Remote Utilization Management Nurse (RN) - Inpatient Claims
Amerit Consulting
- Remote job
Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance, auditing DRG classifications and reviewing hospital bills. The ideal candidate holds an active California RN license with at least 5 years of relevant experience, performing concurrent or post-service inpatient reviews, and communicating findings to #J-18808-Ljbffr Amerit Consulting
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management... ...precertification of inpatient hospitalizations and... ...reviews Qualifications RN license in an eNLC (... ...Prior Authorization Remote Registered Nurse (... ...Manager Clinical Claims Nurse (Healthcare Provider...Remote workClaimsFull timeWork at officeWork from homeNight shift- ...Review 3 Location: Remote CA Duration: 6... ...prepayment facility claims for contract compliance... .../never events. The Utilization Management Nurse, Senior will report to... ...a current California RN License Requires... ...experience including inpatient claims or concurrent...Remote workClaimsContract workWork at officeMonday to Friday
- ...Medicare, and Medicaid health plans, seeks an experienced Utilization Management Nurse (RN) for a remote opportunity supporting inpatient utilization review, medical necessity determinations, and facility claims compliance. Duration: 6 Months Contract with Possible Extension...Remote workClaimsContract workTemporary workWork at officeLocal area
- ...Health Plan in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical... ...discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual...Remote workFull time
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services... ..., reimbursement and claim denials/appeals.• Assesses and coordinates... ...Required Skills/Experience: Licensed RN (multistate or TX RN), 2 years acute...Remote workClaims
$1,751 per month
...Offering Nursing Profession RN Specialty Case Manager Job ID 3558... ...Job Title Utilization Management Registered... ...technologies simultaneously. Remote work experience.... ...precertification, reimbursement, and claim denials or appeals....Remote workClaimsWeekly payWork experience placementShift work- ...Description: Nurses - are you looking for... ...in personalized managed health care, focused... ...life balance. * Remote setting ROLE... ...This individual will utilize clinical knowledge... ...treatment or inpatient confinement. This... ...status, benefit and claim concerns, and validation...Remote workClaimsTemporary workMonday to FridayFlexible hours
$42 per hour
...Ascension Texas Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning... ...records/documentation, precertification, reimbursement and claim denials/appeals. Assesses and coordinates discharge...Remote jobClaims- CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization... ...on certification, and collaboration with claims staff and stakeholders. Applicants should be...Remote jobClaims
- ...is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will... ...administrative reviews of inpatient hospital claims, document... ...support member care and cost management. The role offers autonomy... .... #J-18808-Ljbffr University of Minnesota School of NursingRemote jobClaims
- CorVel is seeking a Utilization Review Case Manager to gather demographic and clinical data for in-patient... ...department’s goals. This remote role requires RN licensure and 4+ years of clinical... ...position emphasizes collaboration with claims staff, physicians, and clients,...Remote jobClaims
- ...Description Job Description The utilization review and management (UM) component program... ...and documentation of claims along the process chain.... ...Qualifications ~ Registered nurse with active, unincumbered nursing... ...This is an in-office, no remote work capability position...Remote workClaimsWork at office
$63.1k - $94.65k
...partner company, which manages all applications... ...is looking for a Utilization Review RN based in the... ...this part-time, remote role, you will apply... ...and minimize claim denials. You will... ...for a registered nurse who combines strong... ...clinical reviews of inpatient admissions,...Remote workClaimsTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift$78k - $85k
...specialty risk manager for self-insured... ..., and AS&G Claims Administration,... ...Case Management nurse is aware the claims... ...for performing utilization review based on... ...appropriate inpatient and outpatient... ...good standing RN license in the... ...disability status. #LI-Remote #LI-AJ1Remote workClaimsFull timeLocal area$78k - $85k
...specialty risk manager for self-insured... ...Hills, and AS&G Claims Administration,... ...hybrid role of nurse case management and utilization review. Position... ...all appropriate inpatient and outpatient procedures... ...good standing RN license in the... ...status. #LI-Remote #LI-AJ1Remote workClaimsFull timeLocal area$1,759.5 per week
...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas, United States Position... ...American Traveler is hiring a remote Utilization Management RN requiring 2... ...precertification, reimbursement, and claims denial/appeal issues Assesses and...Remote workClaimsWeekly payWork experience placementLocal areaShift work$35 - $40 per hour
...offerings for clinical, case management, member engagement,... ..., payment integrity, claims cost containment, and analytics. Job Title RN Utilization Management Reviewer... ...Board of Registration in Nursing. 1 to 2 years of... ...weekends. Location: Fully remote work at home role....Remote workClaimsHourly payTemporary workMonday to FridayFlexible hoursWeekend work- ...you a registered nurse ready to take... ...through compliance management. Here, you'll... ...and audit claims, supportprogram... ...Registered Nurse (RN) license Strong... ...Experience in utilization review, case... ...populations Remote work - enjoy the... ...care, inpatient respite, or general...Remote workClaimsFull timeTemporary workWork at office
- ...Utilization Management Representative II Location: The selected candidate for... ...or incoming post services claims work. Determines contract... ...provides authorization for inpatient admission, outpatient precertification... ...clinical review to a nurse reviewer; and handles...Remote workClaimsFull timeContract workMonday to FridayShift workWeekend work1 day per week
$83k - $99k
...Role and Responsibilities The Utilization Management Nurse collaborates with external... ...monitoring of member utilization and claim patterns; and makes... ...professional experience Active LPN/RN clinical license required 1-... ...$600 wellness reimbursement Remote work and continuing...Remote workClaimsFull timeWork at officeFlexible hours- ...timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions... ...Collaborate with physicians, claims examiners, and other... ...preferred Bachelor's degree in nursing (BSN) from an accredited...Remote workClaimsFull timeWork experience placement
$100k - $130k
...who need it most. The Utilization Management (UM) team plays a... ...guidelines. As the Lead RN, Utilization... ...Utilization Management nurses and clinical reviewers... ...Grievances, Care Management, Claims, Provider Relations,... ...Additionally, we embrace a remote-first culture that...Remote workClaimsFull timeWork experience placementWork at officeFlexible hours- ...Inpatient Utilization Management Clinician The Inpatient Utilization Management... ...utilization review nurses and participate in... ...for proper claims adjudication. Identify... ...Active, unrestricted RN license in state of residence... ...independently in a remote environment while...Remote workClaimsWork at officeNight shiftAfternoon shift
- ...Job Description Utilization Review Manager - KVC Missouri Admissions... ...Location: Remote (Statewide -... ...initial and continued inpatient stay... ...Associate degree in Nursing. Licensure:... ...Registered Nurse ( RN license is highly... ...with accounting or claims for billing resolution...Remote workClaims
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote ~ Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare... ...treatment plans Intensity and duration of inpatient or outpatient services Quality of care concerns...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$54.1k - $77.3k
...talented individual for an Inpatient Coding Auditor, Senior... ...conclusions. Utilizes HMS proprietary auditing... ...standards established by management. Actively cross-trains... ...reviews of multiple claim types to provide a flexible... ...Expect In This Role Remote (work from home)...Remote jobClaimsFull timeContract workWork from homeFlexible hours- ...Registered Nurse: Review and Evaluation... ...through compliance management. Here, you'll champion... ...review and audit claims, support program... ...Registered Nurse (RN) license Strong... ...Experience in utilization review, case management... ...vulnerable populations Remote work enjoy the...Remote jobClaimsWork from home
- ...you a registered nurse ready to take your... ...through compliance management. Here, you'll champion... ...review and audit claims, supportprogram... ...Registered Nurse (RN) license Strong... ...Experience in utilization review, case management... ...populations Remote work - enjoy the...Remote workClaimsFull timeTemporary workWork at officeWork from home
$63k - $90.4k
...Nurse Case Manager The Nurse Case Manager (NCM) is responsible for applying... ...workers' compensation claims to assess, evaluate, plan, implement... ...based guidelines. The NCM utilizes clinical knowledge to... ...ongoing treatment as well as inpatient or outpatient hospitalization...Remote workClaimsContract workCasual workWork at office- ...Utilization Review Nurse Join our team at Cobalt Benefits Group... ...physicians, specialists, case managers, and other members of... ...reviews of inpatient cases using Milliman,... ...activities. Review medical claims and pre-... ...Current, unrestricted RN license (State license...Remote workClaimsFull timeTemporary workSummer workWork at officeFlexible hours
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