Remote Utilization Review RN - Insurance/URAC Expertise
Innovative Systems Group
A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and knowledge of accreditation standards. Candidates must reside in IL or TX and possess strong communication skills to interact with providers and members. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review RN - Insurance/URAC Expertise in Richardson, TX vacancy
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
IntePros
New York, NY1 day ago $46 per hour
...Registered Nurse-Utilization Review Job ID #2038951... ...Review Registered Nurse (RN) supporting a health plan or insurance organization, you will use your clinical expertise to evaluate the medical necessity... ...$46.00 / hour Remote, California Profession...Remote workTotalMed Staffing
United States4 days ago- ...vision insurance, paid time off, paid holidays, tuition... ...assistance, 403(b), remote work United States,... ...AM - 5:00 PM As a Utilization Review Registered Nurse for Johns... ...~ Knowledge and expertise in utilizing various criteria... ...Registered Nurse (RN) license in Maryland (...Remote workFull timeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD2 days ago - USI Insurance Services seeks an experienced RN Utilization Review Nurse to assess workers' compensation care for MA licensure holders. Remote opportunities exist for East Coast candidates with MA licensure. The role evaluates medical necessity, ensures guideline adherence...Remote job
$75k - $100k
Description Our Utilization Management RN (Registered Nurse... ...judgment to review medical services... ...We are open to remote work in the following... ..., regulatory and URAC standards. Minimum... ..., and insurance benefits. ~ Strong... ...diverse experience and expertise that includes:...Remote workFor contractorsWork at officeLocal areaImmediate startWPS Health Solutions
Kansas City, MO4 days ago$30 - $38 per hour
...Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑... ...external audits to include URAC and NCQA. Maintain HIPAA compliance... ...successfully perform in a remote healthcare environment.... ...that values your expertise Technology and equipment support...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend workSanta Barbara Cottage Hospital
New York, NY4 days ago- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
Berkshire Hathaway Homestate Companies
Omaha, NE4 days ago - ...Concierge Home Care in Jacksonville, FL is seeking an experienced Utilization Review Specialist (RN) to join its remote home health team. The ideal candidate should have strong expertise in OASIS, coding, QA, and home health documentation review. This role offers flexibility...Remote work
Concierge Home Care
Jacksonville, FL4 days ago - ...A national insurance group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and ensure compliance... ...Candidates should have a BSN or RN degree and at least 5 years of... ...The position offers options for remote work, health insurance, and other...Remote workFull time
Berkshire Hathaway Homestate Companies
Omaha, NE3 days ago $2,210 per week
...and voluntary life insurance. Critical Illness,... ...Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces... ...knowledge of URAC guidelines, Hines... ...is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hoursHines
Freeport, IL1 day ago- USI Insurance Services seeks a licensed RN to assess and approve medical treatments for workers’ compensation claims. Remote opportunities exist on the East Coast; MA RN license required. The... ...medically necessary care. You will review requests, advocate for injured workers...Remote job
- ...is seeking a Registered Nurse (RN) Medicare Quality Assurance Reviewer to support their Utilization Management team. The role involves providing clinical expertise, conducting quality assurance reviews... ...a competitive salary with remote work flexibility and numerous employee...Remote job
- ...Epidemiologists is seeking a Clinical Utilization Review Nurse (RN) to conduct utilization management reviews remotely. Candidates must hold a BA/... ...providing subject matter expertise in a remote environment.... ...medical, dental, vision insurance, and additional paid time off...Remote jobFull time
- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to... ...Systems policies on Health Insurance Portability and... ...professional development and expertise in utilization review.... ...required for facility based staff; optional for remote staff.Remote workWork at office
Nexus Health Systems
Houston, TX5 days ago - ...faculty or staff position, please review this tip sheet ( . The Case Manager RN (U) coordinates the overall... ...family, healthcare personnel, and insurers. Evaluates the needs of the patient... ...avoidable days. Enter Ancillary notes utilizing the templates for care...Remote workFull timeTemporary workWorldwide
University of Miami
Miami, FL2 days ago - ...Case Manager RN (U) The Case Manager RN (U) coordinates the... ...family, healthcare personnel, and insurers. Evaluates the needs of the... ...days. Enter Ancillary notes utilizing the templates for care... ...develop patient care plans and review medical needs for continued hospital...Remote work
University of Miami
United States2 days ago - ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workContract workWork from home
Medix
New York, NY2 days ago $69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare... ...Ideal candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote workMVP Health Care
Schenectady, NY5 days ago- ...Registered Nurse for a clinical review role. You will evaluate patient data... ...Friday, 9:30 AM to 6:00 PM, with a remote setting. Qualified candidates will have a current RN license, 3–5 years of acute care experience, and familiarity with URAC guidelines. #J-18808-Ljbffr...Remote workMonday to Friday
Hines
Rockford, IL1 day ago $23.76 - $51.49 per hour
...Molina Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly payMolina Healthcare
Nevada, IA3 days ago- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring... ...closely with healthcare providers, insurance companies, and case managers to... ...Utilization Review Specialist applies clinical expertise and analytical skills daily to...Remote work
Bradford Health Services
United States4 days ago - ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
Guidehealth
Chicago, IL1 day ago - ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of Assignment: 13 weeks Shift / Hours...Remote workShift workWeekend work
AMN Healthcare
United States4 days ago - ...offering a unique opportunity with no nights, weekends, or holidays. Utilize your mental health and substance abuse experience in a dedicated... .... The role requires direct patient assessment and adherence to URAC guidelines while maintaining quality standards. Enjoy...Remote workFlexible hoursWeekend work
Hines and Associates
Rockford, IL3 days ago - COMAGINE HEALTH is seeking a Clinical Utilization Review Nurse (RN) for a full-time remote position, focused on medical necessity assessments in healthcare. Applicants must have a BA/BS in Nursing and at least 3 years of clinical experience. The role requires strong communication...Remote jobFull timeContract workWork from home
- ...telephonic and e-referral case review and authorization of services utilizing established mental health... ...is full-time, fully remote (work from home) and... ...Include: • One (1) year health insurance plan experience or... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States4 days ago $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 workHourly payPart timeSanta Barbara Cottage Hospital
New York, NY4 days ago$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend workPacer Group
Everett, WA5 days ago$45k - $70k
...United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use... ...and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for... ...benefits package including health insurance, retirement plans, and paid...Remote workDane Street
New York, NY7 days ago- ...TurningPoint Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be a Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking skills and attention to detail. The...Remote work
Alumni Ventures
Florida, NY5 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review RN - Insurance/URAC Expertise. Be the first to apply!
Related searches
- rn relocation bonus Richardson, TX
- flex rn Richardson, TX
- charge registered nurse Richardson, TX
- ccu rn Richardson, TX
- international registered travel nurse Richardson, TX
- interventional radiology rn Richardson, TX
- rn risk management Richardson, TX
- travel clinic rn Richardson, TX
- rn quality Richardson, TX
- private rn Richardson, TX