Remote RN - Clinical Utilization Reviewer (Alabama)
Palo Verde Community College District
- Remote job
Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective care within contract guidelines. Applicants must be an active RN in Alabama with at least 3 years of direct patient care experience and a BA/BS in Nursing. Experience in long-term care, provider relations, and PA reviews is valued. #J-18808-Ljbffr Palo Verde Community College District
$75k - $88k
...an alternative application process. Clinical Reviewer RN - Alabama Alabama, US Salary Range: $75,000.0... ...and patient outcomes. Our talented remote workforce spans the country and... ...Position Overview We are seeking Clinical Utilization Review Nurses (RN) based in Alabama...Remote workFull timeContract work$45 - $50 per hour
...looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr...Remote jobHourly pay- ...subsidiary, seeks a Medical Reviewer II (RN) to perform medical claim reviews... ...decisions and supports utilization review across multiple services. The position is remote, full-time, with standard hours... ...associate degree, and 2+ years of clinical RN experience required. #J-1...Remote jobFull time
$62.7k - $100.4k
...Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews... ...of an accredited registered nursing (RN) degree program required Three (3)... ...or home health experience preferred Utilization Management/Utilization Review experience...Remote workHourly payWork at office- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration:... ...Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $...Remote workContract work
$32 - $33 per hour
...situation fit into our culture. We have an opening for a: RN - Clinical Field Reviewer (Remote in Montana) The RN Clinical Field Reviewer is a remote... ..., practice cultural humility with each client, and utilize evidence-based practice as a foundation for our interventions...Remote workFull timeTemporary workLocal area$88k - $93k
Profile Remote work opportunities are available in the following states: AK, AR... ...encouraged to apply. Job Summary The Utilization Management Clinical Review nurse reviews and makes decisions... ...Experience Required: Active, unrestricted RN license U.S. Citizen Ability to...Remote workContract workTemporary workInterim roleWork at officeLocal areaShift work- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources... ...). These will be completely remote positions, working entirely... ...'s home. The Nurse will be reviewing cases, educating patients on... ...the HCWs must have pertinent clinical experience within the past two...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on... ...schedule of 8 hours per day, requiring an RN with a Bachelor's degree, state licensure...Remote jobWork from homeMonday to Friday
$70k - $120k
...Fully Remote : Clinical Documentation Specialist Job Description... ...concurrent and retrospective reviews of medical records to ensure... ...complete clinical documentation. Utilize clinical knowledge and expertise... ...Qualifications Registered Nurse (RN) with a current license from...Remote workLocal areaMonday to Friday- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role... ...and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include reviewing medical necessity, coordinating with providers...Remote jobWork from home
- Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who uses clinical nursing skills to support coordination, documentation and communication... ...offices for training. You will work from home in a remote role with primary responsibilities in utilization management...Remote jobWork from home
$50k
...Department Overview The Clinical Documentation Specialist will... ...concurrent and retrospective review of provider documentation, query... ...of patient records in a remote setting. The Registered Nurse... ...physicians and nursing as needed. Utilizes software systems (including...Remote workFull timePart time- UnitedHealth Group seeks an experienced SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims. The role requires documenting determinations and maintaining screening criteria, contributing to efficient, compliant health...Remote job
- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical... ...and payers to ensure compliance with clinical guidelines, regulatory requirements, and... ...hospital-based) ~ Skilled experience with remote work Length of assignment: 13...Remote workShift workWeekend work
- ...R1 RCM is seeking an experienced Utilization Review Author (RN) for our Physician Advisory Team. The role involves first-level admission and continued stay reviews using InterQual/MCG criteria and requires hospital-based UR or Case Management experience. The position offers...Remote workFlexible hours
- NTT DATA, Inc. in Tampa, Florida seeks a BPO Clinical Review Specialist to perform clinical and medical necessity reviews supporting member... ...compliance with NCQA standards and Medicaid guidance. This remote Florida role offers benefits including medical, dental and vision...Remote job
- ...RN Utilization Review Location: Torrance, CA Job Type: Travel Discipline: RN Specialty: Utilization Review Facility Setting: Short Term Acute Care (STAC) Accepting Locals per Radius Rule?: Yes Contract Length: 13 weeks Shifts: Days Shift Details...Remote workContract workTemporary workLocal areaShift work
$65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30)... ...No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work$1,949.74 per month
...Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review RN Weekly Pay $1949.74 Shift... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift work$38.46 - $43.27 per hour
...Clinical Reviewer As the Clinical Reviewer, you will be responsible for... ...to: Performing case reviews utilizing regulatory guidelines criteria... ...NY office. Ability to work remotely one day per week after... ...Nurse, required (open to any RN state license). Graduate...Remote workHourly payFull timeFor contractorsWork at office1 day per week- ...Occupational Therapist to deliver on Cohere’s therapy programs by reviewing medical information and applying evidence-based guidelines. This remote role supports a fast-paced review team and requires clinical acumen and effective communication. You’ll perform timely...Remote job
$100k
...3 years Salary $100,000 Remote Job Job Description This is a remote position. The Utilization Management (UM) Nurse is responsible for conducting clinical reviews and assessing the medical necessity... ...Registered Nurse (RN) license in the applicable state...Remote workContract workWork experience placement- ...Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations... ..., and accurately document clinical information from medical...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Overview In this role, you will manage utilization review processes, ensuring quality patient care while optimizing resource use. Your... ...weekend, contributing to a collaborative and supportive remote work environment. Benefits ~ Weekly Pay...Remote workWeekly payMonday to FridayWeekend work
- CVS Health is seeking a Utilization Management Nurse Consultant (RN) for a remote role. You will perform concurrent reviews for acute inpatient admissions and support timely transitions of care. Required RN license, 5+ years acute care, 2+ years UM/Case Management experience...Remote job
- ...Fully Remote Utilization Review Position Setting: Fully Remote – Utilization Review Schedule: Full... ...N/A Job Requirements: Active RN license with Multi-State/Compact... ...Review experience Minimum 3 years of clinical nursing experience (acute care/hospital...Remote workFull timeMonday to Friday
$40.12 - $62.19 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty service... ...ensure hospital stays are clinically appropriate and fully covered... ...information. This is a Full-time remote position.... ...: The Utilization Review RN reviews the medical record by...Remote workFull time- ...Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified...Remote work
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