Fully Remote Utilization Review Nurse (RN)
TRISTAR Company
- Remote job
TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers’ compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to determine medical necessity and appropriateness of care. The position requires a nursing degree and an active RN/LPN license, with CCM/CMCN/CPHUR/CPDM/CDMS certifications preferred. #J-18808-Ljbffr TRISTAR Company
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
- ...Position Summary: The RN Integrated Care Coordinator (UM)... ...hours are required to address utilization review cases. Roles and Responsibilities... ...current, unrestricted Texas nursing license or Compact License.... ...Requirements This is a remote position. Our whole company...Remote workLive inFlexible hoursWeekday work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident... ...Authorization Review to join our Utilization Management team. In this role,... ...Qualifications ~ Active RN license (WA; must be in good standing...Remote workContract work
- ...Management Location: 100% Remote Schedule: M-F 9:00... ...This position is fully remote, but... ...an Illinois state RN license Assess and... ...Summary Works with the Utilization Management team... .../utilization review and other utilization... ...State Registered Nursing (RN) license in good...Remote workContract work
$35 - $40 per hour
...seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior... ...hrs/day Mon - Fri, 40 hrs/week Fully Remote Position Pay Range: $35 - $40 per...Remote workHourly payLocal areaShift work- ...Are you an RN looking to transition into or grow your career in Utilization Review? We're seeking a clinically strong... ...-oriented Registered Nurse to join our Utilization... ...in a fast-paced, remote environment. Reliable... ...Consider This Opportunity? Fully remote position with a...Remote workTemporary work10 hours per weekShift workWeekend workAfternoon shift
$35 - $40 per hour
...Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources... ...vocational nursing. Current, active nursing license (RN, LPN, or LVN) in good standing with the Arizona...Remote workContract workFlexible hoursWeekend work$43 - $63 per hour
...Job Description Job Description The Utilization Review Nurse plays a key role in evaluating patient admissions to ensure appropriate levels... ...Management, or Clinical Documentation Improvement Active Nevada RN license required Minimum 3 years of Utilization...Relocation package$42 - $65 per hour
...Job Description Job Description Utilization Review Nurse Location: Las Vegas, NV Job Type: Full-Time Pay: $42–$65/hr + Sign-On Bonus... ...~ Graduate of an accredited School of Nursing. ~ Current RN license in the applicable state. ~5+ years of acute care...Full timeRelocation package$40.12 - $62.19 per hour
...Utilization Review Nurse RN Work Schedule: This is an EVERY Saturday and Sunday role Summary: The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention...Weekend work- ...Research, Rehabilitation Therapy and Nursing. Job Description · The... ...or risk management issues. · Utilization and Quality Management/Outcomes experience... ...discharge planning, or Concurrent review. Qualifications · RN Diploma, RN Associate's degree or Bachelors...Work experience placement
- ...Utilization Review Nurse, RN Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our... ...opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and...Work at officeLocal area
- ...Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our growing team. Lighthouse Care Center of... ...opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and...Work at officeLocal area
- ...current Arkansas licensure as a RN. Preferably experienced in the... ...with the Medical Staff, review organizations, administration... ...Must be able to apply current nursing knowledge to determine appropriate... ...control system to assure effective utilization of hospital facilities and...Work at office
$88.85k
...Utilization Management (UM) Claims Review Nurse RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los...- ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity...Remote work
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract to full... ...Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team....Remote workFull timeContract work
$65k - $78k
...development. Your Role In Our Mission Review admissions, procedures, services, and... ...management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements...Remote workFull timeWork at officeWork from homeFlexible hours- Centene Management Company LLC is seeking a remote Nurse Reviewer to perform concurrent reviews, determine the member’s health status, and oversee... ...and discharge planning teams while educating providers on utilization processes. The ideal candidate holds a nursing degree with...Remote job
$33 - $37 per hour
...today to see how a conversation can turn into a long‑lasting and rewarding career! Job Description Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the...Private practiceWork at office- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation...Remote workMonday to Friday
- ...Job Description Job Description UTILIZATION REVIEW REGISTERED NURSE (UR RN) Department: Integrated Health Management Reports To: Integrated Health Management Supervisor/Director Clinical Oversight: Medical Director, as applicable FLSA Status: Non-Exempt...Hourly payFull timeWork experience placement
$36.9 - $69.95 per hour
...Utilization Review Registered Nurse, (RN) - Care Management, Per Diem, Variable Shift Island Health is seeking an experienced Utilization Review Registered Nurse for our hospital in Anacortes, WA. Work Schedule: 0.1 FTE / 0 hours per week - Additional information...Daily paidZero hours contractFlexible hoursShift work- ...term care facilities. In partnership with nursing home operators, these Medicare Advantage... ...Bonus Program JOB SUMMARY The Utilization Review Nurse is to assess the medical necessity... ...active and unrestricted Registered Nurse (RN) license EQUAL OPPORTUNITY EMPLOYER...Remote workFull timeTemporary workLocal area
- ...OpportunityThis is a remote position. Seeking a detail... ...analytical Registered Nurse (RN) to join our team in a... ..., this position is fully virtual and open to candidates... ...be responsible for reviewing and abstracting... ...reported data. You will utilize abstraction tools and...Remote workWork at officeWork from homeHome office
- ...Description Summary: The competent Nurse, in the same or similar clinical setting,... ...Standards of Practice, provides nursing care utilizing the nursing process, including assessment... ...Certifications BLS required RN License in state of employment or compact...Full time
$33 - $37 per hour
A national healthcare staffing firm seeks an experienced RN Utilization Review Nurse in Troy, MI. Responsibilities include utilization review for Medicaid and Medicare, managing authorization processes, and collaborating with healthcare teams to ensure quality care. Ideal...Hourly payMonday to Friday$32 - $48 per hour
...Shifts - No Weekends - Competitive Sign on Bonus Available! Job Summary The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide...Full timePart timeWork from homeRelocation packageMonday to FridayShift workDay shift3 days per week- ...built an innovative culture that allows nurses to grow their skillsets, develop their practice... ...impact. Job Duties The Endoscopy RN provides primary nursing support to the... ...is accountable for the delivery of care utilizing skills learned in the clinic. Assists other...Full timeTemporary workPart timeFlexible hoursShift workRotating shift
$10k
...patients and families facing cancer and complex medical needs. Our nurses deliver inpatient chemotherapy, palliative, and endof-life care... ...Nursing (Inpatient) | Mercy Hospital St Louis Registered Nurse (RN) or Licensed Practical Nurse (LPN) Full-time or Part-time | Day...Full timeContract workTemporary workPart timeImmediate startShift workNight shiftWeekend workDay shiftAfternoon shift
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