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 (South Carolina/North Carolina)
Primary Therapist - Virtual (South Carolina/North Carolina)
30+ days ago
Monte Nido
- Remote: United States, North Carolina (USA), South Carolina (USA)
PsychotherapyCounseling TechniquesHealthcare StrategyEmotional DisordersDischarge PlanningUtilization Management
Utilization Review Nurse- PRN (9a-9p EST)
Utilization Review Nurse- PRN (9a-9p EST)
Today
Netsmart
- Remote: United States
- Part time
Utilization ManagementNurse Licensure CompactInterQual CriteriaCase Management SystemsClinical AssessmentsElectronic Medical Record
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)
Physician Advisor - Utilization Management
Physician Advisor - Utilization Management
30+ days ago
Ochsner Health
- Remote: United States
- Full time
Electronic Medical RecordHealth Reimbursement ArrangementHealthcare QualityUtilization ManagementCommunicating With PatientsBasic Patient Care
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
US Registered Nurse
US Registered Nurse
30+ days ago
Nezda Technologies Inc.
- Remote: United States
- Full time
Utilization ManagementInternational Laws
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
Senior Manager, Resource Management
Senior Manager, Resource Management
20 day ago
Wpromote
- Remote: United States
- Full time
Utilization ManagementStaff PlanningResource ManagementAnalyticsGT-SUITE (Simulation Software)Project Management
Care Manager BH (CA licensure) - Remote
Care Manager BH (CA licensure) - Remote
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 58 - 93K
Discharge PlanningInpatient CareSubstance Abuse PreventionMental Health EducationUtilization ManagementCrisis Intervention
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
Associate Medical Director
Associate Medical Director
30+ days ago
Blue Cross NC
- Remote: United States, Georgia (country), Arizona (USA), Arkansas (USA), Florida (USA), Indiana (USA), Kansas (USA), Kentucky (USA), Missouri (USA), North Carolina (USA), Oklahoma (USA), Pennsylvania (USA), South Carolina (USA), Tennessee (USA), Utah (USA)
- Full time
- Senior (5-10 years)
- 146 - 278K
Healthcare StrategyMedical LawPublic HealthClinical ConsultingData ManagementReimbursement Regulations
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
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
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)
Group Health Operations Manager (RN/LPN)
Group Health Operations Manager (RN/LPN)
5 day ago
Dane Street, LLC
- Remote: United States
- Full time
Business OperationsUtilization ManagementPerformance ManagementFinancial AnalysisStaff PlanningInsurance Law
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
Care Team Member - LPN/LVN - Remote - CST Time Zone (IL and Compact licensed required)
Care Team Member - LPN/LVN - Remote - CST Time Zone (IL and Compact licensed required)
30+ days ago
Optimize Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
Career DevelopmentClinical MedicineHealth And Wellness CoachingCare Management SoftwareCare CoordinationMotivational Interviewing
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
Clinical Review Nurse - Prior Authorization
Clinical Review Nurse - Prior Authorization
Today
Centene Corporation
- Remote: United States
- Full time
Clinical Data AnalysisUtilization ManagementRegulatory ComplianceMedical NecessityNursingClinical Data Management
Part-Time Weekend Medical Director (Remote)
Part-Time Weekend Medical Director (Remote)
30+ days ago
Highmark Health
- Remote: United States, Kansas (USA)
- Part time
- Junior (1-2 years)
- 19 - 342K
Utilization ManagementMedical ManagementManaged CareClinical ConsultingOnline CommunicationMedical Software
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
Senior Healthcare Analyst, Actuarial
Senior Healthcare Analyst, Actuarial
13 day ago
Cohere Health
- Remote: United States
- Full time
AnalyticsCost ManagementCustomer EngagementActuarial SciencePython (Programming Language)SQL (Programming Language)
Medical Director - Pediatric Infectious Disease - EviCore
Medical Director - Pediatric Infectious Disease - EviCore
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticePediatric Diseases And DisordersHealth LawsMedical Licensing (Health Law)Utilization ManagementClinical Assessments
Telephonic Case Manager I
Telephonic Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, Pennsylvania (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Utilization ManagementNeurologyMedical HumanitiesProject AssessmentsPhysical Medicine And RehabilitationCost Containment
Physician Advisor, Utilization Review Management
Physician Advisor, Utilization Review Management
5 day ago
Sutter Health
- Remote: United States
- Full time
Utilization ManagementHealthcare Delivery ModelsCare ManagementClinical DocumentationHealth Reimbursement ArrangementMedical Necessity
Trainer/ Quality RN
Trainer/ Quality RN
30+ days ago
Advantasure
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 67 - 98K
CPT CodingNastran (Computer-Aided Design Software)Care ManagementRocksDBICD 503Project Management
Remote Care Management Nurse (Future Opportunities)
Remote Care Management Nurse (Future Opportunities)
30+ days ago
Cambia Health Solutions
- Remote: United States, District of Columbia (USA), Idaho (USA), Iowa (USA), Maine (USA), Massachusetts (USA), Oregon (USA), Utah (USA), Washington (USA)
- Freelance
- Mid-level (2-5 years)
- 64 - 105K
Documentation GenerationHealthcare Industry KnowledgeCare ManagementOrganizational StructureUtilization ManagementNursing
Clinical Appeals RN- Coding - Remote in US
Clinical Appeals RN- Coding - Remote in US
13 day ago
UnitedHealthcare
- Remote: United States
- Full time
AppealsCoding TheoryNurse Licensure CompactManaged CareMedical Record ManagementClinical Data Analysis
Neurologist Needed for Utilization Review work - Remote 1099
Neurologist Needed for Utilization Review work - Remote 1099
13 day ago
Medical Review Institute
- Remote: United States
- Freelance
Utilization ManagementMedical Licensing (Health Law)NeurologyBasic Patient CareMedical Licensing (Health Law)Global Positioning Systems
Enterprise PHCO - Medicare & Duals - Lead
Enterprise PHCO - Medicare & Duals - Lead
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Care ManagementMedical ManagementUtilization ManagementContinuous Improvement ProcessProject ManagementClinical Informatics
Clinical Support Coordinator - Part-Time
Clinical Support Coordinator - Part-Time
19 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Part time
Data ProcessingCare ManagementTeleconferencingUtilization ManagementAdobe Creative Cloud
Provider Engagement Account Manager
Provider Engagement Account Manager
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- 55 - 99K
Provider ModelAccount ManagementNetwork Performance ManagementUtilization ManagementProject ManagementQuality Assessment
Inpatient Concurrent Review RN
Inpatient Concurrent Review RN
6 day ago
Dignity Health Global Education
- Remote: United States
- Fixed term
Utilization ManagementCare ManagementMedical NecessityDischarge PlanningAcute CareInterQual Criteria
Consulting Team Lead - Microsoft Fabric & Power BI at Collectiv
Consulting Team Lead - Microsoft Fabric & Power BI at Collectiv
30+ days ago
Collectiv
- Remote: United States, Illinois (USA)
- Full time
- Senior (5-10 years)
Power BIMicrosoft AzureUtilization ManagementCustomer Relationship Management
Care manager (LMFT or LCSW) - Remote
Care manager (LMFT or LCSW) - Remote
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Mid-level (2-5 years)
Discharge PlanningUtilization ManagementClinical Data Analysis
Authorization Coordinator - Part Time
Authorization Coordinator - Part Time
30+ days ago
DaVita Kidney Care
- Remote: United States
- Part time
- Mid-level (2-5 years)
- 36 - 57K
Utilization ManagementPharmacy ExperiencePrior AuthorizationTax ExemptionClinical Data Analysis
Behavioral Health - Utilization Review – RN
Behavioral Health - Utilization Review – RN
30+ days ago
UST HealthProof
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 51 - 77K
Insurance PoliciesUtilization ManagementClinical AssessmentsCare Management
Lead Research Scientist
Lead Research Scientist
18 day ago
Humana
- Remote: United States
- Full time
EpidemiologyData ScienceBiostatisticsStatistical AnalysisPython (Programming Language)R (Programming Language)
Clinical Formulary Pharmacist - Government Programs
Clinical Formulary Pharmacist - Government Programs
30+ days ago
Maxor National Pharmacy Services, LLC
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Utilization ManagementCompliance ManagementPharmacy ExperienceDrug Utilization ReviewClinical PracticesPolicy Development
UR Case Manager II
UR Case Manager II
30+ days ago
CorVel Corporation
- Remote: United States, Texas (USA)
- Full time
- Mid-level (2-5 years)
- 63 - 96K
Utilization ManagementWorkers' Compensation ClaimsCPT CodingICD Coding (ICD-9/ICD-10)OrthopedicsClinical Assessments
Obstetrics/Newborn/Pediatrics Clinical Documentation Specialist PRN
Obstetrics/Newborn/Pediatrics Clinical Documentation Specialist PRN
30+ days ago
Wellstar Health System
- Remote: United States
- Part time
- Senior (5-10 years)
Coding TheoryLine ChartDiagnosis-Related GroupClinical DocumentationCoding TheoryMedical Abbreviations
Career Opportunities: Utilization Management Medical Director - Remote in US (28039)
Career Opportunities: Utilization Management Medical Director - Remote in US (28039)
30+ days ago
Gainwell Technologies LLC
- Remote: United States
- Senior (5-10 years)
- 100 - 150K
InterQual CriteriaUtilization ManagementManaged CareAnalyticsAuditing
Medical Director, Children's Services (SafetyNet & Behavioral Health)
Medical Director, Children's Services (SafetyNet & Behavioral Health)
30+ days ago
Univera Healthcare
- Remote: United States, Massachusetts (USA), New York (USA), Virginia (USA)
- Full time
- Expert & Leadership (>10 years)
Behavioral HealthChild And Adolescent PsychiatryClinical AuditingIntegrated CareEvidence-Based PracticeCommunications Systems
Medical Director -Pediatric Cardiology
Medical Director -Pediatric Cardiology
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
CardiologyClinical AssessmentsEvidence-Based PracticeMedical Record ManagementComputer SystemsUtilization Management
