Remote Utilization Management RN - Appeals & Case Review
UnitedHealth Group
- Remote job
UnitedHealth Group seeks a Utilization Management Nurse to review medical records, extract data, and craft defensible appeal letters per policy. Per diem schedule with flexible start times, remote work across the U.S. emphasizes HIPAA and adherence to company policies. Role requires an Associate's degree, an active RN license, 3+ years in ED/telemetry/ICU/CCU, and strong MS Office skills, plus typing 45 wpm. Perks include a comprehensive benefits package and telecommuter policy adherence. #J-18808-Ljbffr UnitedHealth Group
- ...Remote Full Time Days And Every Other Weekend RN Case Manager -Utilization ReviewJoin our team as a remote full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK.Get to Know Your Team:INTEGRIS Health, Oklahoma's...Remote workFull timeWork at officeShift workWeekend work
- ...Case Manager, RN- Utilization Review A Brief Overview The Utilization Review Case Manager validates the patient's placement to be at the most appropriate... ...Campus 1 Tampa General Circle Tampa 33601 Eligible for Remote Work: Fully Remote Job: Case Management...Remote workFull timeWork at officeMonday to FridayShift work
- ...Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides... ...regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews... ...reimbursement and claim denials/appeals.• Assesses and...Remote work
- ...PRN Utilization Management RN Reviewer NEJoin Cleveland Clinic Weston Hospital's team... ...reporting, concurrent denials appeals process, clinical team... ...weekend requirements.This remote role is limited to Florida... ...that the UR process for the case was followed.Attend all staff...Remote workFull timeReliefWeekend work
- ...for implementing the utilization management process for patients admitted... ...and concurrent review functions utilizing medical... ...and management, appeals, special studies, projects... ...1 year of previous Case Management, Utilization... ...prevention/management. Current RN License. Computer...Remote jobWork at officeMonday to Friday
- ...UCI Health Utilization Management Position UCI Health is one of... ...admission and concurrent review functions utilizing... ...prevention and management, appeals, special studies,... ...and 1 year of previous Case Management experience... ...skills in English Current RN License Computer...Remote jobDaily paidWork at office
- ...Description Job Description The utilization review and management (UM) component program ensures that external... ...: Work closely with medical staff, case managers, and other healthcare... ...for lunch This is an in-office, no remote work capability position Travel...Remote workWork at office
$32 - $48 per hour
...better health. Position Overview The Utilization Review Specialist RN assumes responsibility and... ...payers, as well as coordination and management of appeals for accounts deemed appropriate for... ...Utilization Review Specialist RN Department: Case management Location: Gateway...Hourly payFull time$32 - $48 per hour
...Utilization Review Specialist RN Full-Time | Case Management | Gateway Regional Medical Center | Granite City, Illinois Gateway Regional Medical Center is... ...review and documentation Managing and coordinating appeals for denied or at-risk accounts Collaborating...Full timeWeekend workWeekday work$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$15k
...Case Manager / Utilization Review Nurse (RN) Working at Cibola General Hospital makes a big difference in our community! Cibola General Hospital Rooted... .... Assist with preparation and submission of denial appeals, including supporting clinical rationale and...Hourly payFull timeTemporary workRelocation package$50 - $85 per hour
...Case Manager Utilization Review RN Under the general direction of the Director of Behavioral Health, the Case Manager Utilization Review RN provides... ...admission status determination Denial prevention and appeal success Timely discharge planning Reduction in...Full timeTemporary workPart time- Description The Case Manager / Utilization Review Nurse (RN) is responsible for coordinating patient care progression, discharge planning, and utilization... .... Assist with preparation and submission of denial appeals, including supporting clinical rationale and documentation...Work at office
$65.8k - $130.8k
Onsite or Remote Flexible Hybrid Work Schedule... ...UM Denial Nurse Reviewer supports high-quality... ...guidance on denial cases, and ensures... ...Two or more years of utilization review/utilization management experience in an HMO... ...Knowledge of the appeals process Experience...Remote workMonday to FridayFlexible hours- ...TitleRegistered Nurse (RN) for Critical Incident Management... ...responsible for reviewing and evaluating critical... ...participate in hearings, appeals, and stakeholder... ...beyond individual cases and contribute to... ...while utilizing technology to support remote and hybrid work functions...Remote workWork from home
$77.91k - $116.86k
...saving them. Together.The Remote Auditor, Delegate UM/CM plays... ...program by conducting Utilization Management (UM) and Case Management (CM) audits to ensure... ..., Audit Administration for review and resolution. Through... ...(LVN) or Registered Nurse (RN). Other: • Required: None...Remote workFull timeWork at office$2,150 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Lafayette, Indiana. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 10/12/2026 ~ Duration: 1...Temporary workFor contractorsZero hours contractLocal areaImmediate startShift work- ...and monitoring the utilization of behavioral health... ...Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member... ...degree and active NYS RN license required.... ...be opportunity for remote work within all jobs...Remote workContract workWork at office
- ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective... ...inpatient and continued stay reviews, and presenting complex cases for Medical Director review, while staying compliant...Remote work
- ...States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient... ...planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and... ...management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
- ...contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with... ...policies. The position allows for remote work, preferably from Iowa, with possible... ...include preparing case reviews, generating appeal communications...Remote workContract work
$39.64 - $61.45 per hour
...a Friend Back Remote Work from Home Share... ...Plans(JHHP) is the managed care and health... ...AM - 5:00 PM As a Utilization Review Registered Nurse for Johns... ...Unencumbered Registered Nurse (RN) license in Maryland (... ...responsibility. In cases where the range is...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift- ...Centene Management Company LLC is hiring for a remote RN/LPN utilization reviewer. You will evaluate patient care, determine appropriate level of care, and contribute to discharge planning while coordinating with Medical Affairs. Role requires 2+ years acute care and UM...Remote workMonday to Friday
- ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization... ...requirements while working remotely. Key responsibilities: Conduct... ...Previous Utilization Management, Appeals, or Denials Management...Remote workFull time
$1,600 - $1,800 per week
...HIRING: Registered Nurse - Utilization Management Location: Buckley AFB &... ...no holidays, no telehealth/remote work Minimum Qualifications... ..., active, and unrestricted RN license ~... ...Utilization Management, Utilization Review, or Case Management ~• Preferred...Remote workContract workImmediate startMonday to Friday- ...Utilization Management Registered Nurse (UM RN) This is a remote Stanford Health Care job. The Utilization Management... .... Medical Records Review: Examine patient... ...costs. Denials and Appeals Management: Address... ...denials by reviewing cases, gathering relevant data...Remote workWork experience placement
$31.94 - $43.92 per hour
...psychosocial assessments Create and manage discharge plans... ...care planning discussions Utilization Management Review medical necessity & admission... ...Option 1: 3+ years recent Case Management (acute care) OR Option 2: 3+ years RN in: Med/Surg Telemetry...Relocation packageShift workWeekend workAfternoon shift- ...LTSS department. RN will be responsible for providing case management services and evaluating... .... May also manage appeals for services... ...authorization and concurrent review. Provides monthly... ...setting by utilizing the applicable... ...Additional Info: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
- ...Currently seeking a Utilization Management RN . Please see details and qualifications... ...below: Position is remote - candidate must reside in the... ...through medical record review to determine medical necessity... ...information when needed. Refer cases that do not meet criteria to...Remote workImmediate startDay shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN - Appeals & Case Review. Be the first to apply!
- rn research Newtown Square, PA
- flex rn Newtown Square, PA
- surgery rn Newtown Square, PA
- registered nurse Newtown Square, PA
- rn ambulatory surgery Newtown Square, PA
- disability registered nurse Newtown Square, PA
- endoscopy rn Newtown Square, PA
- progressive care unit registered nurse Newtown Square, PA
- nursery rn Newtown Square, PA
- kaiser permanente rn Newtown Square, PA


