Remote Utilization Management Jobs

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Dane Street, LLC
Physician Reviewer - Neurological Surgery (Utilization Review) LA
30+ days ago

Dane Street, LLC - Insurance - SME

Remote from
Louisiana (USA)
Fixed term
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Dane Street, LLC
Group Health Medical Director
30+ days ago

Dane Street, LLC - Insurance - SME

Remote from
Florida (USA)
Fixed term
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Alcon
Field Access Manager
15 days ago

Alcon - Health Care - XLarge

Remote from
Connecticut (USA), District of Columbia (USA), Maryland (USA) +3
Full time

Senior (5-10 years)

Utilization Management
Health Reimbursement Arrangement
Prior Authorization
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Prime Therapeutics
Physician Clinical Reviewer- Orthopedics- REMOTE
4 days ago

Prime Therapeutics - Insurance - Large

Remote from
United States
Part time
Orthopedics
Utilization Management
Medical Necessity
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Medical Review Institute
Pulmonology Utilization Review -Remote - 1099 (contract)
30+ days ago

Medical Review Institute - SME

Remote from
Florida (USA)
Freelance

Senior (5-10 years)

Utilization Management
Medical Record Management
Pulmonology
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Alliant Health Solutions
Review Nurse, UCR & Medical Claims
16 days ago

Alliant Health Solutions

Remote from
Georgia (USA)
Full time

Mid-level (2-5 years)

Acute Care Nursing
Utilization Management
Medical Insurance Claims
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Alludo
Customer Success Manager
14 days ago

Alludo - Information Technology & Services - TPE

Remote from
Canada, California (USA)
Full time

Mid-level (2-5 years)

Customer Success Management
Product Renewals
Microsoft Dynamics CRM
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OperationsArmy
Legal Intake Specialist (PH | Remote)
30+ days ago

OperationsArmy

Remote from
Philippines
Full time
PDF Management Software
Medical Record Management
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Brigham and Women's Hospital
Per Diem Health Plan UM Medical Director
15 days ago

Brigham and Women's Hospital

Remote from
Massachusetts (USA)
Freelance

Expert & Leadership (>10 years)

Utilization Management
Grievance Arbitration
Medical Necessity
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Guide Health
Utilization Management Registered Nurse
15 days ago

Guide Health

Remote from
Illinois (USA)
Full time
Care Coordination
Utilization Management
Medical Necessity
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MedeAnalytics
VP, Government Strategic Growth (State & Federal Government)
7 days ago

MedeAnalytics - SME

Remote from
United States
Full time

Expert & Leadership (>10 years)

165 - 195K
Healthcare Analytics
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Rising Medical Solutions
Triage Nurse - Remote
7 days ago

Rising Medical Solutions - Insurance - SME

Remote from
Illinois (USA)
Full time

Junior (1-2 years)

Care Management
Nurse Licensure Compact
Clinical Assessments
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LTC Properties, Inc.
Care Manager, RN - Remote
30+ days ago

LTC Properties, Inc. - Real Estate Management & Development

Remote from
Florida (USA)
Full time

Mid-level (2-5 years)

Care Management
Care Planning
Mental Health Nursing
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Guide Health
Clinical Case Manager- Social Worker
30+ days ago

Guide Health

Remote from
Georgia (USA)
Full time

Senior (5-10 years)

Care Coordination
Chronic Care
Care Management
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Medtronic
Field Service Coordinator
30+ days ago

Medtronic - Medical Device - XLarge

Remote from
Netherlands
Full time
49 - 74K
SAP CO
Supply Chain
Service Planning
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Regard
Provider Success Manager
15 days ago

Regard - Scaleup

Remote from
Canada, Arizona (USA), California (USA) +7
Full time

Mid-level (2-5 years)

Cerner EHR
End-User Training And Support
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NextGen Healthcare
Client Success Manager II – Digital Touch & Low Touch
13 days ago

NextGen Healthcare - SME

Remote from
India
Full time

Mid-level (2-5 years)

Account Management
Customer Success Management
Customer Retention
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CERIS
Payment Integrity Analyst II - DRG Auditor
30+ days ago

CERIS

Remote from
Texas (USA)
Full time
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CERIS
Payment Integrity Analyst II
30+ days ago

CERIS

Remote from
Texas (USA)
Full time
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CERIS
Payment Integrity Analyst III
30+ days ago

CERIS

Remote from
Texas (USA)
Full time
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Partners Health Management
I/DD Utilization Management Reviewer, QP (Remote-NC)
15 days ago

Partners Health Management - SME

Remote from
North Carolina (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Medicaid Waiver
Medical Necessity
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McLaren Health Care
Utilization Management Registered Nurse, MI - Remote
30+ days ago

McLaren Health Care - XLarge

Remote from
Michigan (USA)
Full time
Utilization Management
Nursing
Managed Care
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University of Miami
Oncology Prior Authorization Case Manager, Non-RN - Remote
28 days ago

University of Miami - XLarge

Remote from
Florida (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Insurance Reviews
Prior Authorization
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Blue Cross NC
Manager - Medicare Formulary Strategy
23 days ago

Blue Cross NC - Insurance - XLarge

Remote from
Alabama (USA), Arizona (USA), Arkansas (USA) +12
Full time

Expert & Leadership (>10 years)

Medicare Part D
Medicare
Medicare
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EFI Global
Claims Adjuster - Workers' Comp (REMOTE- NC/SC/VA exp needed))
30+ days ago

EFI Global - Construction & Civil Engineering - SME

Remote from
North Carolina (USA), South Carolina (USA), Virginia (USA)
Full time

Mid-level (2-5 years)

Settlement
Subrogation
Workers' Compensation Claims
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Sophos
Team Lead 2, Penetration Testing
30+ days ago

Sophos - Large

Remote from
Japan
Full time
Penetration Testing
Application Security
Red Teaming
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Trustmark
Senior Director, Client Management
30+ days ago

Trustmark - Health, Sport, Wellness & Fitness - Large

Remote from
Illinois (USA)
Full time
107 - 160K
Business Relationship Management
Group Health Insurance Sales
Client Services
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MedImpact Healthcare Systems, Inc.
Provider Liaison Pharmacist
30+ days ago

MedImpact Healthcare Systems, Inc. - Pharmaceuticals - Large

Remote from
Tennessee (USA)
Full time

Senior (5-10 years)

48 - 48K
Pharmacy Benefit Management
Drug Utilization Review
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Nezda Technologies Inc.
USRN
30+ days ago

Nezda Technologies Inc. - Human Resources, Staffing & Recruiting - Scaleup

Remote from
Philippines
Full time
Utilization Management
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Medline Industries, LP
Product Sales Specialist - Remedy & Readycare (West Coast)
7 days ago

Medline Industries, LP - XLarge

Remote from
California (USA), Oregon (USA), Washington (USA)
Full time

Mid-level (2-5 years)

Demonstration Skills
Clinical Trials
Healthcare Industry Knowledge
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Blue Cross NC
Senior Actuarial Analyst – Pharmacy Benefit Oversight
20 days ago

Blue Cross NC - Insurance - XLarge

Remote from
Alabama (USA), Arizona (USA), Arkansas (USA) +12
Full time

Senior (5-10 years)

Pharmacy Benefit Management
Mathematical Modeling
Actuarial Science
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MVP Health Care
Professional, Prospective Review RN
15 days ago

MVP Health Care

Remote from
New York (USA)
Full time
Nurse Registry
Medical Record Management
Utilization Management
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Sedgwick Ireland
Claims Adjuster l Workers Compensation l IL
30+ days ago

Sedgwick Ireland - Startup

Remote from
Illinois (USA)
Full time

Mid-level (2-5 years)

56 - 80K
Settlement
Subrogation
Workers' Compensation Claims
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NTT DATA
Epic Tapestry Business Systems Analyst
7 days ago

NTT DATA - Information Technology & Services - XLarge

Remote from
Louisiana (USA)
Full time

Senior (5-10 years)

Azure Data Factory
Microsoft SQL Server Data Engine (MSDE)
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MDA Edge
Utilization Management Policy Initiatives Registered Nurse
27 days ago

MDA Edge - Scaleup

Remote from
California (USA)
Full time

Senior (5-10 years)

Utilization Management
Associate Insurance Regulatory Compliance
Health Policy Development
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Virtix Health
Remote Physician (MD/DO), (IC to FTE) PMR, Orthopedics or Neurology, Outpatient Prior Authorizations (REMOTE/FT)
8 days ago

Virtix Health

Remote from
Maryland (USA), Oregon (USA)
Full time
Medicare
Medical Record Management
Prior Authorization
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Collaborative Solutions, LLC
Senior Manager, Workday Integrations (Global Delivery Center Manila)
20 days ago

Collaborative Solutions, LLC - Consumer Services - SME

Remote from
Philippines
Full time

Senior (5-10 years)

Workday (Software)
Workday (Software)
Workday Adaptive Planning
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Centene Corporation
Behavioral Health Program Manager
30+ days ago

Centene Corporation - XLarge

Remote from
Washington (USA)
Full time

Senior (5-10 years)

70 - 126K
Behavioral Health Interventions
Behavioral Health
Project Management
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Magellan Health
Care Coordinator- CISC
14 days ago

Magellan Health - XLarge

Remote from
New Mexico (USA)
Full time

Expert & Leadership (>10 years)

Care Coordination
Care Planning
Health Risk Assessments
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Highmark Health
Medical Case Manager - Utilization management (UM) Remote
3 days ago

Highmark Health

Remote from
United States, Austria, Delaware (USA) +1
Full time

Mid-level (2-5 years)

Care Coordination
Care Management
Utilization Management
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agilon health
Director, Operations and Planning
6 days ago

agilon health - Scaleup

Remote from
Texas (USA)
Full time

Expert & Leadership (>10 years)

Operational Excellence
Project Management
Managed Care
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CareSource
Mom & Baby Care Manager
30+ days ago

CareSource - Insurance - Large

Remote from
Mississippi (USA)
Full time

Mid-level (2-5 years)

56 - 90K
Care Coordination
Care Planning
Psychosocial Assessments
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Acentra Health
Behavioral Health, Supervisor - Arkansas Fully Licensed, Unrestricted Social Work or Counseling (Remote within Arkansas)
30+ days ago

Acentra Health - Large

Remote from
Arkansas (USA), Oregon (USA)
Full time

Senior (5-10 years)

69 - 87K
Utilization Management
Clinical Consulting
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Acentra Health
Clinical Appeals Professional (Remote within Maine)
22 days ago

Acentra Health - Large

Remote from
Maine (USA)
Full time
67 - 84K
Patient Education And Counseling
Medical Record Management
Utilization Management
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CorVel Corporation
Medical Case Manager I
8 days ago

CorVel Corporation - Insurance - Large

Remote from
Georgia (USA)
Full time

Junior (1-2 years)

Nurse Registry
Workers' Compensation Claims
Case Management Systems
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Centene Corporation
Provider Engagement Account Manager
30+ days ago

Centene Corporation - XLarge

Remote from
Mississippi (USA)
Full time
56 - 101K
Provider Model
Performance Based Contracting
Network Performance Management
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Bluestone Physician Services
Care Coordinator, LSW
14 days ago

Bluestone Physician Services - Medical Device - SME

Remote from
Minnesota (USA)
Full time

Expert & Leadership (>10 years)

Care Coordination
Care Management
Common Assessment Framework
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DCX PH Inc.
UM Licensed Vocational Nurse
5 days ago

DCX PH Inc. - Scaleup

Remote from
United States
Full time

Mid-level (2-5 years)

Utilization Management
Prior Authorization
Medical Necessity
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Allegion
Regional Operations Manager
8 days ago

Allegion - Security & Investigations - XLarge

Remote from
Indiana (USA)
Full time

Senior (5-10 years)

Business Operations
KPI Management
Service Provisioning
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Mount Saint Vincent
Rehab Liaison Manager
6 days ago

Mount Saint Vincent

Remote from
United States
Full time
Federal Financial Institutions Examination Council (FFIEC) Compliance
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