RN - Utilization Review
$35 - $46 per hourOscar Health
Now hiring: RN - Utilization Review in Remote at Oscar Health. Job type: Full-Time. Review the complete description and requirements below to determine if this opportunity is the right fit for you. Compensation: $35 — $46 per hour. Posted: Oct 21, 2026. Oscar Health is seeking a Utilization Review Nurse to join our team. You will review cases, verify medical records, and consult with care providers to assess treatment appropriateness using Oscar Clinical Guidelines, MCG, and InterQual. The role reports to the Supervisor, Utilization Review. This remote position is open to multiple states with occasional travel for meetings and events. The base pay ranges from $35.00 to $45.94 per hour, plus benefits and vacation accrual. #J-18808-Ljbffr
- ...the United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...remote, full-time role requires an active RN license, nursing degree, and experience with... ...physicians and care management to ensure timely reviews, document outcomes, and maintain...SuggestedFull timeRemote work
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...strong team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization review...SuggestedWork at officeRemote work
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...SuggestedRemote job
- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...SuggestedWork at officeRemote work
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...SuggestedRemote work
- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials for a seamless patient care continuum. You will liaise with third party payers, clinicians and care teams to ensure appropriate...Remote work
$65k - $85k
...Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with strong experience in OASIS, coding, QA, and...Remote workMonday to FridayWeekend workWeekday work$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside while still making a massive impact on patient care? We are seeking a dedicated Utilization Review Nurse to join our remote team. In this role, you...Work at officeRemote work10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports... ...role requires a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of related...Full timeRemote work$45 - $50 per hour
...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 kozmetickesluzby....Remote jobHourly pay- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically... ...RN license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate degree...Remote workWork from homeMonday to FridayWeekend work
- ...improvement huddles, employee surveys, and town hall meetings Job Description A Day In The Life The Utilization Review Specialist (RN) is responsible for ensuring appropriate utilization of healthcare services across the continuum of care. This role evaluates...Full timeWork at officeWeekend work
$63.1k - $94.65k
...experience, education, certifications, and overall qualifications. *Must have current compact RN license, or be willing to obtain* Schedule Information: Our Utilization Review team provides coverage seven days a week, operating between 8:00 a.m. and 10:00 p.m. To...Temporary workPart timeWork at officeLocal areaRemote workFlexible hoursShift work- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with clinical guidelines, regulatory requirements...Remote workShift workWeekend work
- ...Overview This remote position in Utilization Management requires a Registered Nurse with 2 years of experience. Responsibilities include working with providers, managing reviews, and utilizing EMR systems. The role follows a Monday through Friday schedule with...Weekly payRemote workMonday to FridayWeekend work
$63.1k - $94.65k
...position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Utilization Review RN based in the United States. Join a healthcare team dedicated to improving patient outcomes, ensuring appropriate...Temporary workPart timeWork at officeRemote workWork from homeFlexible hoursShift workAfternoon shift- ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning, and recovery for injured employees while advocating for effective medical treatment. Key responsibilities...Full timeWork experience placementRemote work
- ...Job Title: RN Utilization Review City: Torrance State: CA Job Type: Travel Discipline: RN Speciality: Utilization Review Facility Setting: Short Term Actut Care (STAC) Accepting Locals per Radius Rule?: Yes Contract Length: 13 weeks Shifts...Contract workTemporary workLocal areaRemote workShift work
$2,158.8 per week
...Ref. 65547807 RN - Utilization Review $2,158.80 per week Location: Fort Myers, FL Type: Travel Schedule: 5x8 Days Time: 13 Weeks Job Title: RN - Utilization Review - Travel Location: Fort Myers, FL...Weekly payWork experience placementRemote workMonday to FridayFlexible hoursShift workWeekend work$2,023.3 per month
...Corporate Center Job Type Travel Offering Nursing Profession Registered Nurse (RN) Specialty Utilization Review Job ID 38245223 Job Title Registered Nurse (RN) - Utilization Review Weekly Pay...Weekly payContract workLocal areaRemote workMonday to FridayShift workWeekend work- ...Job Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers...Temporary workRemote workShift workWeekend work
- ...their families. The following Job Description will also apply at Broward Pace Program sites. Job Title: Utilization Review RN Job Summary The Utilization RN is responsible for conducting prospective, concurrent, and retrospective...Full timePart timeWork at officeLocal areaRemote workWeekend workAfternoon shift
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS) Pay...Local areaImmediate startRemote workMonday to FridayShift workWeekend work- ...Job Summary and Responsibilities As our Utilization Review RN, you will meticulously review medical records to confirm appropriate admission status and continued hospitalization, utilizing established criteria and critical thinking. You'll work hand-in-hand with Concurrent...Remote work
- HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The ideal candidate has an RN license...Remote job
- HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and others from admission onward...Remote job
$47.03 - $63.48 per hour
...that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare. The RN, Senior Utilization Review Quality will play an essential role in reviewing and ensuring the quality of the VUR teams’ work efforts in partnership...Temporary workWork at officeLocal areaRemote work- ...RN - Utilization Review MedWave Healthcare Staffing is currently seeking a Utilization Review RN for a travel assignment in Tuba City, Arizona. The candidate that will best match this position will have at least 1 year of experience as a RN and previous travel experience...Weekly payContract work
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding... ...admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Remote Utilization Review Specialist In this remote role, you will conduct utilization reviews, ensuring that patient care meets the necessary standards. You will coordinate with healthcare teams for optimal patient outcomes while managing documentation and compliance...Weekly payRemote work
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