Remote RN: Medical Management & Utilization Specialist (Temp)
SCAN Group
SCAN is seeking a Medical Management Specialist-RN in California to promote quality and cost-effectiveness of care under regulatory guidelines. You will support utilization management, conduct reviews, and coordinate with the Medical Director for complex requests.
Responsibilities include coordinating care across inpatient and outpatient settings, ensuring timely determinations, and maintaining strict documentation and privacy standards. Remote work mode is available.
#J-18808-Ljbffr- ...care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through accurate... .... Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review when...Temporary workRemote workWork experience placementLive outFlexible hours
- ...Logan Health is seeking a Utilization Management Specialist to join our team in a fully remote role focused on inpatient admissions reviews, physician documentation... ...insurers to ensure appropriate patient status and medical necessity. Ideal candidates bring acute care...Remote work
- ...Logan Health is seeking a Utilization Management Specialist to join our dedicated team. You’ll review admissions... ...appropriate authorization and medical necessity. This role emphasizes strong... ...a four 10-hour shift schedule, remote work with Montana residency, and a competitive...Remote workShift work
- ...CVS Health is hiring a Registered Nurse (RN) for Utilization Management to assess and coordinate care, ensuring appropriate utilization and outcomes... ...critical care, and flexibility for a 24/7 operation. This remote, full-time position offers a comprehensive benefits...Remote workFull time
- ...Logan Health Medical Center is seeking a Utilization Management Specialist to review admissions across the system and determine... ...appropriate status. This role suits an RN or Social Worker with acute care... .... The position is fully remote for Montana residents and offers...Remote work
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing... ...to authorize care and ensure medical necessity. The position emphasizes strong... ..., with a four-day work week and remote options for Montana residents. #J-...Remote work
- ...UnitedHealth Group in the DC area is seeking an HCBS Utilization Management Nurse to perform pre-service coverage... ...and external partners to determine medical necessity and appropriate care. Requires a District of Columbia RN license and 2+ years in clinical settings,...Remote work
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient... ...-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team... ...Collaborate with Branch Directors, Clinical Managers, and field clinicians Support...Remote workMonday to FridayWeekend workWeekday work- ...Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and discharge planning in collaboration...Remote workPart timeRelief
- ...Registered Nurse (RN) | Medical-Surgical Location: Denver, CO Agency: Concentric... ..., appendectomy, and medical management Utilize remote telemetry equipment and document patient... ...by taking advantage of the temporary, temp-to-hire, and direct placement services...Temporary workRemote workWeekly payFull timeContract workImmediate startNight shift
- ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a...Remote workWork from homeWeekend workAfternoon shift
- ...Alliance Health is seeking an UM Clinical Specialist RN-Physical Health (Remote, NC Based) to assess medical necessity and oversee reviews across inpatient,... ...with 3–5 years of nursing experience and prior Utilization Management exposure. Strong communication and...Remote workWork at office
- ...Logan Health is seeking a Utilization Management Specialist to review admissions across our system and determine appropriate status. The role demands... ...partners, and clear communication. This full-time, remote-enabled position requires Montana residence, with four 10...Remote workFull timeShift workWeekend work
- ...Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across the continuum... ...inpatient nursing, and 2+ years in utilization management or discharge planning, with an...Remote jobWork from homeMonday to FridayWeekend work
- HonorHealth is seeking an RN Utilization Review Specialist to review and monitor health care service utilization... ...appropriate levels of care and medical necessity across admissions and... ...discharge. You will work with the Care Management team to ensure documentation supports...Remote jobDaily paid
- ...is seeking an experienced Registered Nurse to join our Utilization Management team in a remote capacity. The role focuses on ensuring members receive appropriate... ...of care. The ideal candidate will have an unrestricted RN license, 2+ years in adult acute or critical care, and...Remote job
- CVS Health is seeking a Registered Nurse (RN) for Utilization Management to ensure appropriate care delivery and coordinate patient care with clinical teams. The role emphasizes evidence-based review, care coordination, and collaboration with providers to optimize outcomes...Remote jobFull timeFlexible hoursAfternoon shift
- Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses... ...admissions and service requests for medical necessity, coordinating care, and... ...organization. The role requires Texas RN licensure and a nursing diploma, with...Remote job
$69.39k - $88.61k
Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and... ...s degree in a related field, an active RN/Social Work/Clinical Counselor license,...Remote jobFull time- Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care. The role collaborates with Admitting, Financial...Remote job
- ...Jobgether, on behalf of a partner company, seeks an experienced Case Manager – Utilization Review Specialist to oversee admission and concurrent reviews remotely in the United States. You will evaluate medical records for medical necessity, coordinate appeals, and...Remote work
$35 - $37 per hour
...poster from The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $36-37/hr Start... ...case reviews using national medical guidelines (MCG, Interqual, etc.),... ...No NPs, whether practicing or not. Utilization Review experience is helpful but not...Temporary workRemote workPermanent employmentFull timeMonday to Friday- ...BlueCross BlueShield of South Carolina is seeking a Remote RN Medical Reviewer II to perform medical reviews using clinical documentation... ...documentation, determine medical necessity, and support claims and utilization practices in a work-from-home setup. The role requires an...Remote workWork from home
- ...Area Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA)... ...plan standards for associated medical groups.Key Responsibilities:Supervise... ...-licensed denial unit staff, managing daily tasks, performance... ...accredited Registered Nursing Program; RN preferred.Minimum of five...Temporary workRemote workPermanent employment
$60.53k - $129.63k
...Health, is a URAC-accredited medical management organization founded in 1993... ...Summary Join our Utilization Management team as a Nurse Consultant... ...from providers. Remote Work Expectations This is... ...Associate's degree in nursing (RN) required, BSN preferred....Temporary workRemote workHourly payFull timeWork experience placementLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce... ...Program JOB SUMMARY: The Utilization Review Nurse is to assess the medical necessity... ...and unrestricted Registered Nurse (RN) license EQUAL OPPORTUNITY EMPLOYER...Temporary workRemote workFull timeLocal area
$26.01 - $56.14 per hour
...am-5:00pm EST Location: 100% Remote (U.S. only) About Us... ...Health, is a URAC-accredited medical management organization founded in 1993... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant... ...Active, unrestricted RN license in your state of residence...Temporary workRemote workHourly payFull timeLocal areaMonday to FridayFlexible hoursShift work$80k - $150k
...Asset Management SpecialistOrbital Engineering, Inc. is currently seeking an Asset Management Specialist with experience in CASCADE and ELECTRIC UTILITIES for a REMOTE WORK role for our Utility Services team to... ...balance. Our benefits include medical, dental, vision, and...Temporary workRemote workWork at officeWork from home$40.08 - $54.93 per hour
...week at Buffalo Possibility of working remotely one day per week based on staffing needs... ...weekends Employee occupational health, case management, urgent care, clinic, or Emergency... ...remote means. Makes referrals for ongoing medical care and return to work following Employee...Temporary workRemote workMinimum wageContract workLocal areaMonday to FridayShift workDay shift2 days per week1 day per week
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