Remote Utilization Review RN - Insurance/URAC Expertise
Innovative Systems Group
- Remote job
A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and knowledge of accreditation standards. Candidates must reside in IL or TX and possess strong communication skills to interact with providers and members. #J-18808-Ljbffr Innovative Systems Group
- Providence is seeking an RN for a remote Utilization Review role. This per diem position involves conducting prospective, retrospective, and concurrent... ...California ministries, requiring strong clinical expertise and a solid understanding of Utilization Management. The...Remote jobDaily paid
- A national insurance group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and ensure compliance... ...Candidates should have a BSN or RN degree and at least 5 years of... ...The position offers options for remote work, health insurance, and other...Remote jobFull time
- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to... ...Systems policies on Health Insurance Portability and... ...professional development and expertise in utilization review.... ...for facility based staff; optional for remote staff....Remote workWork at office
$64.17k - $96.26k
...management. The Utilization Management... ...provides utilization review/pre-... ...documentation and ERISA / URAC guidelines... ...experience required RN (Registered... .... ~ Remote Work Environment... ...healthcare industry expertise to clients in... ...travel insurance ~ Paid time...Remote workLocal areaRelocation packageFlexible hoursWeekend work$45.9 - $71.4 per hour
Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable... ...(medical, dental, vision), life insurance, disability insurance, time off benefits... ...services and sharing of specialized expertise. Equal Opportunity Employer...Remote jobMinimum wageLocal areaShift work$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour Shift... ...and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license. Member...Remote workHourly payFull timeContract workImmediate startShift work3 days per week$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour Shift... ...and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license. Member...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...and voluntary life insurance. Critical Illness,... ...-life balance. ~ Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces... ...knowledge of URAC guidelines, Hines... ...is not limited to RN, LMSW, LMHC. # Must...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
$69.38k - $92.28k
MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum... ...candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent...Remote job- CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote job
- ...Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity...Remote work
- ...in Nevada seeks a Supervisor, Clinical Review to supervise clinical staff conducting utilization reviews. Ideal candidates will have an active RN licensure in Alabama, with 3+ years of... ...skills are crucial. The position offers a remote work option along with comprehensive...Remote work
$84.06k - $118.67k
...seeks a Licensed Registered Nurse for a remote position in Utilization Management. The role involves... ...admissions and discharge planning, conducting reviews for medical necessity, and assisting... ...claims issues. Candidates must hold an RN license from the Texas Board of Nursing...Remote job- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote jobFull time
- P3 Health Partners is looking for an RN Concurrent Review nurse to guide utilization management efforts in our mission-driven organization. This role offers hybrid or fully remote arrangements, with major responsibilities in telephonic review and collaboration with provider...Remote job
- ...is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals... ...clinical nursing experience, including utilization review, and a valid RN license in Florida or Kentucky. Strong...Remote jobFull time
- Providence Health & Services is seeking an RN Utilization Review for a part-time remote position. This role focuses on conducting clinical reviews and utilization reviews across Southern California ministries, requiring effective problem-solving and decision-making skills...Remote jobPart time
- Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including... ...benefits package is provided, including 401(k) matching and health insurance. #J-18808-Ljbffr Providence Health & ServicesRemote job
- ...healthcare organization is seeking a remote RN to ensure appropriate... ...quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations... ...benefits including health insurance, retirement contributions, and...Remote job
- A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of... ...certifications, the UMRN will collaborate with care management and insurance payers. This position offers flexible scheduling and...Remote jobFlexible hours
$75k
...Houston, Texas, is looking for a Registered Nurse (RN) to perform concurrent inpatient utilization reviews. The role requires a BSN and current nursing license... ..., dental, and vision benefits. The position is remote with a standard Monday-Friday schedule and a supportive...Remote jobMonday to Friday$49.34 - $76.59 per hour
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote job$65 per hour
...RN Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift... ...No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- ...State and Territorial Epidemiologists is seeking a Clinical Review Supervisor to provide operational supervision of clinical staff conducting utilization review activities. This fully remote position requires an RN license and relevant experience in patient care and...Remote job
- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote job
$50.68 per hour
Children's Hospital Colorado is seeking a Utilization Review RN to support medical necessity reviews and compliance in a hybrid role based in Colorado. This position requires strong pediatric nursing experience and knowledge of utilization review. Responsibilities include...Remote jobHourly payFlexible hours$211.2k - $277.2k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in...Remote workFull timeLocal areaWork from homeHome officeWeekend work$47.06k - $70.24k
...solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill... .... Candidates must have a current RN license and at least four years... ...benefits offered including health insurance and 401K options. #J-18808-Ljbffr...Remote job- Concierge Home Care is seeking a Utilization Review Specialist (RN) for a remote opportunity. This position requires a Florida RN License, OASIS Certification... ...with a full benefits package, including medical and dental insurance. #J-18808-Ljbffr Santa Barbara Cottage HospitalRemote jobFlexible hoursWeekend workWeekday work
- ...are seeking an experienced Utilization Review Nurse to join our team in a... ...Nassau County (Hybrid: In Office/Remote) Schedule: Monday to Friday... .... Communicate with insurance companies to ensure coverage... ...meetings. Qualifications Active RN license in the state of New...Remote workWork at officeMonday to FridayFlexible hours
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