RN Utilization Review (Remote) - $42/hr.
$42 per hourPacer Group
Austin, TX
- Remote job
Ascension Texas Utilization Management Department (Fully Remote)
Provides health care services regarding admissions, case management, discharge planning and utilization review.
Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.
Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.
Assesses and coordinates discharge planning needs with healthcare team members.
May prepare statistical analysis and utilization review reports as necessary.
Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations.
Within scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment.
Pacer GroupVacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Review (Remote) - $42/hr. in Austin, TX vacancy
$42 - $65 per hour
...Job Description Job Description Utilization Review Nurse Location: Las Vegas, NV Job Type: Full-Time Pay: $42–$65/hr + Sign-On Bonus Job Summary Review patient... ...accredited School of Nursing. ~ Current RN license in the applicable state. ~5+...SuggestedFull timeRelocation packageLancesoft INC
Las Vegas, NVmore than 2 months ago- ...Program sites. Job Summary The Utilization RN is responsible for conducting... ..., and retrospective clinical reviews to determine medical... ...accordance with CMS PACE regulations (42 CFR Part 460) and are... ...Environment Work Conditions Remote role with reliable high-speed...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
- ...a Pre-Authorization Nurse to review prior authorization requests for... ...decision-making abilities. Remote position from LA with a choice... ...Thurs), 8-hour shifts. Active RN license in Louisiana and 2+... ...are required; health plan or utilization management background is a plus...Remote workShift work
IntelliResume
United States2 days ago - ...United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...care management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
Well Sense Health Plan
United States4 days ago $30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart timeSanta Barbara Cottage Hospital
United States7 hours ago- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
NurseRemotely
United States2 days ago - ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning, and recovery for injured employees while advocating for effective medical treatment. Key responsibilities...Remote workFull timeWork experience placement
Virtual Vocations Inc
United States3 days ago - ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...Job Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient medical records to assess the appropriateness... ...experience (hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT - 13 weeks...Remote workTemporary workShift workWeekend work
Trinity Clinics AMN
Fort Myers, FL3 days ago - ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...– 5 pm with one hour for lunch This is an in-office, no remote work capability position Travel ~ Some travel may be...Remote workWork at office
MedTrust LLC
Oklahoma City, OK25 days ago - ...Your future role at a glance Location: Remote Department: Ascension Care Management Insurance - Utilization Review Schedule: Day Shift | PRN until 12/31/26 #LI-Remote How you’ll make an impact in this role Comprehensive Clinical Review: Conduct prospective...Remote workReliefLocal areaDay shift
Ascension
Saint Louis, MO7 hours ago $65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
Jacksonville, FL4 days ago$1,851.96 per month
...Nursing Profession Registered Nurse (RN) Specialty Utilization Review Job ID 38245223 Job Title Registered... ...Must be computer literate and have some experience with remote work. Responsibilities Utilize clinical...Remote workWeekly payContract workLocal areaMonday to FridayShift workWeekend workLee Health-Corporate Center
Fort Myers, FL7 hours ago$2,065 per week
...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements... ...a Utilization Review Extension (UR EXT) specialist for a remote position. This role involves conducting utilization...Remote workTemporary workZero hours contractMonday to FridayShift workWeekend workCross Country Nurses
Fort Myers, FL10 days ago- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a 100% remote, full-time role supporting Alaska contracts. The nurse will assess medical necessity and care quality through prospective, concurrent, and retrospective reviews, applying InterQual criteria...Remote jobFull time
$63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance Utilization Review RN As a nurse at Sedgwick, you can build a meaningful and... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your...Remote workWork experience placementLocal areaFlexible hours$3,389 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Wildomar, California, United States Position ID: P-764191... ...Orientation begins at the Wildomar, CA location, with initial remote patient care before transitioning to onsite work at the...Remote workWeekly payLocal areaShift workAfternoon shift$65 per hour
...RN Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule... ...(72 HOURS / 2 WEEKS) Pay Rate: $65/hr Description: Start date: ASAP Shift: 5x... ...No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work$48 - $55 per hour
...Job Description Job Title: Registered Nurse – Utilization Review (Remote) Location: Fort Myers, FL (Remote) Job... ...Candidates Required: Yes Pay Rate: $48 - $55/hr Position Overview We are seeking an experienced RN to perform utilization review, assess medical...Remote workContract workLocal areaMonday to FridayShift workWeekend workDay shiftCompu-Vision - South
Houston, TX11 days ago$2,627 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Dalton, Georgia, United States Position ID: P-764760 Assignment... ...travel experience required Candidates who have been remote for the past 6 months must have recent experience with...Remote workWeekly payPermanent employmentShift workWeekend workDay shift$2,147 per week
...Travel RN - Case Management/Utilization Review American Traveler Somerville, Massachusetts, United States Position ID: P-762577 Position status... ...pay) Description American Traveler is hiring a remote RN for Utilization Management requiring an active MA RN...Remote workWeekly payLocal areaMonday to FridayShift work$2,167.25 per week
...Travel RN - Case Management/Utilization Review American Traveler Fort Myers, Florida, United States Position ID: P-762130 Position status:... ...is hiring a Registered Nurse - Utilization Review for a remote position requiring provider-side UR experience and CCM/...Remote workWeekly payPermanent employmentWork experience placementMonday to FridayShift workWeekend work$26.41 - $51.49 per hour
...a complact license. The Care Review Clinician will provide prior authorization... ...or previous experience with Utilization Reviews. WORK SCHEDULE:... ...work schedule. This is a remote position. Home office with internet... ...experience. Registered Nurse (RN). License must be active and...Remote workHourly payWork experience placementWork at officeHome officeMonday to Friday- ...specific to the LTSS department. RN will be responsible for... ...authorization and concurrent review. Provides monthly telephonic outreach... ...of treatment setting by utilizing the applicable medical policy... ...standards. Additional Info: *possible remote opportunity after training if...Remote workContract workMonday to FridayFlexible hours
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type:Full Time The individual in this position is responsible to... ...) Job Schedule Full time Job Shift Day Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
$63.1k - $94.65k
...qualifications. Must have current compact RN license, or be willing to obtain* NICU... ...encouraged to apply. Schedule Information: Our Utilization Review team provides coverage seven days a week... ..., and Abilities Required: This is a remote role which requires access to high speed...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work- Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care... ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...Telecommuting Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
United States2 days ago - ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
The Judge Group
United States2 days ago - ...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely discharges, and refer members to appropriate resources while working remotely. Key responsibilities Assist in building and implementing...Remote workFull time
Virtual Vocations Inc
United States3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Review (Remote) - $42/hr.. Be the first to apply!
