Remote Utilization Management Nurse Coordinator (RN/LVN)
Yoh Services LLC
- Remote job
Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully remote. The role reviews outpatient authorizations, assesses medical necessity, and collaborates with interdisciplinary teams to ensure appropriate care while complying with CMS and health plan guidelines. #J-18808-Ljbffr Yoh Services LLC
$45 per hour
Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’smanaged care health plan client based out of Fairfield & Redding, CA. Anticipating to betemporary for at least 6 months with potential for temp-to-hire...Remote jobContract workTemporary workMonday to FridayWeekend work- Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...to optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote job
- ...Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and... ...inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote workWork from home
$77.91k - $116.86k
...Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review... ...and ancillary service providers to coordinate care activities. Identifies... ...active, valid, and unrestricted LVN or RN license in California (Non-Compact...Remote jobImmediate startMonday to Friday$65k - $85k
...Jobs > Licensed Vocational Nurse (LVN) - Utilization Management & Inpatient Case... ...Inpatient Case Management Fully Remote Remote Worker - N/A Full-time... ...inpatient case management, and coordination of transitions of care ,... ...review and elevate to an RN, Medical Director, or...Remote workFull timeWork at office- ...Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the... ...administrative compliance. Unlike remote roles, this position relies heavily on... ...site UM Nurse is a Registered Nurse (RN) responsible for performing admission...Remote workFull timeImmediate startShift work
$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States WHO WE ARE NeueHealth is a value-driven healthcare company... ...that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health...Remote workHourly payFull timeContract workWork at officeWork from home- ...Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating and documenting medical services and benefit determinations. The role involves... ...Degree in nursing, an active compact RN license, and at least three years of geriatric...Remote work
$70k - $75k
Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company... ...AI tools more reliable and user-friendly. Care Coordination & Quality Support Initiating referrals of...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...NeueHealth is seeking a Utilization Management Nurse (LVN/LPN) for a remote role based in California. The position focuses on reviewing prior authorizations, ensuring alignment with coverage policies and medical necessity, and collaborating with providers, patients, and...Remote work
$60k
...Integra is looking for a LPN/LVN experienced in the managed care payor environment to... ...-service and post-service utilization reviews and appeals for... ...Active, Licensed Vocational Nurse, or Licensed Practical... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area- ...Looking for qualified MDS Coordinators (RN or LPN) to join our team! Location... ...an experienced Registered Nurse (RN) or Licensed Practical... ...Monitor and document the management of Medicare and Managed Care... ...telemedicine services and remote health monitoring to advanced...Remote workFull timeLocal areaShift workNight shiftDay shiftAfternoon shift
$21 - $28 per hour
...CareHarmony's Intake Coordinators (LPN) (NLC) (LVN) work comprehensively with providers... ...deliver value-based care management initiatives for their... ...experienced Licensed Practical Nurse – LPN Nurse (LPN) (NLC) (LVN... ...What's in it for you?Fully remote position - Work from the comfort...Remote workFull timeWork experience placementWork at officeHome officeMonday to FridayShift workDay shift- University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient outcomes. The position emphasizes...Remote job
- Centene Management Company LLC is seeking a nurse to facilitate medical necessity grievances, appeals and denials while reviewing clinical... ...criteria are met. The role requires California RN/LPN licensing and supports remote work with PST hours. Responsibilities include...Remote job
- NeueHealth is hiring a Utilization Management Nurse (LVN/LPN) based in California for a remote, full-time role. The PA Nurse reviews prior authorizations, verifies coverage, and ensures medical necessity under state and plan policies. You will collaborate with Medical Directors...Remote jobFull time
- CVS Health is seeking an Utilization Management Nurse Consultant who must reside in Florida. This remote, full-time role reviews clinical... ...medical necessity criteria, and coordinates utilization management with... ...position requires an active Florida RN license and at least 3 years...Remote jobFull time
- Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote jobWork from home
$38 - $40 per hour
...Title: RN -- Review Analyst Location: Remote Duration: 12 months with... ...and retrospective utilization reviews for inpatient... ...outreach, and coordinate care across the healthcare... ...Utilization Management (UM) , Case Management... ...'s degree in Nursing or a related field...Remote workHourly payWork at officeMonday to FridayShift work- ...currently hiring for an LPN Utilization Management Coordinator I to join BlueCross... ...0pm and will be fully remote . The candidate may be required... ...School of Licensed Practical Nursing or Licensed Vocational Nursing... ...: Active, unrestricted LPN/LVN licensure from the United...Remote workFull timeFor contractorsWork experience placementCurrently hiringWork at officeLocal areaMonday to Friday
- Astrana Health is seeking a CA-licensed Utilization Review Nurse to support the Health Services Department. You will review outpatient services... ...and refer cases to Medical Directors as needed. This is a remote role for CA-licensed RNs/LVNs, with candidates living in California...Remote jobCasual workWork at office
$45 - $45.5 per hour
Overview Job Title: Nurse Case Management Senior Analyst Location: REMOTE Duration: 5-6 Months (Contract... ...treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options... ...more junior team members. RN and current unrestricted...Remote workContract workImmediate startMonday to FridayAfternoon shift$33 - $46 per hour
ExamWorks is seeking a Utilization Review Nurse Auditor to join our team. This fully remote role requires RN/LPN/LVN licensure and strong medical terminology, anatomy, and physiology knowledge to review care for medical necessity according to evidence-based guidelines....Remote jobHourly payMonday to Friday- ...Description Position Summary: The Utilization Management Nurse (UMN) works under general supervision... ...: Current unrestricted Florida RN or LPN License. Minimum of two years... ...utilizing standardized Review Criteria; Coordinates with the Medical Director/Physicians...Remote workWork at officeWeekend work
- ...Wound Care Nurse (RN or LPN)Location: Middleton Oaks Health and RehabilitationJob... ...provide high-quality wound management and support to our residents... ...communication and care coordination.Wound Care Program... ...From telemedicine services and remote health monitoring to...Remote workFull timeLocal areaShift workNight shiftDay shiftAfternoon shift
- .... Work Shift As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the... ...and administrative compliance. Unlike remote roles, this position relies heavily... ...site UM Nurse is a Registered Nurse (RN) responsible for performing admission...Remote workImmediate startShift work
- ...Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective... ...criteria, ensuring medical necessity, and coordinating with care teams. Ideal candidates hold an RN license with 3+ years in case or utilization...Remote workWork from home
- ...Cambia Health is seeking an Utilization Management Nurse who can conduct prospective, concurrent, and retrospective reviews to ensure medical necessity and proper care pathways. You will apply evidence-based criteria and consult with physicians as needed. In this role...Remote work
$60.2k - $107.4k
...About This Role As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs... ...Requirements Education: Active, unrestricted RN license in state of residence Experience: 1+ years...Remote workPermanent employmentFull timeDay shift- ...authentic experience! Under the general direction of the Utilization Management Manager, the Utilization Management Nurse is responsible for prospective and concurrent/... ...in an acute care facility utilizing an active RN license is required. Experience in an HMO or experience...Remote jobTemporary workFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse Coordinator (RN/LVN). Be the first to apply!
- library coordinator Redding, CA
- continuous improvement coordinator Redding, CA
- experience coordinator Redding, CA
- art coordinator Redding, CA
- maths coordinator Redding, CA
- technology coordinator Redding, CA
- soccer coordinator Redding, CA
- work from home travel coordinator Redding, CA
- healthcare coordinator Redding, CA
- sustainability coordinator Redding, CA


