Remote Nurse: Clinical Utilization Review
HealthHelp - A WNS Company
Houston, TX
- Remote job
WNS is seeking a clinically trained reviewer to perform utilization reviews and case management activities. The role requires RN or LVN/LPN licensure and at least two years in related functions, with strong knowledge of regulatory standards and insurance terminology. The candidate will work remotely, coordinate with providers and clients, and help ensure timely, compliant care decisions while maintaining thorough documentation. #J-18808-Ljbffr HealthHelp - A WNS Company
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Nurse: Clinical Utilization Review in Houston, TX vacancy
$65k - $75k
...Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies... ...Training: 10:30am CST - 7:00pm CST Location: Remote Compensation Disclosure The base salary for...Remote workLocal areaMonday to FridayHealthHelp
United States3 days ago- ...Registered Nurse (RN) | Utilization Review Location: Pennsylvania Agency: Pyramid Consulting, Inc... ...Position Key Responsibilities ~100% REMOTE role but candidate has to be in (PA,... ...to Medical Directors with relevant clinical information, including potential...Remote workWeekly payFull timeImmediate start
Pyramid Consulting, Inc.
Pennsylvania10 days ago $69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused on helping our clients... ...and Commercial Payers. You will work remotely in a fast paced and dynamic... ...And Abilities Needed Experience with utilization management systems or clinical decision...Remote workFor contractorsWork at officeWork from homeHome officeShift work- ...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... ...with management and providing guidance on clinical questions. This is a unique opportunity to work from...Remote workFull timeWork from home
ExamWorks
United States4 days ago $38 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $38 to $45 per hour Shift Information... ...Travel Registered Nurse – Utilization Review (Remote) Location: Fort Myers, Florida Facility: Lee Health...Remote workHourly payFull timeContract workWork experience placementMonday to FridayShift workWeekend workLancesoft Inc
Fort Myers, FL3 days ago- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... ...from an accredited Registered Nursing Program; RN preferred. 2....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
United States4 days ago - Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
$2,065 per week
...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements ~ Specialty... ...Review Extension (UR EXT) specialist for a remote position. This role involves conducting utilization...Remote workTemporary workFor contractorsZero hours contractMonday to FridayShift workWeekend work- ...first-level admission and continued stay case reviews, the full-time Registered Nurse Utilization Review will work remotely to assess cases using client-specific... ...evidence-based criteria while ensuring appropriate clinical documentation and orders are in place. Key responsibilities...Remote workFull time
Virtual Vocations Inc
United States5 days ago - ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
United States5 days ago - ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
IntePros
United States4 days ago $27.02 - $48.55 per hour
## Clinical Review Nurse - Concurrent ReviewApply: Remote-IA: Full time: Posted Today: 1658058**Position Purpose:** Performs concurrent reviews, including... ...requires an Iowa or compact nursing license. Previous utilization management, Med/Surg, ICU, and/or pediatric...Remote workHourly payFull timeWork from homeMonday to FridayCentene Corporation
Brooklyn, NY2 days ago- Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas. Review... ...for diverse populations. The position emphasizes utilization review, documentation, and collaboration with...Remote jobWork from home
- ...States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual... ...management to ensure timely reviews, document outcomes, and...Remote workFull time
Well Sense Health Plan
United States1 day ago - ...Registered Nurse - Utilization Review About Company Bestica: We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
Bestica Healthcare
United States1 day ago $1,949.74 per month
...Job Type Travel Offering Nursing Profession Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift workProvidence Health and Services
Eureka, CA3 days ago- ...Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a 100% remote, full-time role supporting Alaska contracts. The nurse will assess medical necessity and care quality through prospective, concurrent, and retrospective reviews, applying InterQual criteria...Remote workFull time
Comagine Health
Las Vegas, NV1 day ago - ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
TriWest Healthcare Alliance
Phoenix, AZ12 hours ago - A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating... ...of experience in utilization review and significant clinical experience in an acute setting. Strong written and...Remote work
Insight Global
United States4 days ago - ...and experienced Registered Nurse with specialties in Medical/... ...health, or hospice care. Clinical assessment, medication... ...Certifications: Experience in Utilization Review or case management roles.... ...to work independently in remote settings. Must be able...Remote workFlexible hours
vTech Solution
Santa Rosa, CA2 days ago - ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization... ...regulatory requirements while working remotely. Key responsibilities:... ...determinations using approved clinical criteria and organizational...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
Virtual Vocations Inc
United States1 day ago $71.1k - $97.8k
...Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate... ...candidates will be licensed RNs with a minimum of two years clinical experience. The compensation ranges from $71,100 to...Remote workWork from homeHong Kong Study Skills Research Institute
Juneau, AK1 day ago- ...Summary: Work Mode: 100% Remote - MS (candidates can... ...medical necessity reviews of inpatient admissions... ...stays. Apply clinical criteria and guidelines... ...determinations within nursing scope. Identify discharge... ...ensure appropriate utilization, regulatory compliance...Remote workHourly payFlexible hoursShift workWeekend work
Axelon
United States5 days ago $1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB,... ...No weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...in Utilization Management, Utilization Review, or Case Management ~• Preferred Certifications...Remote workContract workImmediate startMonday to FridayVarite
Aurora, CO4 days ago- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote jobContract work
- ...Description Job Description The utilization review and management (UM)... ...facilities are medically necessary, clinically appropriate, evidence-based,... ...~ Registered nurse with active, unincumbered nursing... ...This is an in-office, no remote work capability position...Remote workWork at office
MedTrust LLC
Oklahoma City, OK17 days ago $1,966 per week
...among the first 25 applicants Nurses - are you looking for a... ...Holidays Work-life balance. Remote/hybrid setting (once trained... ...DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours$36 - $40 per hour
...Utilization Review Registered NurseThis role focuses on performing comprehensive concurrent... .... The Utilization Review Registered Nurse evaluates clinical information, applies medical necessity... ...EnvironmentThis position is 100% remote, with a preference for candidates located...Remote workContract workTemporary workMonday to FridayShift workActalent
San Antonio, TX5 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Nurse: Clinical Utilization Review. Be the first to apply!
Related searches
- permanent nurse practitioner Houston, TX
- nursing home nurse practitioner Houston, TX
- clinical resource nurse Houston, TX
- nurse practitioner - house calls Houston, TX
- matron Houston, TX
- pediatric nurse practitioner Houston, TX
- nurse manager Houston, TX
- nurse practitioner - hourly Houston, TX
- nurse practitioner - medicare assessments Houston, TX
- orthopedic nurse practitioner Houston, TX