Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Utilization Management Nurse (RN) - Inpatient Claims

Amerit Consulting

Sacramento, CA
  • 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

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse (RN) - Inpatient Claims in Sacramento, CA vacancy
  • $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 work
    Claims
    Full time
    Work at office
    Work from home
    Night shift

    Broadpath Inc

    United States
    4 days ago
  •  ...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 work
    Claims
    Contract work
    Work at office
    Monday to Friday

    Pacer Group

    California
    4 days ago
  •  ...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 work
    Claims
    Contract work
    Temporary work
    Work at office
    Local area

    Amerit Consulting

    Sacramento, CA
    2 days ago
  •  ...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 work
    Full time

    Well Sense Health Plan

    United States
    5 days ago
  •  ...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 work
    Claims

    3B Healthcare

    Austin, TX
    4 days ago
  • $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 work
    Claims
    Weekly pay
    Work experience placement
    Shift work

    Ascension Seton - Austin

    Austin, TX
    4 days ago
  •  ...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 work
    Claims
    Temporary work
    Monday to Friday
    Flexible hours

    Hines and Associates

    Stillman Valley, IL
    2 days ago
  • $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 job
    Claims

    Pacer Group

    Austin, TX
    3 days ago
  • 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 job
    Claims

    CorVel Corporation

    Folsom, CA
    4 days ago
  •  ...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 Nursing
    Remote job
    Claims

    University of Minnesota School of Nursing

    Minneapolis, MN
    2 days ago
  • 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 job
    Claims

    CorVel Brand

    Folsom, CA
    3 days ago
  •  ...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 work
    Claims
    Work at office

    MedTrust LLC

    Oklahoma City, OK
    6 days ago
  • $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 work
    Claims
    Temporary work
    Part time
    Work at office
    Work from home
    Flexible hours
    Shift work
    Afternoon shift

    Jobgether

    Oregon State
    3 days ago
  • $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-AJ1
    Remote work
    Claims
    Full time
    Local area

    Intercare Holdings Insurance Services, Inc.

    United States
    2 days ago
  • $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-AJ1
    Remote work
    Claims
    Full time
    Local area

    Intercare Holdings Insurance Services, Inc.

    United States
    2 days ago
  • $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 work
    Claims
    Weekly pay
    Work experience placement
    Local area
    Shift work

    American Traveler

    Austin, TX
    3 days ago
  • $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 work
    Claims
    Hourly pay
    Temporary work
    Monday to Friday
    Flexible hours
    Weekend work

    Sagility LLC

    New York, NY
    2 days ago
  •  ...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 work
    Claims
    Full time
    Temporary work
    Work at office

    The CKHobbie Group

    Harrisburg, PA
    3 days ago
  •  ...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 work
    Claims
    Full time
    Contract work
    Monday to Friday
    Shift work
    Weekend work
    1 day per week

    Elevance Health

    United States
    2 days ago
  • $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 work
    Claims
    Full time
    Work at office
    Flexible hours

    Healthcare Management Administrators

    Bellevue, WA
    5 days ago
  •  ...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 work
    Claims
    Full time
    Work experience placement

    Virtual Vocations Inc

    United States
    4 days ago
  • $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 work
    Claims
    Full time
    Work experience placement
    Work at office
    Flexible hours

    Clover Health

    Remote
    2 days ago
  •  ...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 work
    Claims
    Work at office
    Night shift
    Afternoon shift

    BigR.io

    Charlestown, MA
    22 hours ago
  •  ...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 work
    Claims

    KVC Health Systems

    Kansas City, MO
    21 days ago
  • $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 work
    Bi-weekly pay
    Full time
    Temporary work
    For contractors
    Local area
    Work from home

    Guidehealth

    United States
    5 days ago
  • $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 job
    Claims
    Full time
    Contract work
    Work from home
    Flexible hours

    Gainwell Technologies

    Austin, TX
    3 days ago
  •  ...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 job
    Claims
    Work from home

    The CKHobbie Group

    Pittsburgh, PA
    3 days ago
  •  ...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 work
    Claims
    Full time
    Temporary work
    Work at office
    Work from home

    The CKHobbie Group

    Harrisburg, PA
    3 days ago
  • $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 work
    Claims
    Contract work
    Casual work
    Work at office

    AF Group

    United States
    5 days ago
  •  ...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 work
    Claims
    Full time
    Temporary work
    Summer work
    Work at office
    Flexible hours

    Cobalt Benefits Group

    United States
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management Nurse (RN) - Inpatient Claims. Be the first to apply!