Remote Utilization Review Case Manager
Quorum Health
Quorum Health is seeking a Case Manager - Utilization Review Specialist for a remote role. The Specialist will manage admission reviews, conduct appeals, and identify workflow improvements. This position requires a current RN license and significant experience in healthcare, particularly in case management and utilization review. The ideal candidate will have a strong understanding of regulatory standards and excellent analytical skills, as well as the ability to maintain confidentiality per HIPAA regulations. Strong communication skills and flexibility are essential. #J-18808-Ljbffr
- The University of Miami is seeking a full-time Utilization Review Case Manager to work remotely. This role involves conducting chart reviews for clinical utilization and authorization to optimize patient outcomes and avoid treatment delays. The ideal candidate will hold...Remote jobFull time
$77.96k - $120.37k
...The Case Management Supervisor is responsible for directing the operations... ...management. This is a remote position. ESSENTIAL FUNCTIONS... ...daily, weekly, monthly reviews of various reports, invoices... ...aptitude with the ability to utilize Microsoft Office including Excel...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- ...elevate outcomes, and love your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the Bay Area—where your... ..., AI-assisted decision support, virtual nursing, and remote monitoring; clear investment in clinician well-being...Remote workWeekend work
$31.94 - $43.92 per hour
...psychosocial assessments Create and manage discharge plans Coordinate with... ...Lead care planning discussions Utilization Management Review medical necessity & admission status... ...Requirements Option 1: 3+ years recent Case Management (acute care) OR Option 2...SuggestedRelocation packageShift workWeekend workAfternoon shift$89.76k - $127.98k
...Position Summary This position is responsible for performing utilization management and concurrent review activities to ensure appropriate level of care... ...continued stay determinations. Collaborate with physicians, case managers, social workers, and interdisciplinary care...SuggestedWork at officeFlexible hoursWeekend workWeekday work- ...Utilization Review Case Manager Dilkon Medical Center - Dilkon, AZ 86047 Overview Level: Experienced Position Type: Full-Time Job Shift: Day Education Level: Bachelors Degree Travel Percentage: Negligible Description Under general supervision of the PRC...Full timeWork at officeFlexible hoursShift workNight shiftAfternoon shift
$55.56 - $85.96 per hour
...Under general supervision, the Utilization Review Case Manager (UR CM) performs review of patient charts as defined by the Hospital's Utilization Review Plan. The UR CM validates the patient’s admission status and level of care to be at the most appropriate based on nationally...Contract work- ...Utilization Review Nurse Works under the supervision of the Director of Care Management. Reviews the medical record on a concurrent basis, utilizing criteria accepted and approved... ...and resource in Utilization Review and Case Management. Partners with Social Workers to...Work experience placement
$89.76k - $127.98k
...Summary This position is responsible for performing utilization management and concurrent review activities to ensure appropriate level of care... ...environment. Duties of a Utilization Review and Appeals Case Manager may include the following but are not limited to...Full timeWork at officeFlexible hoursWeekend workDay shiftWeekday work- ...Job Details Position: Utilization Review Case Manager Location: Idaho Falls, ID 83404 Type: Full Time Education Level: Registered Nurse (or Licensed Practical Nurse in the State of Idaho) Job Summary Under the general direction of the UR/Case Manager and the UR Medical...Full time
- ...Licensed Practical Nurse to provide discharge planning and utilization review services. This position requires a current active license... ...education, and preferably at least one year of experience in case management/utilization review. Responsibilities include analyzing...
$46.44 - $69.66 per hour
...services with physicians, nurse managers, and multidisciplinary team... ...psychological issues arise; reviews medical records of patients for... ...Health) Post Acute Care Case Manager: reviews and screens... ...reduce unnecessary healthcare utilization and address SDOH in partnership...Shift work- ...Job Title: RN Case Manager/Utilization Review Location: Tuba City, AZ Job Type: Contract (13 weeks) Position Details Schedule: Monday to Friday, 8 AM - 5 PM; Weekend on-call rotation (1 weekend/month) EMR System: Allscripts Pay: Competitive rates (details provided upon...Contract workMonday to FridayWeekend work
- ...Loma Linda University Health seeks a Case Manager-1-BMC responsible for utilization review duties, ensuring maximum quality of patient care. This role requires an RN license and offers an engaging opportunity for professionals to contribute actively in a healthcare environment...
$25k
...Job Description Job Description To Apply for this Job Click Here Position: UTILIZATION REVIEW RN- Case Management (IN PERSON) - Up to $25K SIGN ON BONUS Location: Farmington, NM **Onsite- In person Schedule: Days Responsibilities: Meets expectations...Work at officeRelocation package- ...United Cerebral Palsy of Georgia seeks an RN Case Manager/Utilization Review in Tuba City, Arizona. The role involves case management and utilization review for both inpatient and outpatient settings, ensuring seamless patient care and service planning. The ideal candidate...Contract work
- ...our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! General Summary The ED Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring that the patient meets acute inpatient...Temporary workWork at office
- ...Ahhmgt in Leesville, Louisiana is seeking a Case Management RN responsible for overseeing Utilization Review and Resource Management. This role involves daily reviews of medical records to ensure appropriate admissions and continued hospital stays, aiming for quality...
- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
$32 - $48 per hour
...to better health. Position Overview The Utilization Review Specialist RN assumes responsibility... ...all payers, as well as coordination and management of appeals for accounts deemed appropriate... ...Review Specialist RN Department: Case management Location: Gateway Regional Medical...Hourly payFull time- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workContract workWork from home
- ...International Medical Group) is seeking a Case Manager to evaluate the necessity and... ...travelers. The role offers hybrid or remote work options and an opportunity to engage... ...IMG to contribute to quality patient care and utilization review processes. #J-18808-Ljbffr...Remote work
- ...Position Summary: The Registered Nurse Non-Certified Case Manager works with physicians and multidisciplinary team members to develop... ...BLS Minimum of 2 years of nursing experience MUST HAVE UTILIZATION REVIEW EXPERIENCE Preferred Bachelor's Degree in Nursing 2 years of...Shift workDay shift
$55.56 - $85.96 per hour
...Rose Senior Living - Avon is seeking a Utilization Review Case Manager to conduct patient chart reviews and ensure proper admission status and level of care. The role involves collaborating with payers for clinical service authorization and adherence to quality standards...Hourly pay$75 - $85 per hour
...Job Description Job Description Job Title: Manager, Clinical Resource/Case Management Location: Remote Type: Contract | 27 Weeks Shift &... ...Resource Department to lead Case Management, Utilization Review, and Social Work in an acute care hospital. The...Remote workContract workTraineeshipMonday to FridayShift workRotating shiftDay shift- ...Mountain View Hospital is seeking a Utilization Review Case Manager responsible for ensuring accurate handling of medical necessity reviews in Idaho Falls, ID. The role requires a Registered Nurse or Licensed Practical Nurse license in Idaho and at least 3 years of clinical...
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board... ...performing detailed reviews of medical cases while ensuring high standards of patient care....Remote workFull timeWork from home
- ...individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is... ...settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge...Daily paidLocal area
- ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in... ...providers. This position offers the flexibility of remote work while supporting professional growth and...Remote work
- ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
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