Remote Utilization Nurse (RN) - Prior Authorizations
Central California Alliance for Health
Central California Alliance for Health is seeking a Part Time Prior Authorizations Nurse (RN) for a temporary remote role in California. The assignment runs through December 2026 and is 20-40 hours per week, Monday–Friday.
The nurse will ensure prior authorization requests meet contractual requirements, participate in UM Care Programs, and apply CMS and Medi-Cal guidelines. Requirements include a CA RN license, a Nursing degree, and 5+ years in patient care with prior UM/Case Management
#J-18808-LjbffrVacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Nurse (RN) - Prior Authorizations in United States vacancy
$72.8k - $130k
...occasional opportunity for remote work based on... ...needs. As a Sr Utilization Management Nurse in the Springfield MA... ...review of current and prior patient conditions, documents... ...a Registered Nurse (RN) with a current,... ...UM, including prior authorization, concurrent authorization...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaOptum
Charlton, MA3 days ago- ...CVS Health in the United States is seeking an experienced Utilization Management Nurse Consultant (RN) to join our remote team. You will review prior authorization requests, evaluate medical necessity, and apply clinical criteria to support timely, cost-effective care...Remote work
CVS Health
United States4 days ago - ...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
NeueHealth
Sacramento, CA1 day ago - ...Utilization Management Nurse The primary role of the Utilization Management Nurse... .... This includes providing prior authorizations, concurrent review,... ...facility. This is primarily a remote telephonic position with normal... ...clinical experience as RN, LPN/LVN required....Remote workContract workWork at officeWeekend work
AllyAlign Health
United States5 days ago $26.01 - $62.32 per hour
...one family and one community at a time. RN Utilization Management Nurse Consultant (Medicare - Joint Procedures) Remote | Full-Time | Monday-Friday (9:00 am to 5:... ...Nice to Have Utilization Management or Prior Authorization experience Managed care and/or Medicare...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday workCVS Health
Guin, AL4 days ago$26.01 - $62.32 per hour
...family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you... ...Nice to Have Utilization Management or Prior Authorization experience Managed care background...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday workCVS Health
Sioux Center, IA5 days ago$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... ...all. JOB SUMMARY The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated...Remote workHourly payFull timeContract workWork at officeWork from homeNeuehealth
United States3 days ago- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...an Illinois state RN license Assess and analyze... ...eligibility Process prior authorization determinations within... ...Summary Works with the Utilization Management team primarily... ...IL State Registered Nursing (RN) license in good...Remote workContract work
Integrated Resources
Springfield, IL3 days ago $54.1k - $116.77k
...one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN Remote | Full-Time | Weekday Schedule Are you... ...Qualifications Utilization Management or Prior Authorization experience Managed care background Ambulatory...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident... ...Review to join our Utilization Management team. In this role, you... ...assigned Qualifications ~ Active RN license (WA; must be in good standing...Remote workContract work
SPECTRAFORCE
Washington DC5 days ago $29.1 - $62.32 per hour
...Utilization Management Nurse Consultant### Utilization Management Nurse ConsultantApply: Remote: NH - Work from home: Work At Home-Arkansas: Work... ...Clinical Precertification RN (Medicare)** **Remote | Full... ...management and prior authorization decisions* Identify opportunities...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftCVS Health
New York, NY4 days ago$70.2k - $120.4k
...every member feels valued.The Utilization Review RN will review and document... ...ResponsibilitiesMedica's Utilization Review Nurses are responsible for reviewing and documenting prior authorization requests and member case... ...requiredThis position is a Remote role. To be eligible for...Remote workWork experience placementMedica
Minnetonka, MN2 days ago- ...Reports to the Health Plan Manager of Utilization Management. This position will be an integral... ...OR LICENSURE: 1. Current Registered Nurse license issued by the state in which... ...care management review processes (Prior Authorization, Predetermination, Concurrent Reviews,...Remote workCasual workWork at officeShift work
Peak Healthcare
United States5 days ago $29.1 - $62.32 per hour
...partner is looking for a Utilization Management Nurse Consultant based in Canada... ...Registered Nurse to join a remote Utilization Management team... ...contribute to effective prior authorization decisions, improved healthcare... ...Registered Nurse (RN) license in the state of residence...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftJobgether
New York, NY4 days ago$39 - $40 per hour
...Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the... ...Utilization Management RN experience, including Prior Authorization and Concurrent Review Experience...Remote workDaily paidContract workMonday to FridayShift workWeekend workThe Judge Group
Chicago, IL1 day ago$32.01 - $68.55 per hour
...Position Summary This Utilization Manager position is with Aetna... ...Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will... ...Experience with Prior Authorizations Knowledge of Medicaid and...Remote workHourly payFull timeLocal area10 hours per weekFlexible hoursThe Muse
Albany, NY2 days ago$89.54k - $136.47k
...Remote Utilization Review Registered Nurse Sentara Health is hiring a Remote Utilization Review Registered... ...licensure. Conducts primary function of prior authorization for inpatient and outpatient... ...information. Education: N-3 Years RN- Diploma (required) BSN (...Remote workFull timeShift workSentara Healthcare
Norfolk, VA5 days ago$89.54k - $136.47k
...Overview Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must reside in the... .... Conducts primary function of prior authorization for inpatient and outpatient reviews... ...information. Education N-3 Years RN- Diploma (required) BSN (...Remote workFull timeTemporary workShift workSentara Hospitals
Virginia Beach, VA3 days ago$75k - $100k
...Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical... ...evidence-based criteria, authorize requested services as... ...Location We are open to remote work in the following approved... ...and behavioral health prior authorization requests...Remote workFor contractorsWork at officeLocal areaImmediate startWPS—A health solutions company
Tallahassee, FL4 days ago- ...organization, seeks an experienced Registered Nurse for a remote Utilization Management role. You will review... ...medical necessity, and support prior authorization decisions while collaborating with... ...teams. The ideal candidate has 3+ years RN experience, ADN required with BSN...Remote job
- ...DescriptionJob Description Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-... ...Registered Nurse (RN) with experience in utilization... ...party payers regarding authorization and coverage... ...reimbursement methodologies and prior authorization processes...Remote workFull timeSecond jobWork at office
Ova Technologies
Alpharetta, GA1 day ago $90k - $107k
...professionals, including doctors, nurses, business people, tech... .... The UMCM will utilize clinical knowledge to... ...candidate will have prior authorization (outpatient review)... ...Massachusetts Registered Nurse (RN) license required... ...after hire. This is a remote role with occasional...Remote workFlexible hoursShift workMass General Brigham Health Plan Holding Company, Inc.
Somerville, MA3 days ago- ...Health is seeking an experienced Utilization Management RN to review prior authorization requests across multiple specialties... ...a high-volume caseload from a remote home office. The ideal candidate... ...RN license, 3+ years of clinical nursing, and 2+ years in utilization management...Remote jobHome office
- WPS Health Solutions seeks an experienced Utilization Management Registered Nurse (UM RN) to evaluate efficiency, appropriateness, and medical necessity... ...teams, and other departments while reviewing prior authorization requests and ensuring alignment #J-18808-Ljbffr WPS...Remote job
$35 - $40 per hour
...seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to... ...and AI model development for prior authorization use cases. The ideal candidate... ...day Mon - Fri, 40 hrs/weekFully Remote PositionPay Range: $35 - $40 per...Remote workLocal areaShift workPRIDE Health
Minneapolis, MN4 days ago$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating... ...Review and process prior authorizations and reauthorization requests in... ...Current, active nursing license (RN, LPN, or LVN) in good standing...Remote workContract workFlexible hoursWeekend workIntePros
Phoenix, AZ2 days ago- ...Summary Behavioral Health Utilization Manager will perform... ...facility contract status prior to processing authorization requests. Complies with established... ...: Bachelor's degree in nursing. Current state Registered... ...Work Schedule: Remote Other Requirements...Remote workContract workWork experience placement
Harris Health
Houston, TX2 days ago - Central California Alliance for Health is seeking a Prior Authorizations Nurse (RN) for a temporary, full-time role. This remote-in-California position reports to the Utilization Management Supervisor and involves ensuring PA requests comply with contracts and evidence...Remote jobFull timeContract workTemporary work
- ...Utilization Review NurseThis position has a remote option for those living close and will be able to come into the... ...as needed.The Utilization Review Nurse is responsible for determining the... ..., or Leader of Leaders.The prior authorization role completes an assessment of...Remote workFull time
CHRISTUS Health
Alamogordo, NM1 day ago - ...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
Wellstar Health Systems, Inc.
Augusta, GA22 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Nurse (RN) - Prior Authorizations. Be the first to apply!
Related searches
- kaiser rn United States
- outpatient rn United States
- sedation rn United States
- 1099 rn United States
- ed rn United States
- registered nurse office United States
- rn visa sponsorship United States
- labor & delivery rn United States
- registered nurse remote United States
- mother baby postpartum rn registered nurse United States