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
348 jobs
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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 AssessmentsCase Management ToolsMedical Licensing (Health Law)Utilization Management
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 ManagementCase Management ToolsHealth LawsMedical Licensing (Health Law)
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 AuthorizationClient ServicesSoftware DocumentationICD Coding (ICD-9/ICD-10)Transitional Bilingual Education
Senior Analyst, Client Analytics
Senior Analyst, Client Analytics
13 day ago
New Century Health
- Remote: United States
- Full time
SAS (Software)SQL (Programming Language)Data VisualizationBusiness Intelligence ToolsHealthcare AnalyticsValue-Based Care
Utilization review Nurse
Utilization review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: Michigan (USA)
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
UM Coordinator - Remote in Idaho
UM Coordinator - Remote in Idaho
30+ days ago
UnitedHealthcare
- Remote: United States, Idaho (USA)
- Mid-level (2-5 years)
- 59 - 116K
Utilization ManagementNurse Licensure CompactManaged CareCare ManagementManaged CareCare Management
Care Coordinator- CISC
Care Coordinator- CISC
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 50 - 75K
Clinical Social WorkProject CollaborationCare CoordinationCost Benefit AnalysisOutcome InterpretationSocial Work
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
Physical Medicine And RehabilitationCost Benefit AnalysisContinuous Quality Improvement (CQI)Commercial InsurancesUtilization ManagementCredential Manager
Sr. Clinical Quality Program Manager
Sr. Clinical Quality Program Manager
3 day ago
WellSky
- Remote: United States
- Full time
Utilization ManagementRegulatory ComplianceAnalyticsClinical Quality ManagementPerformance ImprovementHealthcare Quality
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 ManagementNeurologyPhysical Medicine And RehabilitationCost ContainmentOrthopedics
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 ManagementData EntryCppunitInternal Documentation
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 ManagementClinical ConsultingProvider Network ManagementClinical Assessments
Clinical Product Consultant - UM
Clinical Product Consultant - UM
30+ days ago
Iodine Software
- Remote: United States
- Freelance
- Senior (5-10 years)
Project ManagementUtilization ManagementClient ServicesCare ManagementReimbursement RegulationsProject Collaboration
VP, Regional CMO - West
VP, Regional CMO - West
30+ days ago
CenterWell Senior Primary Care
- Remote: United States, Texas (USA)
- Expert & Leadership (>10 years)
Clinical GovernanceValue-Based CareBasic Patient CareTeam NursingPublic HealthNetwork Administration
Career Opportunities: Field Reimbursement Access Manager (Georgia - Northern FL) (16111)
Career Opportunities: Field Reimbursement Access Manager (Georgia - Northern FL) (16111)
30+ days ago
Bausch + Lomb
- Remote: United States
- 150 - 175K
Liability InsuranceReimbursement RegulationsStakeholder EngagementProject ManagementMedical AssistanceBusiness Planning
Utilization Review Nurse-Weekends-Remote
Utilization Review Nurse-Weekends-Remote
18 day ago
Sentara Healthcare
- Remote: United States
- Full time
Care CoordinationUtilization ManagementAcute CarePrior AuthorizationInterQual CriteriaNurse Licensure Compact
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 ManagementSales StrategyEvidence-Based PracticeGovernment Rebates
Non- Clinical Coding and OASIS Review Manager
Non- Clinical Coding and OASIS Review Manager
25 day ago
BAYADA Home Health Care
- Remote: United States
- Full time
MOQ (Software)Outpatient CodingICD Coding (ICD-9/ICD-10)MedicareUtilization Management
Telephonic Case Manager
Telephonic Case Manager
14 day ago
Genex Services
- Remote: United States
- Full time
Care ManagementWorkers' CompensationClinical PracticesNurse RegistryNursingUtilization Management
Remote Beahvioral Medical Director - Kentucky
Remote Beahvioral Medical Director - Kentucky
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Clinical GovernanceUtilization ManagementClinical AssessmentsQuality AssessmentKey Performance Indicators (KPIs)Cost Containment
Medical Director - Gulf South
Medical Director - Gulf South
30+ days ago
Conviva Care Solutions
- Remote: United States
- Full time
- Senior (5-10 years)
- 199 - 274K
Utilization ManagementInpatient CareDischarge PlanningUtilization ManagementMedical GuidelineInternal Medicine
Senior Actuarial Analyst
Senior Actuarial Analyst
24 day ago
Cohere Health
- Remote: United States
- Full time
Outcome InterpretationFinancial ModelingHealthcare AnalyticsCost Benefit AnalysisPython (Programming Language)Statistical Analysis
Utilization Clinical Reviewer - Appeals
Utilization Clinical Reviewer - Appeals
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
Primary Therapist - Virtual
Primary Therapist - Virtual
12 day ago
Monte Nido & Affiliates
- Remote: United States
- Freelance
PsychotherapyNutrition InterventionCounseling TechniquesEmotional DisordersDischarge PlanningCare Planning
Primary Therapist - Virtual (NY license required)
Primary Therapist - Virtual (NY license required)
25 day ago
Monte Nido & Affiliates
- Remote: United States
- Freelance
PsychotherapyCounseling TechniquesEmotional DisordersDischarge PlanningUtilization ManagementGroup Therapy
Medical Director--Claims Management
Medical Director--Claims Management
3 day ago
Humana
- Remote: United States
- Full time
Clinical Data AnalysisLanguage InterpretationRegulatory ComplianceUtilization ManagementMedical Licensing (Health Law)Utilization Management
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
14 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Care CoordinationUtilization ManagementClinical AssessmentsMedical NecessityClinical Quality ManagementNurse Licensure Compact
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
Pharmacy Coordinator
Pharmacy Coordinator
5 day ago
Centene Corporation
- Remote: United States
- Full time
Pharmacy ExperiencePrior AuthorizationUtilization ManagementClient EducationPharmacy ExperienceProcess Improvement
Pre-Service Utilization Management LVN
Pre-Service Utilization Management LVN
Today
CommonSpirit Health
- Remote: United States
- Full time
Utilization ManagementClinical InformaticsMedical NecessityICD 503Benefits AdministrationMedical Abbreviations
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
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
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
Utilization Management Manager
Utilization Management Manager
5 day ago
Vālenz®
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementQualification Protocols (IQ/OQ/PQ)Healthcare Software ImplementationBudget ManagementMbaas
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
VP, Regional CMO - Central
VP, Regional CMO - Central
30+ days ago
CenterWell Senior Primary Care
- Remote: United States, Kentucky (USA)
- Expert & Leadership (>10 years)
Clinical GovernanceValue-Based CareBasic Patient CareTeam NursingPublic HealthNetwork Administration
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
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
