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

Remote Utilization Management RN - Post-Acute Care

Humana

Humana is seeking a Utilization Management Registered Nurse who uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations. This remote role focuses on post-acute care services including SNF, Home Health and DME, reporting to the Manager of Utilization Management.You will review requests using established criteria, complete determinations within processing timeframes, and communicate with providers andJ-18808-Ljbffr

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN - Post-Acute Care in Sioux Falls, SD vacancy
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation...  ...Home/Home Solutions team, focusing on post-acute care including SNF, Home Health and DME.The role requires an active RN license in your state, 1+ year of... 
    Remote work

    Humana

    Montgomery, AL
    5 days ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation...  ...using information from physicians and care providers, and communicate with...  ...care. The role emphasizes remote work, prior utilization management experience... 
    Remote work

    Humana

    United States
    3 days ago
  •  ...Dahl Consulting is seeking an experienced Utilization Management Nurse for a 6-month contract to support post-acute care reviews. This remote role requires a Minnesota or Wisconsin home address and RN licensure with at least 3 years of clinical nursing experience.... 
    Remote work
    Contract work

    Dahl Consulting

    United States
    5 hours ago
  •  ...Inc. is seeking a Registered Nurse with utilization management experience to review ED admissions and...  .... Ideal candidates have 3+ years in acute care nursing and 2+ years in utilization management...  ...proficiency in EMR and MS Office. Remote work arrangements are supported where... 
    Remote job

    Netsmart Technologies, Inc.

    New York, NY
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination...  ...and benefit determinations for post-acute care services (SNF, Home Health, DME)....  ...Home/Home Solutions team. This remote role requires compact RN license in your state, hospital/... 
    Remote work
    Work from home

    Humana

    Helena, MT
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination...  ...Management team, handling post-acute care services including SNF, Home Health...  ...care in the right setting. This remote role requires US RN licensure in the state of residence... 
    Remote work
    Work from home

    Humana

    United States
    5 days ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical...  .../Home Solutions Utilization Management team to manage post-acute care services such as SNF, Home Health and DME. You will... 
    Remote work
    Work from home

    Humana

    Jackson, MS
    1 day ago
  •  ...Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and...  ...candidates will have an active RN license, 2+ years in acute or critical care, and an Associate Degree in... 
    Remote work
    Work from home
    Weekend work
    Afternoon shift

    Native American Talent

    Arizona
    1 day ago
  •  ...Logan Health is seeking a Utilization Management Specialist to join our team in a fully remote role focused on inpatient admissions reviews, physician documentation...  ...medical necessity. Ideal candidates bring acute care hospital experience, familiarity with Medicare/... 
    Remote work

    Logan Health

    United States
    3 days ago
  •  ...Humana is seeking a dedicated Utilization Management Registered Nurse to interpret and support medical services, benefit determinations, and coordination for post-acute care services. You will report to the Manager of Utilization Management and contribute to the One Home... 
    Remote work

    Humana

    Madison, WI
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination of medical services and benefit determinations. You will work with a team handling post-acute care services including SNF, home health, and DME, reporting to the Manager... 
    Remote work

    Humana

    Kansas City, MO
    5 days ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care (SNF, Home Health, DME). The role reports to the Manager of Utilization Management and is part of the One Home/Home Solutions... 
    Remote work

    Humana

    El Paso, TX
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical...  ...benefit determinations. The role supports post-acute care—SNF, home health, and DME—while...  ...prior nursing experience in a fully remote, metrics-driven environment. A BSN or... 
    Remote work

    Humana

    Maryland
    5 days ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care including SNF, Home Health, and DME. You will work remotely, applying Milliman Care Guidelines or InterQual criteria... 
    Remote work

    Humana

    Santa Fe, NM
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical...  .../Home Solutions Utilization Management team, focusing on post-acute care such as SNF, Home Health and DME.You will use clinical... 
    Remote work

    Humana

    Maryland
    5 days ago
  •  ...Sentara Health Plans is seeking an RN Clinician for a remote role focused on utilization management and claim review. The position requires...  ...and a BSN, with at least 3 years of acute care experience, including utilization review or post-payment review. CPC certification... 
    Remote work

    Sentara Health

    United States
    3 days ago
  •  ...Health is hiring a Registered Nurse (RN) for Utilization Management to assess and coordinate care, ensuring appropriate utilization...  ...an active RN license, 2+ years acute/critical care, and flexibility for a 24/7 operation. This remote, full-time position offers a comprehensive... 
    Remote work
    Full time

    African American Talent

    United States
    2 days ago
  •  ...Health Medical Center is seeking a Utilization Management Specialist to review admissions...  ...appropriate status. This role suits an RN or Social Worker with acute care experience, capable of...  ...insurers. The position is fully remote for Montana residents and offers a... 
    Remote work

    Logan Health Medical Center

    United States
    2 days ago
  •  ...NaphCare is hiring an experienced Utilization Management Registered Nurse for a Remote role based with an Arizona team. The RN will oversee quality assurance, utilization review...  ...with a BSN or ADN, have 3+ years in acute care and 2 years in utilization review, and possess... 
    Remote work

    NaphCare

    United States
    2 days ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical...  .../Home Solutions Utilization Management team, focused on post-acute care including SNF, Home Health and DME. You will use... 
    Remote work

    Humana

    United States
    3 days ago
  •  ...United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity...  ...an active RN license, 2+ years acute clinical experience, and 1+ year...  ...Health/utilization management; remote work across time zones as #J-... 
    Remote work

    Wellframe

    United States
    2 days ago
  •  ...Health Corporation is seeking an Utilization Management Nurse Consultant for Medicare Home Care in a remote, full‑time role serving Florida members. The RN will review cases, determine coverage...  ...home care after hospital or post‑acute events. The role requires an active... 
    Remote work
    Full time

    CVS Health

    Tallahassee, FL
    4 days ago
  •  ...CVS Health is hiring a Utilization Management Nurse Consultant for a remote EST role. The position requires an RN with 2+ years of adult acute/critical care experience and an active license. Work schedule includes evenings and weekends with a 40-hour week and comprehensive... 
    Remote work
    Afternoon shift

    CVS Health

    New York, NY
    2 days ago
  •  ...seeking an experienced Registered Nurse (RN) for Utilization Management. This full-time, remote role supports a 24/7 team, reviews cases, and coordinates care to improve outcomes within your...  ...license, ADN, and 2+ years in adult acute/critical care, plus strong communication... 
    Remote work
    Full time

    CVS Health

    United States
    2 days ago
  •  ...Working remotely on a call-in basis, the Colorado Licensed Utilization RN Case Manager will coordinate patient admissions and discharges,...  ...medical necessity for various care levels, and collaborate with multidisciplinary...  ...experience as an RN in an acute care setting Graduate of a... 
    Remote work

    Virtual Vocations Inc

    United States
    4 days ago
  •  ...Humana is seeking an Utilization Management RN - Physical Health to support coordination...  .... This full-time role is remote with periodic travel to...  ...years of clinical experience in acute, skilled, or rehab settings...  ...apply nursing expertise to care coordination and benefit processes... 
    Remote work
    Full time
    Work at office

    Humana

    United States
    2 days ago
  •  ...Humana’s Utilization Management team is hiring a Registered Nurse to interpret and support coordination...  ...and benefit determinations for post-acute care (SNF, Home Health, DME). You will report...  ...Home/Home Solutions UM team. In this remote role, you will use established... 
    Remote work

    Humana

    Topeka, KS
    1 day ago
  •  ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care settings, including SNF, home health, and DME...  ...Home/Home Solutions UM team.The RN applies clinical skills and established... 
    Remote work

    Humana

    Virginia Beach, VA
    5 days ago
  •  ...Humana Inc. is seeking a Utilization Management Registered Nurse to interpret...  ...Management.The role supports post-acute care services including SNF,...  ...in the right setting. The RN uses established criteria to...  ...and members, and works in a remote, metrics-driven environment... 
    Remote work

    Humana

    Atlanta, GA
    2 days ago
  •  ...Sentara Health is seeking a Remote Utilization Review Registered Nurse based in Virginia. The role focuses...  ...information. The ideal candidate has a Virginia RN license, 3+ years of acute care nursing, and 3 years in case management, with strong verbal and written... 
    Remote work

    Sentara Health

    United States
    5 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management RN - Post-Acute Care. Be the first to apply!