Remote Optum Utilization Review Jobs in Washington

A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday ...

A national provider of utilization review services seeks independent contract reviewers for a telework opportunity. Physicians can customize their caseload and schedule while providing advisory-only ...

A national Utilization Review provider is seeking Board Certified physicians with an active New York license for a telework opportunity. This role allows for flexible scheduling, where physicians can ...

Austin, TX; Remote This is a rare opportunity to step into a high-impact leadership role at the ... Utilization Review & Authorizations * Oversee authorization strategy and utilization review ...

Job Summary Clinical Reviewer - Substance Use - LPCC, LMFT, LICSW - PRN (Remote U.S.) Responsible ... Review (UR) or Utilization Management (UM) or Prior Authorization experience. In-depth ...

This position is remote U.S.*** ***Working hours between 8:00 a.m. and 6:00 p.m. EST, with ... Conduct utilization reviews as needed to support workload demands and program requirements.

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Apple equipment and a media stipend are provided for remote workspace. About Dane Street: A fast ...

The role is PRN (as needed) and remote within the United States but requires a Minnesota license ... Utilization Review (UR) OR Utilization Management (UM) OR Prior Authorization. * In-depth ...

While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...

While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...

Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...

Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...

Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...

Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...

... Utilization Review or Prior Authorization. * Strong clinical assessment and critical thinking skills. * Proficiency in medical necessity review. * Ability to work independently in a remote ...

... • Review treatment plans to ensure alignment with payer requirements and requested units • ... utilization and flag overutilization or underutilization risks • Communicate authorization ...

Oversee project budgets and staffing utilization. * Review monthly financial reports and support ... Experience managing remote or distributed teams. * Excellent written and verbal communication ...

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...