Remote Utilization Review RN - ER & Acute Care
Netsmart
- Remote job
Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established criteria. The role requires adept EMR review, strong clinical judgment, and collaboration with ED physicians to ensure appropriate authorization. The successful candidate will bring 3+ years of acute care experience, knowledge of InterQual/MCG guidelines, and proven ability to adapt in a fast-paced environment while maintaining #J-18808-Ljbffr Netsmart
$2,210 per week
...managed health care, focused on what... ...Work-life balance. Remote/hybrid setting (... ...individual will utilize clinical... ...a second level reviewer. This individual... ...not limited to RN, LMSW, LMHC. Successful... ...3 years recent acute clinical practice... ...Unit - ICU Travel ER Registered Nurse...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours$35 - $45.94 per hour
...Utilization Review Nurse Remote Hi, we're Oscar. We're hiring a Utilization... ...records and speak with care providers regarding treatment... ...~ Active, unrestricted RN licensure from the... ...clinical practice in an acute care setting, i.e., ER or hospital) ~ Weekend...Remote workHourly payFull timeWork from homeHome officeWeekend work- Netsmart is seeking a Remote Utilization Review Nurse to evaluate ED admissions using InterQual/MCG criteria and apply evidence-... ...insurance authorization. Ideal candidates have an active RN license, 3+ years in acute care (ER/ICU/medical-surgical), and 2+ years UM experience,...Remote job
- ...staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client... ...role involves evaluating patient care cases and ensuring requested services... ...clinical experience in an acute setting. Strong written and verbal...Remote job
- ...Utilization Review Nurse Responsible for utilization review work for emergency... ...Current and unrestricted RN license At least 3 years clinical experience in acute care setting in emergency room, critical... ...: Comfortable with remote work arrangements and virtual...Remote workFor contractorsWork at office
- ...Medical Center is a 342-bed, acute care, nonprofit hospital... ...Responsible for the review of medical records for... ...Care Coordination staff utilizing evidence-based guidelines... .... Job Requirements Remote. Must reside within driving... ...experience. California RN license. AHA BLS...Remote work
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical... ..., and collaborate with care management and financial clearance... .... Must hold an unrestricted RN or LPN license and have 3+ years of acute care nursing experience....Remote job
$30 - $38 per hour
...solutions, and comprehensive care navigation together in... ...decisions, one review at a time? Why This... ...Current, unrestricted RN license in the United States... ...clinical experience (acute care, med-surg, ICU/ED,... ...or similar setting) ~ Utilization review/utilization management...Remote workHourly payImmediate startMonday to FridayFlexible hours- ...Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review... ...medically necessary, high-quality care while promoting appropriate resource... ...license. Minimum of 2 years of acute care clinical nursing experience....Remote jobWork at office
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type... ...optimal health, access to care, and appropriate utilization... ...Experience: Required: 2 years of acute hospital or behavioral... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
$84.56k - $126.84k
...: Regular Job Overview The Utilization Review RN participates as a member of... ...position will be primarily remote but there may be occasions when... ...Assesses the continuity of care in conjunction with the Case... ...to assure that criteria for acute hospitalization are met. 8....Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift- ...Description Fully remote- Must have state... ...MI unrestricted RN license. You... ...retrospective review of inpatient, outpatient... ...and level of care, including... ...experience in ICU, ER, or medical... ...preferred Prefer utilization management... ...which may include acute patient care, discharge...Remote workWork at officeFlexible hours
- ...Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN... ...from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs... ...hours per day, requiring an RN with a Bachelor's degree, state...Remote jobWork from homeMonday to Friday
$23.76 - $51.49 per hour
...JOB DESCRIPTION This RN will act as a Care Review Clinician and provide clinical review support for Medicare inpatient utilization management activities. Conducts medical necessity reviews... ..., including experience in hospital acute care, inpatient review, prior...Remote workHourly payWork experience placementWork at officeShift work- ...Registered Nurse Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient... ...(OBS). Minimum of 3 years acute medical Care Management/Utilization...Remote work
- ...Health Plans is seeking a Utilization Review Registered Nurse to apply clinical, managed care and utilization review... ...improve member outcomes. This remote role supports the... ...discharge planning. Maryland RN license (or compact) and 3+ years acute care experience plus 1+ year...Remote job
- ...Care Review Clinician This RN will act as a Care Review Clinician supporting our... .... This is a telephonic remote position and productivity... ...candidates will have previous utilization management, case... ...including experience in hospital acute care, inpatient review, prior...Remote workWork at officeMonday to FridayWeekend work
- ...Healthcare seeks an experienced RN to support Arizona Plan... ...member services review processes. The role... ...license and experience with utilization management, prior... ...and outpatient settings. Remote position, must reside in... ...effective, quality member care through integrated #J-...Remote job
$63k - $65k
...RN Utilization Review By joining Sedgwick, you'll be part of something truly meaningful. It's what... ...your career with us, experience our caring culture, and enjoy work-life balance. Here... ...health and well-being of others in a remote work environment. Enjoy flexibility...Remote workWork experience placementLocal areaFlexible hours- Johns Hopkins Health Plans (JHHP) is seeking a Utilization Review Registered Nurse to assess care appropriateness, authorize services, and coordinate discharge planning for plan members. This remote role prioritizes candidates in MD, DC, VA, PA, DE, and FL with strong clinical...Remote job
- ...or holidays. The position emphasizes clinical reviews to determine if treatments meet criteria,... ...Nurses with a current US license and 3-5 years of acute care experience, plus mental health or substance abuse expertise. A remote setting is available within a national scope....Remote jobMonday to FridayWeekend workDay shift
- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time remote role supports compliant, cost-effective care under Alabama...Remote jobFull timeContract work
- ...completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees... ...for first week. This role will be remote BUT regular meetings/trainings require... ...patients, including critical care, for appropriateness of...Remote workReliefWeekend work3 days per week
- ...Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical... ...LPN/LVN license, at least 3 years of nursing in acute or outpatient settings, and 2+ #J-18808-Ljbffr Santa...Remote job
$65k - $85k
Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) for a fully remote home health role in the US. Salary ranges from $65,000 to $85,000 annually, based on experience, with Florida RN license and OASIS/coding certifications required. The role...Remote jobFlexible hours- ...Utilization Review Registered Nurse Johns Hopkins Health Plans... ...(JHHP) is the managed care and health services business... ...balance - This is a remote role! Candidates in the... ...Registered Nurse (RN) license in Maryland (or... ...years' experience as an acute care RN ~1+ years' experience...Remote workMonday to Friday
$65k - $85k
...Utilization Review Specialist (RN) - Remote $65K-$85K | OASIS & Coding Certified | Florida RN License Required Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for...Remote workMonday to FridayWeekday work- HonorHealth is seeking a Utilization Review RN Specialist to review and monitor health care utilization, ensuring medical necessity and appropriate levels of care across... ...accurate documentation for data reporting. Remote work is available after training, with a day shift...Remote jobDay shift
$35.29 - $54.71 per hour
...not offer a hybrid or remote option Minimum Requirements... ...as a Registered Nurse (RN). ~6 months of... ...practice in direct patient care utilizing the nursing process... ...at the point of care Acute Care: Direct care includes... ...of living. Market reviews: All UCHealth positions...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift- 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...Remote job
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