Remote Utilization Management RN - InterQual Expert
The Judge Group Inc
A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating with providers, and managing discharge planning. Candidates must have an active PA RN license and a minimum of three years in Medical/Surgical experience, along with proficiency in Microsoft's applications and InterQual criteria. #J-18808-Ljbffr
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information... ...of Medical/Surgical experience and proficiency with InterQual criteria. This position offers a day shift workload with...Remote workFlexible hoursWeekend workDay shift
- ...and program integrity through compliance management. Here, you'll champion the needs of... ...:Active, unrestricted Registered Nurse (RN) licenseStrong clinical background with... ...electronic medical recordsExperience in utilization review, case management, quality improvement...Remote workWork from home
- ...integrity through compliance management. Here, you'll champion the needs... ...Registered Nurse (RN) license Strong clinical background... ...records Experience in utilization review, case management, quality... ...for vulnerable populations Remote work - enjoy the convenience...Remote workFull timeTemporary workWork at office
- ...integrity through compliance management. Here, you'll champion the needs... ...Registered Nurse (RN) license Strong clinical background... ...records Experience in utilization review, case management, quality... ...for vulnerable populations Remote work enjoy the convenience...Remote jobFull timeTemporary workWork at officeWork from home
- ...Are Currently Seeking An Experienced UTILIZATION MANAGEMENT RN Job Summary Day-to-day management of... ...experience required Experience with InterQual or MCG authorization criteria preferred... ...Clearly communicates instructions to remote users. Background checks/drug-free workplace...Remote workWork at office
$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one... ...Care Guidelines (MCG) or InterQual Criteria Strong... ...community knowledge in a new way. Experts add insights directly into...Remote workDaily paidContract workMonday to FridayShift workWeekend work$100k
...years Salary $100,000 Remote Job Job Description This... ...is a remote position. The Utilization Management (UM) Nurse is responsible for... ...criteria such as MCG and InterQual. Requirements Candidates must... ...unrestricted Registered Nurse (RN) license in the applicable...Remote workContract workWork experience placement- ...RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide... ...Registered Nurse (UMRN) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients,...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...a Friend Back Remote Work from Home Share... ...Plans (JHHP) is the managed care and health services... ...AM - 5:00 PM As a Utilization Review Registered Nurse... ...various criteria sets (i.e. InterQual) Ability to... ...Unencumbered Registered Nurse (RN) license in Maryland (...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through... ...record reviews. The position is remote, requiring candidates to reside in PA... ...with proficiency in Microsoft's applications and InterQual criteria. #J-18808-LjbffrRemote work
- ...seeking a Physician Reviewer to provide remote support for a healthcare organization.... ...necessity determinations and applying InterQual criteria. Candidates should have an MD... ...with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical... ...independent decisions aligned with organizational strategy. Remote-friendly, standard hours, with occasional travel. #J-18808-...Remote work
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Hospital Utilization Management (UM) NurseHow would you like to work in a place... ...administrative compliance. Unlike remote roles, this position relies... ...is a Registered Nurse (RN) responsible for performing... ...Reviews: Use criteria like InterQual or MCG to perform on-site concurrent...Remote workImmediate startShift work
- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
- ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
- ...Utilization Management Clinical ReviewerMass General Brigham Health Plan is an... ...management reviews utilizing Interqual®, company policies and procedures... ...Registered Nurse (RN) license requiredExperienceAt... ...months after hire.This is a remote role with occasional onsite...Remote workWork at officeFlexible hours
- ...Health Plan is seeking an Inpatient Utilization Management Clinician for a fully remote role in the United States. You... ...outcomes. Qualifications include an active RN license, nursing degree, and 2 years of utilization review experience with InterQual. #J-18808-Ljbffr...Remote work
- ...Seeking a full-time remote Utilization Management RN, the successful candidate will manage medical record reviews and denial documentation, develop clinical appeal letters, and utilize clinical judgment to support healthcare provider clients. Key Responsibilities Perform...Remote workFull time
- ...NeueHealth seeks a full-time Utilization Management (UM) Prior Authorization (PA) Nurse in California. You will review and authorize prior authorizations... ...and cost-effective outcomes. Requirements include California RN license, 2–3 years of clinical nursing with at least 1 year...Remote workFull timeContract work
$1,751.31 per month
...Nursing Profession RN Specialty Case Manager Job ID 35561619 Job Title Utilization Management Registered... ...: - Proficiency with InterQual/MCG and CMS regulations.... ...technologies simultaneously. - Remote work experience preferred...Remote workWeekly payWork experience placementShift work$71.1k - $97.8k
...part of our caring community The Utilization Management Registered Nurse uses clinical... ...hold Compact Registered Nurse (RN) license in your state of residence... ...as Milliman Care Guidelines or Interqual. Experience working in a fully remote, metrics-focused role Experience...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$39.83 - $59.74 per hour
...assumptions, and acts of implicit bias. About this position The Utilization Management RN, under the supervision of the Utilization Management... ...Hourspertwoweekpayperiod: 80 Shift: Days 8 hours Call Requirement: None Remote or On-site:Hybrid Remote- Must live in MN or WI FLSA Status...Remote workFull timeContract workFor contractorsFor subcontractorLive inWork at officeShift work- ...Detroit, Michigan Registered Nurse (RN) Contract We are seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan. Job Description: Perform prospective, concurrent and retrospective review of inpatient, outpatient...Remote workContract workLocal areaFlexible hours
$63.1k - $94.65k
...provider of technology-enabled revenue cycle management solutions for health systems, including... .... *Must have current compact RN license, or be willing to obtain* NICU... ...apply. Schedule Information: Our Utilization Review team provides coverage seven days...Remote workWork at officeFlexible hoursShift work- ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse... ...regulatory requirements while working remotely. Key responsibilities: Conduct medical... ...experience is required Experience with Interqual and MCG is preferred Previous...Remote workFull time
$63.1k - $94.65k
...technology-enabled revenue cycle management solutions for health systems,... ...*Must have current compact RN license, or be willing to... ...Schedule Information: Our Utilization Review team provides coverage... ...Abilities Required: This is a remote role which requires access to...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work
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