Remote Utilization Management Jobs
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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
357 jobs
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Career Opportunities: Clinical Operations Manager (24958)
Career Opportunities: Clinical Operations Manager (24958)
Today
CareOregon
- From: Arizona (USA), Idaho (USA), Montana (USA), Nevada (USA), Texas (USA), Utah (USA), Washington (USA), Wisconsin (USA) (Full Remote)
- Full time
Clinical System OperationsUtilization ManagementMedicareCare Management
Licensed Master Social Work Case Manager
Licensed Master Social Work Case Manager
1 day ago
Arkansas Blue Cross and Blue Shield
- From: Florida (USA), Georgia (USA), Illinois (USA), Kansas (USA), Louisiana (USA), Minnesota (USA), Mississippi (USA), Oklahoma (USA), South Carolina (USA), Tennessee (USA), Texas (USA), Virginia (USA), Wisconsin (USA) (Full Remote)
- Full time
Case Management SystemsMedical Social Work
Health Support Coordinator
Health Support Coordinator
1 day ago
Blue Cross and Blue Shield of Minnesota
- From: Minnesota (USA) (Full Remote)
- Full time
Utilization ManagementDisease ManagementCare Management
Trinsic Nurse Care Manager COFR-11
Trinsic Nurse Care Manager COFR-11
1 day ago
Intermountain Health
- From: Colorado (USA) (Full Remote)
- Full time
Patient Education And CounselingCare Management
Clinical Review Nurse-Prior Authorization
Clinical Review Nurse-Prior Authorization
1 day ago
Centene Corporation
- From: Florida (USA) (Full Remote)
- Full time
Clinical Data AnalysisAuthorization (Computing)Utilization ManagementMedical Necessity
Senior Data Analyst, Population Health
Senior Data Analyst, Population Health
1 day ago
Brighton Health Plan Solutions
- From: North Carolina (USA) (Full Remote)
- Full time
AnalyticsSQL (Programming Language)Microsoft SQL Server Data Engine (MSDE)Statistical Modeling
Medical Case Manager - Putnam County
Medical Case Manager - Putnam County
1 day ago
BlueCross BlueShield of Tennessee
- From: United States (Full Remote)
- Full time
Care ManagementNursingUtilization Management
Utilization Management Coordinator (Home-Based) - Prior Authorization
Utilization Management Coordinator (Home-Based) - Prior Authorization
2 day ago
Sanford Health
- From: Wisconsin (USA) (Full Remote)
- Full time
Utilization ManagementCoding TheoryHealth Reimbursement ArrangementClinical Assessments
Clinical Letter Writer - UM & Specialty Experience is a MUST
Clinical Letter Writer - UM & Specialty Experience is a MUST
1 day ago
New Century Health
- From: United States (Full Remote)
- Full time
Utilization ManagementCardiologyMedical WritingOncology
RN Clinical Review Nurse - Prior Authorization
RN Clinical Review Nurse - Prior Authorization
2 day ago
Centene Corporation
- From: New York (USA) (Full Remote)
- Full time
Clinical Data AnalysisUtilization ManagementNurse Licensure CompactMedical Necessity
Behavioral Health Clinical Liaison
Behavioral Health Clinical Liaison
1 day ago
Centene Corporation
- From: United States (Full Remote)
- Full time
Pediatric Medical Director - Florida
Pediatric Medical Director - Florida
1 day ago
Centene Corporation
- From: United States (Full Remote)
- Full time
Clinical GovernanceUtilization ManagementQuality AssessmentCredential Manager
Senior Analyst, Healthcare Analytics Consultant
Senior Analyst, Healthcare Analytics Consultant
1 day ago
Evolent Health
- From: United States (Full Remote)
- Full time
SAS (Software)SQL (Programming Language)Healthcare AnalyticsData Mining
Authorization Specialist Associate
Authorization Specialist Associate
1 day ago
Geisinger
- From: United States (Full Remote)
- Full time
Authorization (Computing)Civic Engagement
Crisis Responder / Qualified Professional
Crisis Responder / Qualified Professional
3 day ago
RHA Health Services, LLC
- From: North Carolina (USA) (Full Remote)
- Full time
Care ManagementBehavioral HealthCrisis Management
Part-time Pediatric / Family Medicine Medical Director - Florida
Part-time Pediatric / Family Medicine Medical Director - Florida
1 day ago
Centene Corporation
- From: United States (Full Remote)
- Part time
Cost ContainmentUtilization ManagementClinical AssessmentsQuality Assessment
Senior Financial Analyst - Employee Benefits
Senior Financial Analyst - Employee Benefits
2 day ago
HUB International
- From: Oregon (USA), Washington (USA) (Full Remote)
- Full time
Financial AnalysisBenefits Administration
Clinical Documentation Specialist 1 - Remote
Clinical Documentation Specialist 1 - Remote
5 day ago
University of Miami
- From: Florida (USA) (Full Remote)
- Full time
Utilization ManagementReimbursement RegulationsData AbstractionClinical Documentation
Resource Manager III, ( 25-1350)
Resource Manager III, ( 25-1350)
4 day ago
GE Vernova
- From: Singapore (Full Remote)
- Full time
Resource AllocationProject ManagementPerformance Management
RC Appellate Clinician - Remote $10K Sign on Bonus
RC Appellate Clinician - Remote $10K Sign on Bonus
10 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
InterQual CriteriaMedical Necessity
Utilization Management Specialist (Home-Based) - Prior Authorization
Utilization Management Specialist (Home-Based) - Prior Authorization
3 day ago
Sanford Health
- From: Minnesota (USA), North Dakota (USA), South Dakota (USA) (Full Remote)
- Part time
Utilization ManagementDiagnosis CodesInterQual CriteriaMedical Necessity
Senior Financial Analyst - Employee Benefits
Senior Financial Analyst - Employee Benefits
2 day ago
HUB International Canada
- From: Oregon (USA), Washington (USA) (Full Remote)
- Full time
Financial AnalysisActuarial Science
Senior Utilization Review Specialist 
Senior Utilization Review Specialist
9 day ago
Compass Health Center
- From: Illinois (USA) (Full Remote)
- Full time
Insurance LawUtilization ManagementPatient Education And Counseling
RN Senior Medical Reviewer - CGS
RN Senior Medical Reviewer - CGS
9 day ago
BlueCross BlueShield of South Carolina
- From: South Carolina (USA), Tennessee (USA) (Full Remote)
- Full time
Clinical AssessmentsUtilization ManagementClinical AssessmentsCare Management
Supervisor, Clinical Review
Supervisor, Clinical Review
30+ days ago
Comagine Health
- From: United Kingdom (Full Remote)
- Senior (5-10 years)
- 81 - 113K
Medical Management
Senior FP&A & Costing Analyst
Senior FP&A & Costing Analyst
8 day ago
Epiq Systems (Private) Limited
- From: Arizona (USA), Florida (USA), Illinois (USA), Kansas (USA), New York (USA), Oregon (USA), Texas (USA) (Full Remote)
- Full time
Financial ManagementCost AccountingCost Benefit AnalysisAWS Cost Management
National Medical Director
National Medical Director
30+ days ago
CorVel Corporation
- From: Virginia (USA) (Full Remote)
- Part time
- Expert & Leadership (>10 years)
Regulatory ComplianceUtilization Management
RN Senior Medical Reviewer - CGS
RN Senior Medical Reviewer - CGS
10 day ago
CGS Administrators, LLC
- From: South Carolina (USA), Tennessee (USA) (Full Remote)
- Full time
Clinical AssessmentsUtilization ManagementClinical AssessmentsCare Management
Medical Review Nurse RN
Medical Review Nurse RN
18 day ago
Florida Blue
- From: Florida (USA) (Full Remote)
- Full time
Clinical Data AnalysisNursingClinical AssessmentsPrior Authorization
Market Quality Improvement Specialist I
Market Quality Improvement Specialist I
4 day ago
CareSource
- From: Ohio (USA) (Full Remote)
- Full time
Technical WritingAnalyticsProject CoordinationQuality Assessment
Care Manager, Health Plan - Licensed / Remote in CA
Care Manager, Health Plan - Licensed / Remote in CA
16 day ago
Magellan Health
- From: California (USA) (Full Remote)
- Full time
Health Risk AssessmentsBehavioral HealthCare ManagementClinical Medicine
Utilization Review Clinician - Behavioral Health
Utilization Review Clinician - Behavioral Health
14 day ago
Centene Corporation
- From: New York (USA) (Full Remote)
- Full time
Clinical Data AnalysisUtilization ManagementMental Health AssessmentsSubstance Abuse Assessments
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
- From: Michigan (USA) (Full Remote)
- Full time
Utilization ManagementNursingCare ManagementClinical Assessments
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
Sidecar Health
- From: Florida (USA), Georgia (USA), Kentucky (USA), Ohio (USA) (Full Remote)
- Full time
Utilization ManagementMedical GuidelineNursingMedical Necessity
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- From: Michigan (USA) (Full Remote)
Discharge PlanningCare Coordination
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
28 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
AppealsInterQual CriteriaMedical Necessity
Clinical Coding and OASIS Review Manager
Clinical Coding and OASIS Review Manager
30+ days ago
BAYADA Home Health Care
- From: Texas (USA) (Full Remote)
- Full time
ICD 503
Clinical Integration Liaison - Licensed/Remote in CA
Clinical Integration Liaison - Licensed/Remote in CA
30+ days ago
Magellan Health
- From: California (USA) (Full Remote)
- Full time
Clinical Data ExchangeUtilization ManagementProject ManagementMental Health Education
Oracle Utilities MDM Consultant
Oracle Utilities MDM Consultant
30+ days ago
Talpro - Leaders in Technology Hiring
- From: India (Full Remote)
- Full time
Oracle Application Framework (OAF)Java (Programming Language)IBM InfoSphere MDM
UM Prior Authorization Nurse, LVN/LPN
UM Prior Authorization Nurse, LVN/LPN
8 day ago
Bright Health
- From: California (USA) (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
Telephonic Medical Case Management (Workers' compensation)
Telephonic Medical Case Management (Workers' compensation)
23 day ago
TRISTAR Insurance Group
- From: South Carolina (USA) (Full Remote)
- Full time
Care CoordinationCare ManagementUtilization ManagementClinical Assessments
UM Prior Authorization Nurse, LVN/LPN
UM Prior Authorization Nurse, LVN/LPN
8 day ago
NeueHealth
- From: California (USA) (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
Clinical Facilitator, RN or SW
Clinical Facilitator, RN or SW
30+ days ago
Healthfirst
- From: New York (USA) (Full Remote)
- Full time
Support EngineeringAdult Learning PrinciplesClinical PracticesCurriculum Development
USRN (Utilization Review)
USRN (Utilization Review)
30+ days ago
Nezda Technologies Inc.
- From: Philippines (Full Remote)
- Full time
- Junior (1-2 years)
Utilization ManagementMedical Insurance Claims
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- From: Michigan (USA) (Full Remote)
Discharge PlanningCare CoordinationClinical Assessments
Career Opportunities: Actuary, Senior (24950)
Career Opportunities: Actuary, Senior (24950)
9 day ago
CareOregon
- From: Arizona (USA), Idaho (USA), Montana (USA), Nevada (USA), Oregon (USA), Texas (USA), Utah (USA), Washington (USA), Wisconsin (USA) (Full Remote)
- Full time
Financial AnalysisData ManagementActuarial Science
Resource Manager
Resource Manager
30+ days ago
Real Chemistry
- From: California (USA), Illinois (USA), Indiana (USA), Massachusetts (USA), New York (USA) (Full Remote)
- Full time
AnalyticsProject ManagementResource Management
Part Time National Dental Specialist, PA
Part Time National Dental Specialist, PA
2 day ago
Avesis, Incorporated
- From: United States (Full Remote)
- Part time
Utilization ManagementInsurance ReviewsOrthodontics
Medical Director -Pediatric Surgery
Medical Director -Pediatric Surgery
5 day ago
Evernorth Health Services
- From: Ohio (USA) (Full Remote)
- Full time
Clinical AssessmentsPediatric Surgery
Family Practice Telecommute Medical Review
Family Practice Telecommute Medical Review
25 day ago
Concentra
- From: New Jersey (USA) (Full Remote)
- Full time
Credential ManagerUtilization ManagementClinical AssessmentsClinical Assessments
