Explore 138 Remote Utilization Management Jobs
Lead a clinical team as a Supervisor in Appeals at Centene, ensuring quality care for members while working remotely.
The Clinical Review Nurse will draft correspondence letters based on clinical review outcomes and ensure compliance with NCQA standards.
Centene is seeking a Vice President, Medical Director to provide strategic and operational leadership in utilization management and clinical policies.
Join our team as a Remote Medical Director to lead medical management and quality improvement initiatives for our members.
Join Centene as a Clinical Review Clinician to perform essential clinical reviews for appeals processing.
Join our team as a Senior Clinical Review Nurse, where you will draft correspondence and conduct clinical reviews to ensure compliance with healthcare standards.
Join Centene as a Remote Market Place Medical Director to lead medical management and quality improvement for a diverse member base.
H.A.H.
Humana At Home 1
The Pre-Authorization Nurse 2 reviews prior authorization requests and utilizes clinical judgment to ensure appropriate care.
The Staff Vice President of Utilization Management will lead and innovate healthcare utilization programs to enhance efficiency and compliance across the organization.
Join CVS Health as a Utilization Management Nurse Consultant, providing essential healthcare service coordination in a remote role.
Join our Medical Management team as a Clinical Review Nurse, focusing on concurrent reviews and ensuring quality patient care.
Join Rightway as a Pharmacy Customer Service Representative to assist members and providers with pharmacy benefit inquiries and enhance the healthcare experience.
S.H.M
Summit Health Management
Join VillageMD as a Senior Analyst in Healthcare Analytics to enhance reporting and analytics capabilities in a mission-driven organization.
H.A.H.
Humana At Home 1
Join our caring community as a Telephonic Nurse Case Manager, coordinating care for TRICARE beneficiaries.
Join CVS Health as a fully remote Utilization Management Nurse Consultant, leveraging clinical skills to manage healthcare services.