensure CompactOnline Communication
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)
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
26 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Care CoordinationUtilization ManagementClinical AssessmentsMedical NecessityClinical Quality ManagementNurse Licensure Compact
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
Nurse Coder DRG Auditor I (US Remote)
Nurse Coder DRG Auditor I (US Remote)
5 day ago
Trend Health Partners
- Remote: United States
- Full time
Coding TheoryDiagnosis-Related GroupCPT CodingClinical PracticesOnline CommunicationConcept Analysis
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
