Remote Utilization Management Nurse - Care Coordination
Humana Inc
- Remote job
Humana Inc. is seeking an Utilization Management Nurse 2 to support coordination, documentation, and communication of medical service determinations. This remote role involves interpreting criteria and policies to provide optimal treatment for members, with occasional travel to Humana offices for training or meetings. The position requires a Florida RN/LPN license with the stated experience and a 40-hour week. #J-18808-Ljbffr Humana Inc
- CVS Health is seeking an Utilization Management Nurse Consultant to perform Medicare precertification activities in a remote, full-time capacity. The role focuses on ensuring appropriate care through evidence-based determinations and collaboration with care teams. Ideal...Remote jobFull timeWork at officeLocal area
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home... ...supports utilization management and benefit coordination, requiring an active RN license and... ...with providers, and ensuring timely care while meeting state and federal...Remote jobWork from home
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home,... ...open to MST/PST residents. You will coordinate and document utilization and benefit... ...ensuring timely, safe, and appropriate care for members. In this role you will review...Remote jobFull timeWork from home
$70k - $75k
...Guidehealth leverages remotely-embedded... ...and a centralized Managed Service Organization... ...Description The Utilization Management... ...services Quality of care concerns... ...friendly. Care Coordination & Quality Support... ...consistent with current nursing practice...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and... ...cases using clinical guidelines and coordinate with providers and departments to... ...in a fast-paced managed care environment. #J-18808-Ljbffr Santa...Remote job
- CVS Health seeks a Utilization Management Nurse Consultant to support a 24/7 operation. In this role you will assess, plan, implement, coordinate, monitor and evaluate healthcare options for members... ...communicate with providers and care teams to facilitate treatment decisions...Remote job
- CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization... ...management, ensuring appropriate care levels within state and federal...Remote jobFull time
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services... ...information.Travel: While this is a remote position, occasional travel to...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift work- ...Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely... ...2+ years in UM within managed care. Prior experience in various reviews...Remote jobWork at office
- Brigham and Women's Hospital in Boston is seeking a Staff Nurse - Per Diem Rotating Day in Utilization Management. The role reviews denials, appeals, and ensures appropriate care levels with care coordination and finance teams. A BSN is required with RN licensure in Massachusetts...Remote jobDaily paid
- ...Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a fully remote role available to MST/PST zone... ...the United States. You will coordinate, document, and communicate utilization... ...to ensure safe, effective care while meeting state and federal...Remote job
- ...Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving... ...the EST or CST zones. You will coordinate, document, and communicate utilization... ...to ensure appropriate care while complying with state and...Remote jobFull time
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical... ...Experience working in a fully remote, metrics-focused role Experience...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- ...Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role available to... ...the MST/PST time zones. You will coordinate, document, and communicate all... ...management, ensuring safe, effective care while meeting regulatory...Remote jobFull time
- ...dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our... ...supporting transitions of care and ensuring patients receive... ...) . This is a fully remote opportunity requiring discipline... ...teams to ensure coordinated and effective care delivery...Remote work
- ...Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The role focuses on assessment, coordination of care, and collaboration with providers to... ...evenings/holidays after training; remote work is allowed with required home setup...Remote jobShift workAfternoon shift
$82k
...Ohio, seeks a dedicated MDS Coordinator (RN/LPN) to lead the MDS... ...CMS compliance, and support care planning and reimbursement... ...documentation improvement and utilization management. The position offers a... ...days on-site and two days remote, Monday through Friday, with...Remote workMonday to Friday$42 per hour
...Programs of All-Inclusive Care for the Elderly (PACE... ...solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers... ...Management Nurse plays a critical role... ...location : This is a fully remote role based in the United...Remote workContract work$26.01 - $68.55 per hour
...passionate colleagues who care deeply, innovate with... ...community at a time. Utilization Management is a 24/7 operation... .... Schedule Fully Remote- WFH M-F 8A-5P EST/9A... ...Position Summary: UM Nurse Consultant Utilizes clinical... ..., plan, implement, coordinate, monitor and evaluate...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$41.71 - $105.65 per hour
...Staff Nurse - Per Diem Rotating Day - BWH Utilization Management The Insurance Support Nurse participates in the timely... ...that are received in the Care Coordination Department. Through sound knowledge... ...Job Details (if applicable) Remote Type Remote Work Location...Remote workHourly payDaily paidShift work$41.71 - $105.65 per hour
..., including doctors, nurses, business people, tech... ..., we support patient care, research, teaching,... ...Diem Rotating Day - BWH Utilization Management The Insurance... ...received in the Care Coordination Department. Through sound... ...(if applicable) Remote Type Remote Work...Remote workHourly payDaily paidShift work$29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate with purpose... ...one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑... ...our team. This is a fully remote role available to... ...your clinical background to coordinate, document, and communicate...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayShift workWeekend work$83k - $99k
.... We only hire people that care deeply about others, thrive... ...Role and Responsibilities The Utilization Management Nurse collaborates with external... ...support and care coordination for complex, catastrophic or... ...600 wellness reimbursement Remote work and continuing education...Remote workFull timeWork at officeFlexible hours$29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate with purpose... ...one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule... ...and care teams to coordinate appropriate treatment Apply...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work- ...InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in... ...and claims knowledge. This is a REMOTE opportunity for candidates living in... ...criteria and contract benefits. * Utilize allocated resources to back up...Remote workContract workTemporary workLocal areaShift work
- ...The RN Program Coordinator functions as a clinical... ...and works as the nursing lead in the GBMS... ...including training staff, managing all program... ...with the primary care team to ensure that... ...proficient in and utilizes the Electronic Health... ...proficient in remote patient monitoring...Remote workWork at office
- ...patient journey - from care navigation and management to payment integrity, plan... ...This Opportunity: As a Utilization Management Nurse, you’ll oversee and... ...the Quality Improvement Coordinator potential quality of care... ...Work: This is a fully remote position, and we’ll...Remote workFull timeImmediate startMonday to FridayFlexible hours
$26.35 - $39.53 per hour
...entitled to high-quality, coordinated care. By uniquely aligning the... ...Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for... ...provided to members under a managed care health plan. This role... ...Corporate office preferred / remote may be considered Collaborative...Remote workHourly payWork at office$26.01 - $56.14 per hour
...EST Location: 100% Remote (U.S. only) About Us... ...-accredited medical management organization founded... ..., cost-effective care management solutions... ...medical journeys. As a Utilization Management (UM) Nurse Consultant... ...process to implement, coordinate, monitor and evaluate...Remote jobHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work- ...demands of hands-on care behind. Instead,... ...a dedicated team, coordinate whole-person medical... ...BHH Registered Nurse (Part-Time) (20–2... ...approach for clients managing severe mental... ...Client Care: Provide remote and in-person... ...Driven Coordination: Utilize our Electronic Health...Remote workPart timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift workNight shiftWeekend workAfternoon shift
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