Remote RN: Utilization Review & Denials Management
$79.75k - $127.59kDartmouth-Hitchcock Medical Center
A leading healthcare provider is seeking a licensed Registered Nurse for a fully remote position. You will develop patient care plans, oversee inpatient denials, and monitor patient progress. Ideal candidates should have a BSN, 3 years of nursing experience, and strong leadership and communication skills. This role offers competitive compensation with a pay range of $79,747.20 to $127,587.20 annually along with comprehensive benefits. #J-18808-Ljbffr
- ...completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical... ...6-8 weeks. This role will be remote, including most training but... ...utilization review process, aids in denial prevention, and serves as...Remote workRelief3 days per week
- .... We offer integrated managed care products, pharmaceutical... ...Supervisor, the LTSS Reviewer is responsible for... ...of the request, utilization determination (and events... ...indicated. Provide verbal denial notification to the... ...solutions include remote options, hybrid work schedules...Remote workFlexible hours
$45 - $50 per hour
...Utilization Management Nurse – Medicare Remote | California RN Required | Must sit in CA We’re partnering with a mission‑driven healthcare organization seeking... ..., concurrent, and retrospective utilization reviews for Medicare members Apply evidence‑based clinical...Remote workContract workTemporary workWork from home- Humana is offering a Utilization Management Behavioral Health Registered Nurse (RN) Internship for transitioning military service members and military spouses. This role involves conducting clinical reviews, communicating with healthcare providers, and ensuring documentation...Remote workInternship
- ...in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience... ...position offers the flexibility of remote work while supporting professional...Remote work
- ...Candidates can be remote but must have an active... ...Massachusetts RN License Job Summary The Clinical Reviewer, Precertification RN... ...is responsible for managing a clinically complex... ...Precertification / Outpatient Utilization Management (UM)... ...defined in the denial letter....Remote workContract workWork at officeWork from home
$50.68 per hour
...Job Job Overview The Utilization Review RN participates as a member of... ...actively participate in denial mitigation. It is a collaborative... ...Name: Utilization Management Job Status: flex, not eligible... ...position will be primarily remote but there may be occasions...Remote workHourly payTemporary workLive inImmediate startRelocationFlexible hoursShift workWeekend workDay shiftAfternoon shift- Ascension is seeking a Remote Registered Nurse for Utilization Management. Your vital role will involve providing healthcare services related to admissions and... ...compliance with federal regulations. You will review service requests for medical necessity and assist with...Remote job
- A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...Remote jobFlexible hours
- Cedarparktexasedc is seeking a Licensed Registered Nurse for a remote position focused on admissions, case management, and utilization management. This role involves reviewing service requests for compliance and coordinating with interdisciplinary teams for discharge planning...Remote jobFull time
- Industrial Asset Management Council, Inc is seeking a remote RN to support various units, requiring at least 2 years of experience in patient care and Utilization Review. Candidates must live within one hour of St. Louis, MO, hold an active RN license, and be available...Remote jobFull time
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position Type Full Time... ...Full time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review/...Remote workHourly payFull timeWork at officeRelocation packageShift work$62.4k - $106.93k
...Physicians Health Plan Inc is seeking a Utilization Management professional in Town of De Witt, NY.... ...regulatory standards and performing clinical reviews to determine service appropriateness.... ...have an Associate degree, active NYS RN license, and a minimum of three years of...Remote job- ...experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant experience in healthcare. The...Remote workWork from home
- ...your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the... ...aligning length-of-stay, throughput, denials prevention, payer relations, and transitions... ...support, virtual nursing, and remote monitoring; clear investment in...Remote workWeekend work
- ...UnitedHealth Group is seeking a Preservice Review RN responsible for evaluating provider requests using established protocols. This role... ...relevant nursing experience. You can enjoy the flexibility of remote work while playing a vital part in reviewing medical necessity...Remote work
- A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote jobFull timeWork at officeWork from home
- ...Texas Health Institute is seeking a Preservice Review RN responsible for evaluating requests from providers based on medical necessity. This role allows remote work flexibility while engaging with critical patient evaluations. Key responsibilities include verifying eligibility...Remote work
$28.94 - $51.63 per hour
...UnitedHealthcare is seeking a Preservice Review RN in Las Vegas, NV. The RN will review provider requests for medical necessity and benefit level, working remotely and collaborating with other staff. Candidates must possess a Nevada RN license and have at least 2 years...Remote workHourly pay- ...U.S. Bankruptcy Court - District of CT is seeking a Preservice Review RN responsible for reviewing provider requests in compliance with established protocols. This role offers flexibility to work remotely within the U.S., providing an opportunity to make a significant...Remote workHourly pay
- ...integrating, and monitoring the utilization of behavioral health (BH... ...Medical Director for review. Refer to and work closely with Case Management to address member needs.... ...degree and active NYS RN license required.... ...may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
- ...A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...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
- ...University of Minnesota School of Nursing is seeking a Preservice Review RN to evaluate requests from providers, ensuring they meet... ...contractual criteria. This position offers the flexibility to work remotely within the U.S. and requires a current RN license in Nevada....Remote workWork at office
- ...care and appropriate utilization of resources, balanced... ...necessity. This position manages medical necessity... ...medical necessity and denial prevention Coordination... ...to Central Utilization Review LVN/LPN Case Manager and... ...Saturday schedule. Remote, but you must live locally...Remote workWork at office
- ...A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization... ...coordinating discharge planning. Candidates must have an active RN license in New Jersey, strong analytical skills, and...Remote workContract work
- ...Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location:... ...Type: Hybrid (85% remote, 15% onsite in Northridge... ...daily tasks, performance reviews, and any necessary disciplinary... ...Nursing Program; RN preferred. 2. Minimum of...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...A healthcare management company is looking for a Part-time remote Utilization Review Nurse based in Coos Bay, OR. The ideal candidate holds a nursing degree and has experience in acute care and utilization review. Key responsibilities include performing clinical reviews...Remote workHourly payPart time
$1,600 - $1,800 per week
...Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson... ...no holidays, no telehealth/remote work Minimum... ...full, active, and unrestricted RN license Certifications:... ...Utilization Management, Utilization Review, or Case Management...Remote workContract workImmediate startMonday to Friday- ...Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in the tri-state area (PA, DE, NJ) M-F,... ...clinical conditions through medical record review to determine medical necessity for services...Remote workImmediate startDay shift
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