Remote Utilization Management Nurse | Case Management Expert
Cambia Health Solutions, Inc.
- Remote job
Cambia Health Solutions, Inc. is seeking an experienced Utilization Management Nurse to support our Clinical Services team. This role focuses on prospective, concurrent, and retrospective reviews to ensure medical necessity and cost-effective care across Oregon, Washington, Idaho, and Utah. The role emphasizes collaboration with interdisciplinary teams, application of evidence-based criteria, and thorough documentation to support transitions of care while protecting member confidentiality. #J-18808-Ljbffr Cambia Health Solutions, Inc.
- ..., a health solutions company, seeks an Utilization Management RN to evaluate medical necessity and service... ...You will authorize care, refer complex cases to medical directors, and may cross-... ...with potential growth into CM roles. Remote work is available in Colorado and other...Remote job
- Jobgether, on behalf of a partner company, is seeking a Case Manager - Utilization Review Specialist for a remote US role. You will oversee admission and concurrent... .... The ideal candidate has 5+ years of clinical nursing and 5-7 years in case management or utilization review...Remote job
- Jobgether is seeking a Case Manager - Utilization Review Specialist to oversee admissions and concurrent... ...appeals. You will work remotely from the United States alongside physicians... ...have five or more years of acute care nursing and five to seven years in case management...Remote job
- ...Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member... ...teams. Ideal candidates hold an RN license with 3+ years in case or utilization management, and can work from home within Oregon...Remote workWork from home
- Jobgether is seeking a Case Manager - Utilization Review Specialist for a remote US-based position. You will oversee admission and concurrent reviews, analyze medical records for medical necessity, and coordinate first-, second-, and third-level appeals with physician advisors...Remote job
- ...Cambia Health is seeking an Utilization Management Nurse to work remotely within Oregon, Washington, Idaho or Utah.... ...and cost-effective care, applying expert clinical judgment and evidence-based... ...hold an RN license with 3+ years in case management or utilization management...Remote work
- ...Cambia Health is seeking an Utilization Management Nurse who can work remotely within the U.S. states of Oregon, Washington, Idaho or Utah. The role focuses... ...effective care. The candidate will bring 3+ years of case/ utilization management experience, an RN license (or...Remote work
- Cambia Health is seeking an Utilization Management Nurse to support prospective, concurrent and retrospective reviews from a home-based role across... ...physicians and care teams. The role requires an RN with 3 years of case management or related UM experience, active RN licensure,...Remote jobWork from home
- ...Cambia Health is hiring an Utilization Management Nurse to support care decisions remotely in OR/WA/ID/UT with opportunities for Idaho or Utah residents. The role... ...requires an active nursing license and 3+ years in case management or utilization management, with strong...Remote work
- ...Cambia Health is seeking an Utilization Management Nurse to support healthcare decisions remotely across Oregon, Washington, Idaho, or Utah. You will review medical... ...(multi-state may be needed), and a background in case management or related fields. #J-18808-LjbffrRemote work
- Cambia Health Solutions, Inc. is hiring a Utilization Management Nurse who will conduct reviews to ensure medical necessity and cost-effective outcomes... ...role requires nursing licensure, at least three years in case management, and the ability to interpret policies. #J-1880...Remote jobWork from home
$37.2 - $50.4 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will... ...Nursing or related field ~3 years of case management, utilization management, disease... ..., and regulatory organizations. #LI-Remote Pay ranges vary based on the...Remote workFull timeWork at officeImmediate startWork from homeFlexible hours$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States WHO WE ARE NeueHealth is a value-driven healthcare company... ...nursing experience, with at least 1 year in utilization review, case management, or a related field. Experience in a managed...Remote workHourly payFull timeContract workWork at officeWork from home- ...Job DescriptionJob DescriptionJob 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...Remote work
- 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...Remote job
- ...Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast... ...closely with participants for referrals to case management and condition management services...Remote workFull timeWork at office
$29.1 - $62.32 per hour
...of a partner company, who manages all applications and next steps... ...partner is looking for a Utilization Management Nurse Consultant based in Canada.... ...Registered Nurse to join a remote Utilization Management team... ...criteria to review cases, assess medical necessity,...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- Cambia Health Solutions, Inc. seeks an Utilization Management Nurse to support member care from home serving Oregon, Washington, Idaho or Utah. The role focuses on prospective, concurrent and retrospective reviews to promote medical necessity and appropriate payment for...Remote job
- Cambia Health is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews from a remote location across OR, WA, ID, or UT. The role emphasizes... ...an RN license with at least 3 years in case or utilization management and can...Remote job
- Cambia Health is seeking an Utilization Management Nurse who can conduct prospective, concurrent, and retrospective reviews to ensure medical necessity... ...as needed. In this role, you will collaborate with case management and other departments, support transitions of care...Remote job
- ...Overview NaphCare is hiring an experienced Utilization Management Registered Nurse just like you to join our Remote based, Arizona team . NaphCare is a family... ...utilization and concurrent review of patient cases Conduct detailed clinical chart assessments...Remote workFull timeShift work
- Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...word processing and spreadsheet programs is essential; UM/Case Management #J-18808-Ljbffr Integrated HomeCare ServicesRemote job
- ...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities. The UM Nurse may also assist with preparing... ...'s home which may be in understaffed/remote areas, in the presence of pets or...Remote workFull timeWork at office
- NeueHealth is hiring a Utilization Management Nurse (LVN/LPN) based in California for a remote, full-time role. The PA Nurse reviews prior authorizations, verifies coverage... ..., with 1 year in utilization review or case management, and an active CA license. #J-18808-...Remote jobFull time
$26.01 - $68.55 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual — shaping... ...and one community at a time. Fully remote with requirement to work the following... ...care, emergency department, or case management Education Associate degree...Remote workHourly payFull timeTemporary workWork at officeMonday to FridayWeekend work$71.1k - $97.8k
...Community and Help Us Put Health First The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...planning, utilization management or case management a plus Health Plan... ...Monday-Friday Travel: While this is a remote position, occasional travel to Humanas...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$82.68k - $96.46k
...Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,... ...Schedule: This is a full-time, remote position working five 8-hour days. We are... ...Medical Director Collaboration: Refer cases that do not meet criteria to the Medical...Remote workFull timeContract workInternshipMonday to Friday- ...Utilization Management Registered Nurse NaphCare is hiring an experienced Utilization Management Registered Nurse just like you to join our Remote based, Arizona team. NaphCare is a family owned, healthcare... ...review of patient cases Conduct detailed clinical...Remote jobFull timeShift work
$38 - $40 per hour
...medical and pharmacy benefit management solutions that run on the... .... Job Summary: The Utilization Management (UM) Nurse will have well-developed knowledge... ...NOTE: This is a Part-Time REMOTE position for 4 Hours on... ...with the registered nurse case managers and other...Remote jobHourly payPart timeWeekend workAfternoon shift$91.25k - $120.91k
...experience! Under the general direction of the Utilization Management Manager, the Utilization Management Nurse is responsible for prospective and concurrent/retrospective... ...equipment, home health, and any high dollar cases Screen medical information provided and...Remote jobTemporary workFlexible hours
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