Remote Inpatient Utilization Nurse - UM (RN/LVN)
Alignment Health
- Remote job
Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will oversee inpatient case reviews, coordinate referrals, and collaborate with physicians, discharge planners, and ancillary services to ensure safe, cost-effective care aligned with guidelines. The role requires strong nursing utilization review skills, Medicare knowledge, and effective communication, with an expectation to support complex cases and participate in multi-disciplinary rounds #J-18808-Ljbffr Alignment Health
$77.91k - $116.86k
...Together.Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient... ...criteria as established per UM policy and procedure. 12.... ...active, valid, and unrestricted LVN or RN license in California (Non-Compact...Remote workImmediate startMonday to Friday- Alignment Health is seeking an experienced inpatient review nurse to join the remote utilization management team. You will review inpatients with complex medical... ...with Milliman Care Guidelines experience and an active LVN license. #J-18808-Ljbffr Alignment HealthRemote job
$65k - $85k
...Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is responsible for... ...ability to work independently in a fully remote environment. Budgeted... ...clinical review and elevate to an RN, Medical Director, or other designated...Remote workWork at office$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’s managed care health... ...in a fully remote managed care setting. The UM RN Nurse Coordinator reviews outpatient authorization...Remote workContract workTemporary workMonday to FridayWeekend work- ...: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between... ...compliance. Unlike remote roles, this position relies... ...Nurse is a Registered Nurse (RN) responsible for performing... ...correct Patient Class (e.g., Inpatient vs. Outpatient with...Remote workFull timeImmediate startShift work
- ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. You will collaborate with the... .... This role requires 3+ years of nursing experience, 2+ years in UM, and strong communication...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for... ...plans, Intensity and duration of inpatient or outpatient services, Quality of... ...Assisting in the development of UM/PHM Committee materials and packets...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- CVS Health is seeking an experienced radi-? nurse for a 100% remote Concurrent Review RN position. The role supports inpatient reviews, discharge planning, and care transitions across the continuum. Required is an active Louisiana RN license (or Compact), with 5+ years...Remote jobWeekend work
$60.2k - $107.4k
...Inpatient Care Management Nurse Optum is a global organization that delivers care... ...responsible for ensuring proper utilization of our health services.... ...the flexibility to work remotely as you take on some tough... ...~ Active, unrestricted RN license in state of residence...Remote workMinimum wagePermanent employmentFull timeWork experience placementLocal area- ...Integra Partners seeks an experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program, collaborating with our Medical... ..., referrals, and handling appeals. Remote opportunities available and strong team...Remote work
- ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. This role collaborates with the... ..., aligned with NCQA standards. The UM Nurse will review requests, approve those...Remote work
- Integra Partners seeks an experienced LPN/LVN to support utilization review in a managed care UM program. You will perform pre/post service reviews, determine... ...administrative appeals within NCQA-aligned guidelines. Remote opportunities across the US are available. #J-18808...Remote job
- ...Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS.... ...decisions align with NCQA-compliant UM programs, contributing to high-... ...active LPN/LVN license, 3+ years nursing experience, and 2+ years UM experience...Remote job
- ...seeking an experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals in a... ...an NCQA-compliant UM program. The role requires... ...licensure, 3+ years of nursing experience, and 2+ years... ...preferred, and we offer remote work options and a comprehensive...Remote job
- ...Partners is seeking a Licensed Practical Nurse to perform pre-service and post-service utilization management reviews and appeals within a NCQA-compliant UM program. You will collaborate with... .... The role requires an active LPN/LVN license, at least 3 years of nursing...Remote job
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will collaborate with the patient’s physician, facility... ...care at the right level. Requirements include a CA LVN/RN license, minimum 3 years in case management,...Remote work
$83.2k
...Job Title: Virtual Care Nurses (RN, LPN/LVN) Location: 100% Remote - United States Employment Type: Full-Time W2 Hourly Compensation: RN... ...accurate, timely, and confidential patient records. · Utilize electronic health record systems (CT360, RXNT, Zoom)...Remote workHourly payFull timeWork from homeHome officeFlexible hours$60k
...Integra is looking for a LPN/LVN experienced in the... ...and post-service utilization reviews and appeals for... ...within an NCQA-compliant UM program. Salary: $60... ...SKILLS/ABILITIES The UM Nurse’s responsibilities... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area- Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatients and collaborate with physicians... ...level. Qualified candidates will hold an active LVN or RN license, have at least 3 years in case management,...Remote job
- CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity... ...include an active RN license (multi-state preferred), 3+ years of nursing, 2+ years in UM/Prior #J-18808-Ljbffr CVS HealthRemote job
$72.8k - $130k
...an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional... ...~ Must be a Registered Nurse (RN) with a current, active, unrestricted... ...knowledge of process flow of UM, including prior authorization...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...Health is seeking a Medicare Precertification Utilization Management Nurse Consultant in the Baltimore area. The role leverages RN clinical expertise to assess care options,... ...years experience, and MS Office proficiency; remote work options with home setup requirements;...Remote workWork from home
- ...Job Posting Aug 11, 2026 Registered Nurse (RN) - Inpatient Adult Unit - ( 26161922 ) Natchaug Hospital doesn't just take great care of... ...as per diem schedules are available. The Registered Nurse utilizes psychiatric/chemical dependency nursing skills as a direct...Remote workDaily paidPart timeRelocation packageShift work
- ...Integra is looking for a LPN/LVN experienced in the managed... ...-service and post-service utilization reviews and appeals for DMEPOS... ...within an NCQA-compliant UM program.The UM Nurse's responsibilities include... ...location in Michigan plus a remote workforce across the United...Remote workTemporary workLocal area
- ...Blue Zones Health seeks a Licensed Vocational Nurse (LVN) for Utilization Management & Inpatient Case Management in a fully remote role based in California. You will monitor inpatient services, perform concurrent reviews, and coordinate transitions of care while collaborating...Remote work
- Integra Partners is seeking an LPN/LVN with UM experience to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with the... ...to the Medical Director. The role supports a remote workforce across the United States and offers competitive...Remote job
- ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS.... ...Director to ensure NCQA-compliant UM programs and benefit determinations. The role requires 3+ years nursing and 2+ years UM experience in...Remote job
- Integra Partners is looking for an LPN/LVN experienced in the managed care payor... ...perform pre-service and post-service utilization reviews and appeals for DMEPOS. This role... ...reviews within an NCQA-compliant UM program. The UM Nurse will review criteria, approve eligible...Remote job
- Integra Partners is seeking an LPN/LVN with managed care experience... ...pre-service and post-service utilization reviews and appeals for DMEPOS... ...necessity reviews meet NCQA UM standards, using InterQual and... ...The role supports a nationwide remote workforce with competitive...Remote job
$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
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