Remote RN, Utilization Management I - Elevate Care
CareOregon, Inc.
- Remote job
CareOregon, Inc. is looking for a Registered Nurse for Utilization Management, primarily focused on benefit management, appeals, and health-related services. This role is remote, requires an Oregon RN license, and offers competitive pay along with extensive benefits. The ideal candidate will have at least 2 years of RN experience and familiarity with healthcare regulations, geared towards ensuring quality patient care. #J-18808-Ljbffr CareOregon, Inc.
- ...MMQ in nursing facilities. The role requires close collaboration with clinicians to discuss patient care and justify decisions. Qualifications include an unrestricted MA RN license, MDS certification or proof, and experience in long-term care and healthcare. Significant...Remote job
- ...recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an... ...include evaluating healthcare services and coordinating care for members. Join a dynamic team and make a meaningful impact...Remote workContract work
$71.1k - $97.8k
...solutions company is looking for a Utilization Management Registered Nurse to interpret and... ...coordinate medical services. This fully remote position requires a Compact RN license and over a year of... ...established criteria and collaborating with care providers. The position offers a...Remote work- ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers... ...with clinicians to optimize resource use and care quality. Qualifications include a NLN-accredited nursing...Remote jobPart timeWork from home
$75.3k - $135.4k
...Corporation is seeking a Clinical Supervisor to oversee the utilization management team ensuring appropriate care for members. The ideal candidate will supervise day-... ...experience in a related field, along with an active RN license in California. This position offers a salary...Remote work$71.1k - $97.8k
...healthcare organization is seeking a Utilization Management Registered Nurse to support the... ...documentation of medical services. This remote position requires a valid RN license and clinical experience.... ...and ensuring appropriate care delivery. The role offers a pay range...Remote work$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work$71.1k - $97.8k
...Humana Inc is seeking a dedicated Utilization Management Nurse to join their team in Topeka, Kansas.... ...clinical knowledge to provide appropriate care for members and coordinate with various... .... Candidates must have an active RN license, at least 3 years of experience...Remote workFull timeWork at office- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
$71.1k - $97.8k
...the United States is seeking a Utilization Management Registered Nurse to utilize... ...services and ensure appropriate care levels for members. This role... ...should possess a Compact RN license and at least one year... ...experience. The position offers a remote work option and includes a...Remote work- ...California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-Authorization... ...facilitate team meetings. A California RN license is required. This position... ...and focuses on improving patient care and operational efficiency. Join us in...Remote work
- ...healthcare organization is looking for a Utilization Management Registered Nurse to work remotely in Cheyenne, Wyoming. You will utilize... ...services and ensure appropriate care levels. The ideal candidate will hold a Compact RN license and have over one year of clinical...Remote work
- ...Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote workFlexible hours
- ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant... ...position offers the flexibility of remote work while supporting professional...Remote work
- ...designated as a regional Coordinated Care Organization (CCO) for... ...Together. This is a remote position in which we are able... ...experience: ~ ~ Health plan utilization management ~ Medicare and Medicaid rules... ...Current unencumbered Oregon RN License required within 90 days...Remote work
- ...Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified...Remote work
$54.38 - $73.41 per hour
ENL Utilization Management Compensation range: $54.38 - $73.41 Your rate of pay... ...services, and our mission is to elevate the health of the... ...on hiring the right team to care for our patients and their families... ...our team. **This position is remote.** POSITION SUMMARY: The...Remote workDaily paidWork at officeImmediate startFlexible hoursShift work- ...reimbursement, and high-quality patient care across skilled nursing and... ...with some flexibility for remote work based on business needs.... ...~ Active, unrestricted RN license in the state of Massachusetts... ...experience ~ Experience in utilization management, medical record review, or...Remote workWeekend workWeekday work
- WPS Health Solutions in Georgia seeks a Utilization Management RN to evaluate medical necessity and authorize services... ..., 4+ years in nursing, 2+ years in managed care, and strong coordination with health care teams. Remote work options are available in several states,...Remote job
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct... ...utilization reviews, support transitions of care, and ensure compliance with Medicare Advantage regulations...Remote job
$39 - $40 per hour
...Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the... ...evaluating healthcare services, coordinating care, and ensuring members receive high-quality...Remote workDaily paidContract workMonday to FridayShift workWeekend work- WPS Health Solutions seeks a Utilization Management RN to assess medical necessity and authorize services... ...and Medical Directors to optimize care. The role requires 4+ years of RN experience... ...analytical and communication skills. Remote work options available within approved...Remote job
- CommonSpirit Health is seeking a Supervisor of Utilization Management (UM). This remote position requires overseeing the Pre-Authorization team while ensuring... ...will be essential in promoting quality patient care. The ideal candidate will have significant experience in...Remote job
- ...Health Solutions is seeking an experienced Utilization Management RN to evaluate medical necessity, authorize services, and coordinate patient care for our Health Plan. You will review... ...cases to medical directors. This remote-friendly role requires strong clinical...Remote job
- ...Solutions in the United States is seeking an experienced Utilization Management RN to evaluate medical necessity and authorize... ...judgment and evidence-based criteria to support quality care while controlling costs. Remote work is available in many states; expect...Remote job
- WPS Health Solutions is seeking an Utilization Management RN to evaluate medical necessity and efficiency... ...are not met. The position supports remote work in approved states, including Michigan... ...collaboration and maintaining quality care while controlling costs. #J-18808-...Remote job
- ...experienced nurse for complex case management and medical necessity determinations... ...Medical Director to ensure quality care and appropriate utilization. The role emphasizes nursing judgment... ...cross-functional collaboration, with remote work options and a hybrid attendance...Remote job
- TEXAS INDEPENDENCE HEALTH PLAN INC is hiring a Utilization Management Nurse to work remotely in Texas. This position requires evaluating inpatient and outpatient... ...vital to ensuring that members receive the necessary care while maintaining compliance with regulations. #J-188...Remote job
- The Carle Foundation in Illinois is seeking an Illinois Licensed Utilization Management RN to work remotely full-time, coordinating patient care, ensuring cost-effective services, and verifying medical necessity criteria during concurrent reviews and documentation. You...Remote jobFull time
- ...Barbara Cottage Hospital is seeking a Per Diem RN for Utilization Management Review. This role offers the flexibility of remote work and requires a valid MA Registered Nurse... ...will participate in ensuring quality patient care through thorough utilization reviews. Responsibilities...Remote jobDaily paid
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