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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Remote Child & Adolescent Behavioral Medical Director - Washington
Remote Child & Adolescent Behavioral Medical Director - Washington
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Utilization ManagementHealth AdministrationInsurance PoliciesClinical ConsultingPerformance ImprovementCost Containment
Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)
Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)
30+ days ago
CNSI
- Remote: United States
Utilization ManagementPsychiatric AssessmentsCommunicating With PatientsManaged Care
Clinical Product Consultant - UM
Clinical Product Consultant - UM
30+ days ago
Iodine Software
- Remote: United States
- Freelance
- Senior (5-10 years)
Utilization ManagementClinical AssessmentsProject ManagementRegulatory ComplianceCare ManagementGoogle Sites
Utilization Management (UM) Registered Nurse (RN)
Utilization Management (UM) Registered Nurse (RN)
30+ days ago
UST HealthProof
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 42 - 64K
Utilization ManagementOnline CommunicationClinical Assessments
Mental Health Therapist (RMHCI, RCSWI)
Mental Health Therapist (RMHCI, RCSWI)
30+ days ago
Discovery Behavioral Health
- Remote: United States, Florida (USA)
- Full time
- Entry-level / graduate
- 52 - 65K
Patient SafetyClinical DocumentationClinical AssessmentsFamily TherapyProject CollaborationUtilization Management
Physician Advisor
Physician Advisor
30+ days ago
Ensemble Health Partners
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
Project ManagementBudget ManagementContinuing Medical EducationExecutive ConversationsUtilization Management
Primary Therapist - Virtual (PST/MST)
Primary Therapist - Virtual (PST/MST)
25 day ago
Monte Nido
- Remote: United States
- Freelance
PsychotherapyCounseling TechniquesEmotional DisordersUtilization ManagementDischarge PlanningNutrition Intervention
Medical Director - EviCore - Cardiology
Medical Director - EviCore - Cardiology
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 196 - 328K
Evidence-Based PracticeCardiologyMedical ManagementLegal KnowledgeMedical Licensing (Health Law)Utilization Management
Medical Director - Neurology
Medical Director - Neurology
Today
The Cigna Group
- Remote: United States
- Full time
Utilization ManagementMedical ManagementCare ManagementClinical AssessmentsBasic Patient CareProject Management
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
30+ days ago
Magellan Health
- Remote: United States, California (USA)
- Full time
- Mid-level (2-5 years)
- 58 - 93K
Behavioral HealthDischarge PlanningUtilization ManagementCrisis InterventionInpatient CareMental Health And Recovery Services
Medical Director Utilization Management
Medical Director Utilization Management
30+ days ago
AmeriHealth Caritas
- Remote: United States
- Expert & Leadership (>10 years)
Medical DirectionClinical PracticesUtilization ManagementQuality AssessmentBehavioral HealthEvidence-Based Practice
Remote Behavioral Medical Director - western region
Remote Behavioral Medical Director - western region
30+ days ago
Centene Corporation
- Remote: United States
- Full time
- Expert & Leadership (>10 years)
- 231 - 440K
Cost ContainmentUtilization ManagementRegulatory ComplianceClinical ConsultingPerformance ImprovementProvider Network Management
LPN/LVN Utilization Management Reviewer
LPN/LVN Utilization Management Reviewer
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityUtilization ManagementService ReviewClinical DocumentationInterQual CriteriaEvaluation Of Care
Remote Medical Director (PRN) - Missouri
Remote Medical Director (PRN) - Missouri
21 day ago
Centene Corporation
- Remote: United States
- Full time
Cost ContainmentUtilization ManagementClinical AssessmentsQuality AssessmentCredential ManagerPerformance Improvement
Virtual Primary Therapist - East
Virtual Primary Therapist - East
21 day ago
Monte Nido & Affiliates
- Remote: United States
- Full time
Psychosocial AssessmentsGroup TherapyFamily TherapyDischarge PlanningPsychosocial AssessmentsTreatment Planning
BH Utilization Manager
BH Utilization Manager
30+ days ago
Harris Health System
- Remote: United States, Texas (USA)
- Full time
- Mid-level (2-5 years)
Managed CareClinical PracticesUtilization ManagementBehavioral HealthMedical Abbreviations
Field Medical Director, Interventional Cardiology (Remote)
Field Medical Director, Interventional Cardiology (Remote)
30+ days ago
Evolent Health
- Remote: United States
- Part time
- Senior (5-10 years)
Utilization ManagementMedical Licensing (Health Law)CardiologyContinuous TrainingCardiovascular DiseaseClinical Data Analysis
VP, Payer Analytics
VP, Payer Analytics
30+ days ago
Trinity Health
- Remote: United States, Michigan (USA)
- Full time
- Expert & Leadership (>10 years)
Financial AnalysisCost ManagementUtilization ManagementRisk ModelingTrading StrategyCost Benefit Analysis
Sales Executive - Payer
Sales Executive - Payer
30+ days ago
Notable
- Remote: United States, California (USA)
- Full time
- Senior (5-10 years)
Healthcare Industry KnowledgeEnterprise SalesValue-Based CareMarket AnalysisHEDIS (Healthcare Effectiveness Data And Information Set)Risk Control
RN Senior Medical Reviewer - CGS
RN Senior Medical Reviewer - CGS
30+ days ago
CGS Administrators, LLC
- Remote: United States, South Carolina (USA), Tennessee (USA)
- Full time
- Senior (5-10 years)
Utilization ManagementNurse Licensure CompactClinical AssessmentsClinical AssessmentsHealthcare Delivery ModelsManaged Care
Program Manager, Utilization Management
Program Manager, Utilization Management
7 day ago
Curana Health
- Remote: United States
- Full time
Utilization ManagementCare ManagementAnalyticsProject ManagementICD Coding (ICD-9/ICD-10)CPT Coding
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
LanceSoft, Inc.
- Remote: United States
- Full time
Discharge PlanningCare CoordinationClinical AssessmentsUtilization ManagementInterQual Criteria
Residential Mental Health Therapist
Residential Mental Health Therapist
30+ days ago
Discovery Behavioral Health
- Remote: United States, California (USA)
- Full time
- Mid-level (2-5 years)
- 67 - 84K
Microsoft NetworkingClinical DocumentationFamily TherapyUtilization ManagementProject CollaborationCrisis Management
C&S Plan Associate Medical Director - Georgia Foster Care - Remote
C&S Plan Associate Medical Director - Georgia Foster Care - Remote
30+ days ago
UnitedHealthcare
- Remote: United States, Georgia (country), Georgia (USA)
- Senior (5-10 years)
- 269 - 425K
Clinical GovernanceUtilization ManagementProvider ModelQuality AssessmentMedicaidState Children's Health Insurance Programs
Customer Service Representative - Remote
Customer Service Representative - Remote
30+ days ago
Easy Recruiter Solutions
- Remote: United States
- Full time
Utilization Management
Medical Director - Care Plus
Medical Director - Care Plus
19 day ago
Humana
- Remote: United States
- Full time
Language InterpretationClinical InformaticsRegulatory ComplianceUtilization ManagementOnline CommunicationMedical Licensing (Health Law)
PRN RN Utilization Review Audit Specialist
PRN RN Utilization Review Audit Specialist
30+ days ago
University of Maryland Medical System
- Remote: United States, Maryland (USA)
- Full time
- Mid-level (2-5 years)
- 7 - 19K
Database ManagementClinical AssessmentsUtilization ManagementNursingBusiness NegotiationCare Management
RN Medical Case Manager I
RN Medical Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, New Mexico (USA)
- Full time
- Mid-level (2-5 years)
- 60 - 90K
Utilization ManagementNeurologyPhysical Medicine And RehabilitationOrthopedicsNurse RegistryManaged Care
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 ManagementClinic Management SystemsInterQual Criteria
Medical Economics Manager
Medical Economics Manager
13 day ago
Healthmap Solutions
- Remote: United States
- Full time
Data MiningEconomicsSQL (Programming Language)Actuarial ScienceUtilization ManagementIndustry Trend Analysis
Utilization Review Nurse 
Utilization Review Nurse
30+ days ago
US Tech Solutions
- Remote: United States, Illinois (USA)
- Mid-level (2-5 years)
Assurance ServicesMedicaid Management Information Systems (MMIS)Prior AuthorizationUtilization ManagementMediTouchManaged Care
Medical Director - Pediatric Pulmonology - EviCore - Remote
Medical Director - Pediatric Pulmonology - EviCore - Remote
30+ days ago
eviCore healthcare
- Remote: United States
- Senior (5-10 years)
- 203 - 338K
Evidence-Based PracticePulmonologyClinical AssessmentsCase Management ToolsComputer SystemsUtilization Management
Remote Utilization Review - Pediatric Physician
Remote Utilization Review - Pediatric Physician
14 day ago
Medical Review Institute
- Remote: United States
- Freelance
Utilization ManagementMedical Licensing (Health Law)Basic Patient CarePediatricsTreatment And Control GroupsGlobal Positioning Systems
Behavioral Health Clinical Care Manager, BSN/LMSW/LCSW
Behavioral Health Clinical Care Manager, BSN/LMSW/LCSW
30+ days ago
AmeriHealth Caritas
- Remote: United States, Michigan (USA)
Differential DiagnosisCare ManagementUtilization ManagementMental HealthMedicareBehavioral Health
Medical Director
Medical Director
30+ days ago
Samaritan Health Services
- Remote: United States
- Part time
- Senior (5-10 years)
Clinical Quality ManagementMedical ManagementUtilization ManagementMedicareManaged CareHealth Policies
Actuarial Manager
Actuarial Manager
30+ days ago
Pediatric Associates Family of Companies
- Remote: United States
- Full time
- Senior (5-10 years)
Utilization ManagementStatistical AnalysisReimbursement RegulationsActuarial SciencePresentation TrainingData Validation
Trainer/Quality RN
Trainer/Quality RN
30+ days ago
Advantasure
- Remote: United States
- Full time
- Mid-level (2-5 years)
Personal Health RecordsMicrosoft SharePointProject ManagementICD 503RocksDBClinical Assessments
CA Telephonic Case Manager II - RN
CA Telephonic Case Manager II - RN
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- Mid-level (2-5 years)
- 58 - 89K
Educational EvaluationMedical HumanitiesUtilization ManagementRehabilitationCost ContainmentOrthopedics
Registered Nurse
Registered Nurse
30+ days ago
US Tech Solutions
- Remote: United States, Kansas (USA)
- Fixed term
- Mid-level (2-5 years)
Managed CareUtilization ManagementPrior AuthorizationInpatient CareMedicareMedicaid
Intake Coordinator
Intake Coordinator
30+ days ago
Highmark Health
- Remote: United States, Sudan, Laos, China, Tunisia, Norway, Italy, Colombia, Alaska (USA), Illinois (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Maryland (USA), Mississippi (USA)
- Full time
- Junior (1-2 years)
- 19 - 96K
Utilization ManagementData EntryAdministrative LawHealth Care IndustryOnline Communication
Medical Director- Radiation Oncology - EviCore
Medical Director- Radiation Oncology - EviCore
30+ days ago
The Cigna Group
- Remote: United States
- Full time
- Senior (5-10 years)
- 203 - 338K
Radiation OncologyUtilization ManagementMedical Licensing (Health Law)Health LawsClinical AssessmentsClinical Assessments
Manager, UM Physical Health Nurse
Manager, UM Physical Health Nurse
26 day ago
Humana
- Remote: United States
- Full time
Utilization ManagementClinical NursingRehabilitationAnalyticsAcute CareNursing
Payer Strategy Director
Payer Strategy Director
30+ days ago
Cohere Health
- Remote: United States
- Senior (5-10 years)
- 28 - 28K
Utilization ManagementHealthcare StrategySales StrategyBusiness AnalysisProject ManagementSystems Design
CA Utilization Review Case Manager I
CA Utilization Review Case Manager I
30+ days ago
CorVel Corporation
- Remote: United States, California (USA)
- Mid-level (2-5 years)
- 56 - 83K
ICD Coding (ICD-9/ICD-10)CPT CodingUtilization ManagementOrthopedicsWorkers' Compensation ClaimsAnalytics
Trainer/Quality RN
Trainer/Quality RN
30+ days ago
UST HealthProof
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 78 - 100K
Personal Health RecordsMicrosoft SharePointProject ManagementICD 503RocksDBClinical Assessments
Medical Director of Integrated Care (Remote-NC)
Medical Director of Integrated Care (Remote-NC)
30+ days ago
Vaya Health
- Remote: United States, North Carolina (USA)
- Full time
- Senior (5-10 years)
- 19 - 19K
Substance Abuse PreventionManaged CareMental Health And Recovery ServicesPharmacy OperationsCrisis ManagementClinical Consulting
Clinical Pharmacist.
Clinical Pharmacist.
30+ days ago
Lifelancer
- Remote: United States, Hawaii (USA)
- Full time
- Mid-level (2-5 years)
- 103 - 191K
Pharmacist AssistanceMedication Therapy ManagementPharmacotherapyPrior AuthorizationPharmacy Benefit ManagementMedication Inventory
Medical Director - Mid West Region
Medical Director - Mid West Region
21 day ago
Humana
- Remote: United States
- Full time
Language InterpretationRegulatory ComplianceUtilization ManagementClinical DocumentationBasic Patient CareUtilization Management
Manager Utilization Management
Manager Utilization Management
30+ days ago
Spectrum Health
- Remote: United States
- Full time
- Senior (5-10 years)
Process ImprovementProject CollaborationQuickbaseUtilization ManagementData EntryCompliance Management
Career Opportunities: Field Reimbursement Access Manager (Southern California) (16113)
Career Opportunities: Field Reimbursement Access Manager (Southern California) (16113)
30+ days ago
Bausch + Lomb
- Remote: United States
- 150 - 175K
Liability InsuranceReimbursement RegulationsProject ManagementMedical AssistanceBusiness PlanningUtilization Management
