Remote Medical Management Nurse - Complex Case Review
The Elevance Health Companies, Inc.
- Remote job
Elevance Health is seeking a Medical Management Nurse to review complex cases, apply clinical guidelines, and determine medical necessity. You will collaborate with healthcare providers, consult the Medical Director on challenging cases, and serve as a resource for clinicians.The role emphasizes driving quality outcomes, supporting case management, and contributing to program improvements while working in a remote, second-shift environment consistent with Elevance Health's hybrid policies.J-18808-Ljbffr The Elevance Health Companies, Inc.
$26.01 - $56.14 per hour
...EST Location: 100% Remote (U.S. only) About... ...a URAC-accredited medical management organization founded... ...patients facing complex medical journeys.... ...Utilization Management (UM) Nurse Consultant specializing in Medical Review, you’ll play a... ...medical review cases. Applies the...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$60.3k - $133.4k
...functions of Utilization Management (UM), Case Management (CM)... ...care. The Primary Nurse Coordinator performs concurrent review, discharge... ...Experience in managing complex or catastrophic... ...guidelines Knowledge of medical management... ...is a Telecommute (Remote) role: Must reside...Remote workTemporary workWork at officeLocal areaImmediate start$26.01 - $56.14 per hour
...EST Location: 100% Remote (U.American Health... ...a URAC-accredited medical management organization... ...of patients facing complex medical journeys.... ...Utilization Management (UM) Nurse Consultant specializing in Medical Review, you’ll play a... ...medical review cases. Applies the appropriate...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$29 - $52 per hour
...is seeking an RN Case Manager to join our team anywhere... ...operations and medical management... ...requiring a Registered Nurse (RN) qualification... ...flexibility to work remotely * from anywhere... ...case management, complex and disease case management... ...in utilization review, concurrent review...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$65k - $78k
...It takes great medical minds to create powerful... ...healthcare's most complex challenges. Join... ...Our Mission Review admissions,... ...referring complex cases to Medical Directors... ...rationale in medical management systems. Assist in training new nurses, provide feedback,...Remote workFull timeWork at officeWork from homeFlexible hours- ...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely... ...resources while working remotely. Key responsibilities Assist... ...members through coaching and case management interventions Educate...Remote workFull time
- Greenlife Healthcare Staffing is seeking a Medical Case Reviewer (PhD/Advanced Clinician) to apply advanced scientific training to review complex vaccine injury cases and support federal compensation decisions.This remote, contract-based role offers flexible case-based...Remote jobContract workFlexible hours
- ...Location: Phoenix, AZ Job type: Remote - Direct Hire Position... ...Psychiatrists, to serve as clinical reviewers for the ECR process.... ...essential role in evaluating complex cases involving members ages 0-18... ...assessments and available supporting medical and clinical records....Remote job
- ...Concurrent Review Registered Nurse (RN) Location: Fully remote. Candidates must be able... ...join its Utilization Management team. In this role... ...authorizations, medical necessity reviews,... ...utilization management, or case management.... .... Escalate complex medical necessity...Remote workWork at officeImmediate start
$41.2 - $62.17 per hour
...Home Health RN Case Manager The RN Home Services... ...as the primary nurse from admission through... ...navigate complex healthcare systems... ...management, utilization review, and/or discharge... ...needed information, medication preparation, etc.... ...If applying for a remote or hybrid role, this...Remote workHourly payWork from home$150 per hour
...US physicians: review de-identified health records and... ...reasoning tasks in a remote project. See qualifications... ...Reviewer – EHR Cases United States Open · Accepting... ...this project Use your medical expertise to review... ...and carefully evaluate complex medical information. To...Remote workHourly payPart time- Clinical Review Nurse - Concurrent Review TX All On-site... ...Description Location: 100% Remote - TX: RN only with TX... ...in by facilities for medical necessity. The nurse... ...deadlines. Will be reviewing cases for medical necessity... ...records in health management systems according to...Remote jobContract workWork from homeShift work
$54.1k - $155.54k
...Summary This is a remote work from home... ..., Inc (AHH) is a medical management company that is a... ...URAC accredited in Case Management, Disease... ...and address complex health and social... ...medical necessity reviews. Required Qualifications... ...as a Registered Nurse with at least 1...Remote workHourly payFull timeLocal areaWork from homeFlexible hours$1,759.5 per week
...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas,... ...Management RN for a fully remote role requiring TX or compact... ...concurrent, and retrospective medical necessity and... ...management and consultation for complex cases Assists staff with...Remote workWeekly payLocal areaShift work$80k - $100k
...Clinical Reviewer – Registered Nurse (RN) Comagine Health |... ...Washington State | Remote / Work From Home... ...: Care Management Contract: Washington... ...~ Comprehensive medical, dental, and... ...spine surgery and complex imaging. Evaluate... ...when cases do not meet established...Remote workFull timeContract workLocal areaWork from homeHome office$3,268 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler... ...a hybrid role supporting complex case management across inpatient... ...2 days onsite and 3 days remote per week Day shift... ...needs assessments and durable medical equipment orders Must...Remote workWeekly payContract workLocal areaShift workDay shift3 days per week$78k - $85k
...specialty risk manager for self-insured... ...: The case manager ensures... ...achievement of maximum medical and disability... ...Management nurse is aware the claims... ...utilization review based on... ...prepare questions on complex cases for peer... ...disability status. #LI-Remote #LI-AJ1Remote workFull timeLocal area- ...HealthPartners is hiring an RN Case Manager. This position... ...in addressing medical and social... ...This is a primarily remote position that includes... ...active Minnesota nursing licensure. May... ...85 members with complex needs. Interacts... ...relevant utilization review, discharge...Remote workLocal area
$2,784 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler... ...or Associate's Degree in Nursing required; BSN or MSN preferred... ...be prepared to take a medication calculation math test for... ...Hospital housing provided in a remote area with shared common...Remote workWeekly payWork experience placementShift workDay shift$35 per hour
...learn more. Base pay range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift Position Description The role... .... Knowledge: • Medical nursing practice, medical case management protocols, quality management and utilization...Remote workHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shift$60.52k - $129.62k
...This is a full-time, remote, telehealth role.... ...have multiple medical, behavioral, and social... ...and costs. As Case Manager RN, you will be... ...information/data review to conduct an evaluation... ...and address complex health and social... ...Qualifications ~ Registered Nurse that must reside...Remote workHourly payFull timeTemporary workLive inLocal areaWork from homeMonday to Friday2 days per week1 day per week$50 - $52 per hour
...Nurse Case Manager Location: New York, NY Schedule/Shift... ...days onsite and 2 days remote Pay: $50.00 - $52.0... ...volume of employee medical absence and leave cases... ...Nurse Case Manager also reviews medical documentation,... ...independently to complex cases. ~ Experience...Remote workContract workTemporary workFor contractorsWork experience placementShift workNight shift2 days per week$77.96k - $120.37k
...The Case Management Supervisor is responsible for... ...management. This is a remote position... ...weekly, monthly reviews of various reports... ...manager is an RN for medical case management activities... ...to communicate complex ideas across... ...school of nursing with a diploma/associate...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift$65k - $85k
...Licensed Vocational Nurse (LVN) - Utilization Management & Inpatient Case Management is... ...of high-quality, medically appropriate, cost-... ...management, concurrent review, inpatient case... ...independently in a fully remote environment.... ...case discussions and complex case reviews as...Remote workWork at office- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is seeking Medical Case Reviewers to support... ...consensus discussions. Ensure compliance with records management, HIPAA, and confidentiality standards. If required,...Remote workHourly payContract work
$58.66k - $142.45k
...Complex Care Case Manager The Complex Care Case Manager supports case managers... ...reports to Case Management Nursing Director, with primary... ...years required Utilization review 5-7 years preferred Knowledge... ...): Shift: 40hr day Remote Type: Hybrid Work...Remote workShift work$105k - $115k
...Workers' Compensation Nurse Case Manager Hybrid (Long Island City, NY) or Fully Remote (for candidates living... ...Early intervention for medical case management on... ...to URAC (Utilization Review Accreditation Commission... ...reviews and roundtables on complex and catastrophic cases...Remote workWork at officeRelocation packageFlexible hours- ...Inc. seeks an experienced Utilization Review RN to perform prospective, concurrent and... ...and outpatient services, ensuring medical necessity and appropriate levels of care... ...years of clinical experience and may have Case Management certification in progress or preferred....Remote work
$26.01 - $56.14 per hour
...community at a time. Utilization Management Nurse Consultant (RN) - Concurrent Review Remote | Acute Inpatient Utilization... ...continued hospital stays Evaluate medical necessity, severity of illness,... ...with Medical Directors on complex cases and escalations Facilitate discharge...Remote workHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home- Description The Clinical Nurse Reviewer plays a crucial... ...by evaluating medical records, treatment... ...decisions in patient management systems. Stay... ...experience, ideally in case management,... ...Ability to interpret complex medical data and translate... .... This is a remote position. While...Remote workWork at office
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