Remote Utilization Review RN (OASIS & Coding)
Santa Barbara Cottage Hospital
- Remote job
Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This role emphasizes OASIS review, coding accuracy, QA, and remote documentation audits. The ideal candidate holds an active Florida RN license, OASIS certification, and home health coding certification with at least 2 years in home health. Excellent attention to detail and independent work are essential. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced... ...Review Specialist (RN) to join our remote home health team.This role is ideal... ...an RN with strong experience in OASIS, coding, QA, and home health documentation...Remote workMonday to FridayWeekend work- ...integrating, and monitoring the utilization of behavioral health (... ...Medical Director for review. Refer to and work... ...for pricing, coding, researching claims to... ...degree and active NYS RN license required. Bachelors... ...may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
- ...Utilizing clinical expertise, the full-time Licensed Medical Review Nurse (LVN/LPN) will conduct medical reviews of claims and documentation... ...with regulations while working remotely on a MST/PST schedule. Key... ...and claims to ensure correct coding and appropriate reimbursement...Remote workFull time
$30.64 - $45.8 per hour
...Utilization Review Nurse The Utilization Review Nurse gathers demographic... ...department and of CorVel. This is a remote position. Essential... ...knowledge of both CPT and ICD coding Ability to interface with... ...state of operation required; RN is required unless local state...Remote workHourly payFull timeWork at officeLocal areaFlexible hours- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on... ...schedule of 8 hours per day, requiring an RN with a Bachelor's degree, state licensure...Remote jobWork from homeMonday to Friday
- ...providing telephonic and e-Referral case review and authorization of services utilizing established mental health and... ...This position is full-time, fully remote (work from home) and requires some... ...State of Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required.Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
$40 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Harrisburg, PA Agency: 22nd Century Healthcare, Inc. Pay: $40 to $45 per hour... ...of five (5) or more years of experience with claims review/coding or processing; be familiar with HCPCS II, CPT, or Dental...Hourly payFull timeContract workWork at officeImmediate startShift work- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract pertinent details... ...using evidence-based literature and coding guidelines. This remote role supports telecommuting from anywhere...Remote jobFlexible hours
- Johns Hopkins Health Plans (JHHP) is seeking a Utilization Review Registered Nurse to assess care appropriateness, authorize services, and coordinate discharge planning for plan members. This remote role prioritizes candidates in MD, DC, VA, PA, DE, and FL with strong clinical...Remote job
- ...Healthcare seeks an experienced RN to support Arizona Plan clinical member services review processes. The role requires an... ...RN license and experience with utilization management, prior authorization,... ...inpatient and outpatient settings. Remote position, must reside in Arizona...Remote job
$44.57 - $60.44 per hour
...Weekly Hours: 24 Job Summary: Review of Home Health OASIS documentation tool and... ...appropriate documentation, resource utilization, quality of care and cost... ...to accurately assign codes. Collaborates with field... ...Experience: 3 years of RN Coding Experience preferred...Hourly payFull timeTemporary workPart timeWork at officeLocal areaFlexible hoursShift workDay shift- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective... ..., concurrent, and retrospective reviews. This full-time remote role supports compliant, cost-effective care under Alabama...Remote jobFull timeContract work
- ...patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...needed 3-4 days for first week. This role will be remote BUT regular meetings/trainings require being onsite...Remote workReliefWeekend work3 days per week
$30 - $38 per hour
A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote jobHourly payPart time$2,210 per week
...Paid Holidays Work-life balance. Remote/hybrid setting (once trained)... ...: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces with... ...includes but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- Molina Healthcare is seeking a Remote Medical Review Nurse (LVN/LPN) for PST schedule in the United States. The role involves reviewing documentation... ...necessity and appropriate level of care, with focus on coding accuracy and reimbursement. The candidate will work MST/PST...Remote jobShift work
- TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews, assisting...Remote job
- Children's Hospital Colorado in Aurora, CO, is seeking an Utilization Review RN to support medical necessity reviews and denial mitigation as part of a multidisciplinary team. The role is primarily remote with potential onsite shifts, and requires BSN, 3 years UR experience...Remote jobPart timeRelocation packageShift workWeekend workAfternoon shift
- ...Responsibilities Responsible for the review of medical records for... ...and the Care Coordination staff utilizing evidence-based guidelines and... ...the market. Job Requirements Remote. Must reside within driving distance... ...1 year experience. California RN license. AHA BLS Ability to...Remote work
- ...Clinical Documentation Specialist RN to ensure CMS program compliance through meticulous review of OASIS admission documents and Plans... ...full-time, day shift role is remote for eligible states and... ...Preferred: BSN and Home Care Coding Specialist credentials. #J-18...Remote jobFull timeDay shift
- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) licensed in Alabama to assess medical necessity and quality of care through prospective... ..., concurrent, and retrospective reviews. This full-time, remote position supports compliant, cost-effective care aligned...Remote jobFull timeContract work
$45 - $50 per hour
...for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby....Remote jobHourly pay- 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
- Job Title Utilization Review/Case Management - Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly...Remote workFull timeShift work
- ...Chart ReviewerIn this position you will be reviewing patient charts to determine if pre-... ...weekendsEducation and Experience:RHIT, RHIA, or related coding certification required.Minimum 3-5 years... ...clinical experience preferred.Previous utilization management or case management experience...Remote workFull timeMonday to Friday
- ...To support a growing healthcare practice, the Per Diem Coding & OASIS Reviewer will work remotely to accurately review clinical documentation, assign ICD-10 codes, and evaluate OASIS assessment items while maintaining communication with clients. Key responsibilities...Remote workDaily paid
$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.00 - $45... ...-paced environment. Comfortable working independently in a remote or office-based setting. Working Conditions May be exposed...Remote workWeekly payContract workWork at officeMonday to Friday$51.43 - $79.84 per hour
Overview Description - This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in Utilization...Remote workDaily paidLive inShift workDay shift- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type:Full Time The individual in this position is responsible to... ...) Job Schedule Full time Job Shift Day Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
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