Remote Preservice Review RN - Case Management
Optum
- Remote job
Optum is seeking a Registered Nurse for Preservice Review/Prior Authorization to support cross-functional care across outpatient and inpatient settings. The role offers opportunities to grow into PA, PACM, ICM, and DCM functions, with remote work available anywhere in the United States. You will review cases, collaborate with Medical Directors, and ensure compliance with policies while maintaining high-quality patient care. #J-18808-Ljbffr Optum
$23.76 - $51.49 per hour
...JOB DESCRIPTION This RN will act as a Care Review Clinician and provide clinical review support for Medicare inpatient utilization management activities. Conducts medical necessity reviews... ...policies. Partners with providers, case management, and care coordination teams...Remote workHourly payWork experience placementWork at officeShift work- ...family, invites you to explore a Concurrent Review Case Manager role. This telephonic position supports... ...reviews and discharge planning, with remote work allowed nationwide. The clinic emphasizes... .... Qualified candidates will hold an RN license (TX RN) or TX LCSW, with 5+...Remote job
- ...holidays. The position emphasizes clinical reviews to determine if treatments meet criteria, with collaboration among case managers and disease management nurses. Qualified candidates... ...health or substance abuse expertise. A remote setting is available within a national...Remote jobMonday to FridayWeekend workDay shift
$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays... ...in supporting utilization management operations by conducting... ...utilization management and case management programs integrate... ...This is a 100% remote role, and requires robust internet...Remote workFull timeFlexible hoursShift work$2,210 per week
...independent leader in personalized managed health care, focused on... ...Work-life balance. Remote/hybrid setting (once... ...decision to a second level reviewer. This individual interfaces with case managers and disease management... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...completion of appropriate clinical review of all applicable patients as... ...stated in system utilization management plan. Oversees Clinical... .... This role will be remote BUT regular meetings/trainings... ...using Epic and escalating cases for status change where necessary...Remote workReliefShift workWeekend work3 days per week
$29 - $52 per hour
...Connecting. Growing together The Preservice Review RN is responsible for reviewing... ...the flexibility to work remotely * from anywhere within the U... ...approve, pend or send the case to the medical director for... ...Qualifications: ~2+ years Utilization Management experience in managed care,...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor... ...license (compact allowed), 1 year UR/UM or Case Management experience, and a strong collaboration with physicians and care teams. Remote work is available after training. #J-188...Remote job
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse... ...currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our... ...appropriate staff (Medical Director, Case Manager, Preventive Services,...Remote workFull timeContract workLocal areaShift work
$80k - $90k
...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...audit activity as assigned by management. Monitors, tracks, and... ...reporting tools, and case management system/tools to... ...to work independently in remote setting with minimum supervision...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- ...Responsibilities Responsible for the review of medical records for... ...the market. Job Requirements Remote. Must reside within driving... ...experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. California RN license. AHA BLS Ability to...Remote work
- Northwestern Medicine is seeking a remote RN Case Manager (PT) to support Utilization Review at Catherine Gratz Griffin Lake Forest Hospital. This role provides staffing coverage with no set schedule and requires availability on weekdays and weekends; shifts are 6a-6p or...Remote jobShift workWeekend workWeekday work
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
- ...Description Job Description The utilization review and management (UM) component program ensures that... ...: 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
- ...Job Description Job Description Remote Utilization Review Registered Nurse (UR RN) Location: Remote (Texas RN... ...) to join our growing Utilization Management team. This fully remote position plays... ...experience in utilization review, case management, or behavioral health and...Remote workFull timeWork at office
$77.91k - $116.86k
...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse... ...primary care physician, facility case manager, discharge planner and... ...active, valid, and unrestricted RN license in California (Non-Compact...Remote workFull timeImmediate startMonday to Friday$85k - $92k
...identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential... ...review, utilization management, or healthcare quality within... ...as a Registered Nurse (RN) or Licensed Clinical... ...environment Other Information Remote or onsite depending on...Remote jobHourly payWork at officeHome office$91.25k - $120.91k
...research all PQI and QR cases as assigned, provide a... ...resolution of case assignments Reviewing escalated issues... ...to the Quality Management (QM) department Investigation... ...unencumbered Registered Nurse (RN) license issued by the... ...for telecommuting/remote work location upon...Remote workTemporary workWork experience placement$60.2k - $107.4k
...Connecting. Growing together. The Concurrent Review Case Manager is responsible for telephonic... ...You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... ...or master's degree in Social Work TX RN license or TX LCSW license, valid Texas...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal area- UnitedHealth Group, via OptumCare, seeks a Concurrent Review Case Manager to monitor and document care, compare it with guidelines, and support... ...with medical leadership and multiple care teams. Remote work from anywhere in the U.S. is offered, with in-office requirements...Remote jobWork at office
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type... ...necessity. This position manages medical necessity process for... ...negotiation with a payer on a case-by-case basis. This position... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle...Remote workFull timeWork at officeFlexible hoursShift work
$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment... ...reviewers to support case review processes. Assist... ...required timelines. Support case management activities and identify... ...working independently in a remote or office-based setting. Working...Remote workWeekly payContract workWork at officeMonday to Friday$84.56k - $126.84k
...Job Overview The Utilization Review RN participates as a member of a... ...Department Name: Utilization Management Job Status: part time, 24 hours... ...position will be primarily remote but there may be occasions when... ...care in conjunction with the Case Managers regarding the...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift$51.43 - $79.84 per hour
Overview Description - This is a remote role. You MUST live in the state... ...(WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical... ...certification upon hire. 1 year of Case Management experience. Why Join...Remote workDaily paidLive inShift workDay shift- ...first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states... ...nurse will ensure timely, accurate case handling and serve as a key liaison... ...) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *...Remote workContract work
$66.83k - $111.38k
...Health Plans is hiring an Utilization Review Nurse/ RN for Medicaid - Remote! Status: Full-time, permanent... ...Nurse is responsible for utilizing management services within the scope of licensure... ...of care coordinator with case management and facilitates member care...Remote workPermanent employmentFull timeTemporary workShift workDay shift$77.96k - $120.37k
...Job Description The Utilization Review Supervisor RN is responsible for directing the operations... ...service, and limited sales management. This is a remote position. ESSENTIAL FUNCTIONS &... ...activities May be required to oversee case management clinical activities (...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- ...Job Description Fully remote- Must have state of MI unrestricted RN license. You will perform... ...and retrospective review of inpatient, outpatient,... ...preferred Prefer utilization management experience... ...care, discharge planning, case management, and utilization...Remote workWork at officeFlexible hours
- ...Case Manager, RN- Utilization Review Under the general supervision of the Utilization Management Manager and in accordance with established policies... ..., reporting, and interdisciplinary collaboration in a remote or hybrid work environment. Qualifications Licensed...Remote workFull timeMonday to FridayShift work
- ...entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs.... ...Associates degree and active NYS RN license required. Bachelors... ...note: The opportunity for remote work may be possible for all...Remote workContract workWork at office
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