Remote Utilization Management RN
Humana Inc
Augusta, ME
- Remote job
Humana Inc. is seeking a qualified Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations. You will report to the Manager of Utilization Management and contribute to post-acute care coordination across SNF, Home Health, and DME settings. You will apply established medical criteria to make determinations, communicate with providers and members, and help ensure patients receive appropriate care in the right setting. #J-18808-Ljbffr Humana Inc
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN in Augusta, ME vacancy
- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: Full-Time Position Overview We are seeking an experienced Utilization...Remote workFull timeMonday to Friday
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and coordinate medical services... ...for post-acute care. You will work remotely, reporting to the Manager of Utilization... .... Requirements include an active RN license in your state and 1+ year of clinical...Remote work
$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...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN performs telephonic review of hospital admissions and recommends alternative levels of care when appropriate. This role...Remote workPart timeMonday to Friday
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
- ...Humana Inc. is hiring a Utilization Management Registered Nurse for remote work. You will apply clinical nursing expertise to interpret, coordinate, document, and communicate medical services and benefit determinations for post-acute care settings. You will make criteria...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
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant (RN) to remotely review authorizations and assess medical necessity across multiple specialties. You will collaborate with care teams to ensure compliant, evidence-based reviews and timely decisions...Remote work
- ...CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate...Remote work
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document... ..., and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings...Remote work
- ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/...Remote workContract workTemporary workMonday to FridayShift work
$47.03 - $63.48 per hour
...provider of technology-enabled revenue cycle management solutions for health systems,... ...the possible in healthcare. The RN, Senior Utilization Review Quality will play an essential... ...patient and client experiences This is a remote position; however, candidates must be...Remote workTemporary workWork at officeLocal area$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 workPart timeWork at officeLocal areaFlexible hoursShift work$47.37 per hour
Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care,... ...regulations. The role requires an active RN/LPN/LVN license and 2-4 years of clinical experience...Remote jobHourly pay- Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho or Utah, conducting prospective, concurrent and retrospective reviews to ensure medical necessity...Remote job
- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
- HealthEdge in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity... ..., and 1+ year in Behavioral Health/utilization management; remote work across time zones as #J-18808-Ljbffr WellframeRemote job
- CVS Health Corporation is seeking an experienced Utilization Management Nurse Consultant (RN) for remote work. You will review prior authorization requests, evaluate medical necessity, and apply clinical criteria to support timely, cost-effective care. Collaboration with...Remote job
- Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote job
- Hanker Systems Inc. is seeking a skilled Registered Nurse for Utilization Management/Utilization Review in a 100% remote role. California licensure is required, with 3+ years in acute hospital care management and recent utilization review experience. Epic proficiency and...Remote job
- 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 jobContract work
- Elevance Health is seeking a Wound Care Utilization Management RN to perform pre-certification and authorization for Home Health Services for members... ...plans of care for continuity of care. This largely remote role requires in-person training sessions; shifts are Monday...Remote jobMonday to FridayShift work
- Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will coordinate with providers and members...Remote job
$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 jobWeekend work- ...is seeking an experienced Registered Nurse to join our Utilization Management team in a fully remote precertification role. Preference is given to Virginia residents or candidates holding Virginia and Compact RN licenses. The position involves reviewing clinical information...Remote job
- ...Behavioral Health Utilization Manager Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned patients... ..., MS Excel, Outlook, and telephone systems Work Schedule: Remote Other Requirements: Able to work independently under general...Remote workContract workWork experience placement
- Guidehealth, a fully remote healthcare company, is seeking a Utilization Management Registered Nurse to perform reviews, apply medical necessity criteria, and document findings in support of determinations. You will collaborate with the Medical Director and peers to ensure...Remote job
- Ensemble Health Partners is seeking a Virtual Utilization Review Specialist to join our remote team. You will perform medical necessity reviews, manage denials, and coordinate with FCC and... .... Qualified candidates hold a current RN license, have at least 1 year in denials...Remote job
- 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 jobFlexible hoursWeekend workDay shift
$71.1k - $97.8k
...a part of our caring community The Utilization Management Registered Nurse uses clinical nursing... ...Must hold Compact Registered Nurse (RN) license in your state of residence... ...Interqual. Experience working in a fully remote, metrics-focused role Experience as...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN. Be the first to apply!
Related searches
- public health registered nurse Augusta, ME
- temporary rn Augusta, ME
- part time rn Augusta, ME
- travel registered nurse l&d Augusta, ME
- nicu registered nurse Augusta, ME
- rn urgent care Augusta, ME
- rn skilled nursing facility Augusta, ME
- womens health rn Augusta, ME
- holistic rn Augusta, ME
- travel clinic rn Augusta, ME



