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
348 jobs
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Primary Therapist - Virtual - (East Coast license)
Primary Therapist - Virtual - (East Coast license)
4 day ago
Monte Nido & Affiliates
- Remote: United States
- Full time
PsychotherapyCounseling TechniquesEmotional DisordersClinical ConsultingDischarge PlanningUtilization Management
Grievance & Appeals Nurse
Grievance & Appeals Nurse
12 day ago
IEHP
- Remote: California (USA)
- Full time
AppealsGrievance ArbitrationCare ManagementUtilization ManagementMicrocomputerClinical Assessments
Medical Director -Pediatric Surgery
Medical Director -Pediatric Surgery
20 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
Pediatric SurgeryEvidence-Based PracticeComputer SystemsUtilization ManagementClinical AssessmentsHealth Laws
Business Analyst III - Risk Adjustment
Business Analyst III - Risk Adjustment
7 day ago
UPMC
- Remote: United States
- Full time
Financial AnalysisSQL (Programming Language)Risk ControlClaims And Litigation ManagementAnalyticsUtilization Management
Orthopedic Surgeon Telecommute Medical Review Stream
Orthopedic Surgeon Telecommute Medical Review Stream
15 day ago
Concentra
- Remote: Colorado (USA)
- Full time
Utilization ManagementClinical InformaticsClinical AssessmentsOrthopedicsManaged Care
Senior Sage X3 Finance Consultant (Remote) at NexTec Group
Senior Sage X3 Finance Consultant (Remote) at NexTec Group
26 day ago
NexTec Group
- Remote: California (USA), Texas (USA), Washington (USA)
- Full time
Accounting SoftwareFinancial AdvisingERP Systems KnowledgeDev TestingUtilization ManagementSystem Configuration
Registered Nurse-Access Care- UMC-Remote Work-36 Hours-Midnights-Detroit
Registered Nurse-Access Care- UMC-Remote Work-36 Hours-Midnights-Detroit
28 day ago
Henry Ford Health
- Remote: Michigan (USA)
- Full time
Utilization ManagementClinical MedicineRegulatory ComplianceCare ManagementEducational AssessmentBasic Patient Care
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
Utilization Review - LPN or Social Worker - Kentucky License (Remote)
16 day ago
Morgan Stephens
- Remote: Kentucky (USA)
- Full time
Utilization ManagementMedical GuidelineClinical AssessmentsHealth Management Information SystemsMedicareInternal Documentation
Neurologist Medical Review Stream
Neurologist Medical Review Stream
15 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsNeurologyManaged CareMedical Licensing (Health Law)
Utilization Review Nurse - LPN (Remote)
Utilization Review Nurse - LPN (Remote)
16 day ago
Morgan Stephens
- Remote: Arizona (USA)
- Full time
Utilization ManagementUsage TrackingProcess ImprovementCode Of Federal RegulationsState LawsCase Management Systems
Medical Director - Florida
Medical Director - Florida
3 day ago
Humana
- Remote: United States
- Full time
Utilization ManagementTreatment PlanningHome Health CareDischarge PlanningMedical GuidelineManaged Care
Full-Time RN Case Manager (UR Focused) | Texas
Full-Time RN Case Manager (UR Focused) | Texas
21 day ago
Beam Healthcare
- Remote: Texas (USA)
- Full time
Care CoordinationCare ManagementDischarge PlanningUtilization ManagementInterQual CriteriaInpatient Care
Utilization Review Nurse - LPN (Remote)
Utilization Review Nurse - LPN (Remote)
16 day ago
Morgan Stephens
- Remote: Florida (USA)
- Full time
Utilization ManagementUsage TrackingRegulatory ComplianceCode Of Federal RegulationsMedicaidMedicare
Clinical Admissions Therapist (Michigan)
Clinical Admissions Therapist (Michigan)
3 day ago
Charlie Health
- Remote: United States
- Full time
TelehealthBehavioral HealthMental Health AssessmentsUtilization ManagementPsychosocial AssessmentsElectronic Medical Record
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
Medical Director - Gastroenterology- Evicore by Evernorth- Remote
15 day ago
Evernorth Health Services
- Remote: Ohio (USA)
- Full time
GastroenterologyUtilization ManagementComputer SystemsClinical AssessmentsClinical AssessmentsHealth Laws
Field Medical Director, Radiology (Pulmonology Preferred)
Field Medical Director, Radiology (Pulmonology Preferred)
5 day ago
New Century Health
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementMedical GuidelineClinical PracticesPulmonologySecondary Research
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
Nurse Intern - Clinical Oversight - Remote
Nurse Intern - Clinical Oversight - Remote
30+ days ago
UnitedHealthcare
- Remote: United States, Texas (USA)
- Internships
- Entry-level / graduate
- 30 - 39K
Utilization ManagementLife SupportClinical Data AnalysisMedical Abbreviations
USRN
USRN
30+ days ago
Nezda Technologies Inc.
- Remote: Philippines
- Full time
- Mid-level (2-5 years)
Utilization ManagementInternational Laws
Supervisor PA & UM Programs
Supervisor PA & UM Programs
13 day ago
MedImpact Healthcare Systems, Inc.
- Remote: California (USA)
- Full time
Clinical InvestigationsPrior AuthorizationPharmacy OperationsQuality AssessmentUtilization ManagementCompliance Management
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
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
Registered Nurse Utilization Management Specialist
Registered Nurse Utilization Management Specialist
12 day ago
UnityPoint Health
- Remote: United States
- Full time
Utilization ManagementNursingUtilization ManagementMedicareCustomer Centricity
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 ManagementRegulatory ComplianceHuman Resource ManagementWorkers' Compensation ClaimsCare Management
Clinical UM Supervisor
Clinical UM Supervisor
30+ days ago
UST HealthProof
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 51 - 77K
Meeting FacilitationCare ManagementUtilization ManagementOnline CommunicationStakeholder Communications
Prior Authorization Nurse Analyst (RN) - REMOTE
Prior Authorization Nurse Analyst (RN) - REMOTE
30+ days ago
WPS Health Solutions
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 66 - 68K
Project CollaborationClinical NursingPrior AuthorizationUtilization ManagementHyland OnBaseOnline Communication
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 ManagementNursingPrior AuthorizationCorporate ForecastingRisk Management
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 CompactOnline CommunicationUtilization ManagementTri-careMedical Practice ExperienceBehavioral Health
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 ScanningEmail SoftwareMedical Abbreviations
RN Senior Medical Reviewer - CGS
RN Senior Medical Reviewer - CGS
24 day ago
BlueCross BlueShield of South Carolina
- Remote: South Carolina (USA), Tennessee (USA)
- Full time
Utilization ManagementClinical AssessmentsClinical AssessmentsHealthcare Delivery ModelsManaged CarePresentation Training
Registered Nurse Advocate, Proactive Care Management
Registered Nurse Advocate, Proactive Care Management
13 day ago
EPIC Insurance Brokers & Consultants
- Remote: United States
- Full time
Care ManagementUtilization ManagementClinical AuditingHispanic And Latino Culture
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 AuthorizationDirect Market AccessBiopharmaceuticals
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
Stakeholder EngagementCost Benefit AnalysisContinuous Quality Improvement (CQI)Care ManagementClinical AuditingHealth Policies
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 ManagementCommercial InsurancesMedicaid
Payment Integrity Manager
Payment Integrity Manager
30+ days ago
CorVel Corporation
- Remote: United States, Texas (USA)
- Senior (5-10 years)
- 5 - 121K
AuditingICD Coding (ICD-9/ICD-10)Benefits Realization ManagementUtilization ManagementWorkers' Compensation ClaimsProject Management
Senior Mainframe Systems Programmer - zOS 
Senior Mainframe Systems Programmer - zOS
30+ days ago
Ensono
- Remote: India
- Senior (5-10 years)
z/OSDisaster RecoveryPerformance AnalysisSystem MonitoringSecurity ManagementDatabase Management
RN Reviewer 
RN Reviewer
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
Utilization ManagementNursingInpatient CareQualification Protocols (IQ/OQ/PQ)Prior AuthorizationWeb Standards
UM Administration Coordinator
UM Administration Coordinator
Today
Humana
- Remote: United States
- Full time
Health AdministrationUtilization ManagementOnline CommunicationMedical AbbreviationsICD Coding (ICD-9/ICD-10)Prior Authorization
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 ManagementProcess ImprovementInternal CommunicationsClinical AssessmentsAnalytics
Care Coordinator IV
Care Coordinator IV
30+ days ago
Presbyterian Healthcare Services
- Remote: United States, New Mexico (USA)
- Full time
- Expert & Leadership (>10 years)
- 91 - 91K
Care CoordinationUtilization ManagementEducational AssessmentCross-Functional CollaborationElectronic ReferralsCost Benefit Analysis
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
Utilization ManagementNeurologyPhysical Medicine And RehabilitationCost ContainmentOrthopedicsNurse Registry
RN I
RN I
22 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: New Jersey (USA)
- Full time
Utilization ManagementCare ManagementClinical AssessmentsPatient Education And CounselingOnline CommunicationForward Planning
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 ManagementCare PlanningAnalytics
Care Coordinator Central DD-Conway (Faulkner Co)
Care Coordinator Central DD-Conway (Faulkner Co)
27 day ago
Empower Healthcare Solutions
- Remote: Arkansas (USA)
- Full time
Care CoordinationPatient Education And CounselingCompliance ManagementProcess ImprovementElectronic ReferralsMedicare
RN Health Coordinator - $5,000 Sign On - Field Based on Oahu, HI
RN Health Coordinator - $5,000 Sign On - Field Based on Oahu, HI
30+ days ago
UnitedHealthcare
- Remote: United States, Hawaii (USA)
- Mid-level (2-5 years)
- 54 - 107K
Care CoordinationNurse Licensure CompactClinical AssessmentsPatient Education And CounselingHome Health CarePublic Health
Care Coordinator- CISC
Care Coordinator- CISC
30+ days ago
Magellan Health
- Remote: United States, New Mexico (USA)
- Full time
- Mid-level (2-5 years)
- 50 - 75K
Care CoordinationHealth Risk AssessmentsCross-Functional CollaborationPublic HealthElectronic ReferralsMedical Management
Primary Therapist - Virtual
Primary Therapist - Virtual
12 day ago
Monte Nido
- Remote: United States
- Freelance
PsychotherapyBasic Patient CareCounseling TechniquesEmotional DisordersDischarge PlanningUtilization 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
DimensioningMental Health EducationDiagnosis CodesUtilization Management
Telephonic Medical Case Manager (Workers' compensation)
Telephonic Medical Case Manager (Workers' compensation)
30+ days ago
TRISTAR Insurance Group
- Remote: United States, South Carolina (USA)
- Full time
- 19 - 192K
Clinical AssessmentsNurse Licensure CompactDischarge PlanningConflict ResolutionWorkers' CompensationManaged Care
