Utilization Management Nurse RN
$45 - $45.5 per hourMindlance
Overview Job Title: Nurse Case Management Senior Analyst Location: REMOTE Duration: 5-6 Months (Contract possibly Extension) Schedule: Monday - Friday 8am-5pm (EST or CST); no weekends, evenings, or overtime. 8 hours per day, 40 hours per week. Base pay range $45.00/hr - $45.50/hr Job Profile Summary Nurse Case Management Senior Analyst Delivers specific delegated tasks assigned by a supervisor in the Nurse Case Management job family. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Provides clinical assessments, health education, and utilization management to members. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. Manages own caseload and coordinates all assigned cases. Completes day-to-day Nurse Case Management tasks without immediate supervision, but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members. RN and current unrestricted nursing license required. Required Qualifications MCG or Interqual Experience, 2 years of Utilization Management Experience. EEO “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” Employment details Seniority level: Mid-Senior level Employment type: Contract Job function: Analyst and Health Care Provider Industries: Hospitals and Health Care Referrals increase your chances of interviewing at Mindlance. Get notified about new Registered Nurse jobs in United States. #J-18808-Ljbffr Mindlance
- ...Mass General Brigham is seeking a Peer-to-Peer Utilization Review Nurse to join the Central Utilization Management team. This role involves evaluating payer denials... ...will have a Bachelor's of Science in Nursing, an RN license, and extensive experience in clinical nursing...SuggestedRemote workFlexible hours
- A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...SuggestedRemote workFlexible hoursWeekend workDay shift
$29.1 - $62.32 per hour
...CVS Health is seeking an experienced Registered Nurse for a remote position focusing on Utilization Management. The role offers a flexible work schedule requiring weekend... .... The selected candidate must possess active RN licensure and at least 3 years of nursing experience...SuggestedHourly payRemote workFlexible hoursWeekend work$85k - $105.34k
...Utilization Review Nurse Remote; Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 974... ...Exempt. Position Purpose The Utilization Management Nurse evaluates clinical service... ...Minimum Qualifications Active, unrestricted RN license (BSN or MSN) in Oregon or a...SuggestedFull timeWork at officeLocal areaImmediate startRemote workMonday to Friday$26.35 - $39.53 per hour
...experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-... ...services provided to members under a managed care health plan. This role involves... ...Education: Registered Nurse (RN) or Licensed Vocational/Practical Nurse...SuggestedHourly payWork at office$75 per hour
Utility Management Nurses | $75/hr Remote This range is provided by Crossing Hurdles. Your actual pay will be based on your skills and experience... ...coding, and privacy standards. Requirements Registered Nurse (RN) or equivalent clinical background. Strong experience (3-5+...Remote jobHourly payContract workPart timeFlexible hours$69.8k - $96.2k
...part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the... ...impact Required Qualifications Licensed Registered Nurse (RN) with compact license with no disciplinary action or in process...Remote jobBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome office$35 - $37 per hour
...job poster from The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $36-37/hr Start Date: April 7th Licenses... ...their travel assignments. No NPs, whether practicing or not. Utilization Review experience is helpful but not required; critical...Remote jobPermanent employmentFull timeTemporary workMonday to Friday- We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’ll perform both inpatient and outpatient utilization reviews while supporting transitions of care and ensuring patients...Remote work
- ...healthcare provider in New Jersey is seeking a Quality Management Nurse to oversee patient care quality. This role... ...an Associate's degree in Nursing, a New Jersey RN license, and experience in clinical nursing or utilization review. The position offers competitive...
$45k - $70k
A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote job- A community hospital in Arizona is seeking a Utilization Management Nurse to ensure healthcare efficiency and quality through diligent review of medical records and adept communication. You'll engage with multiple stakeholders to uphold clinical decision-making and regulatory...
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...provide own equipment Must have an active PA license or a Nurse Licensure Compact to include PA. **Minimum of three (3) years...Immediate startRemote workWeekend workDay shift
$45k - $70k
A healthcare management firm is seeking a Utilization Management Nurse Reviewer to ensure efficient use of medical services. The role involves reviewing medical records, assessing treatment necessity, and collaborating with healthcare providers. Candidates should possess...Remote job- A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote job
$29.1 - $62.32 per hour
...will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary Utilize your clinical experience and skills in a... ...directed. Required Qualifications Registered Nurse Education: Diploma RN acceptable; Associate degree/BSN...Full timeTemporary workWork at officeLocal areaWork from homeShift workWeekend work- 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 inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote job
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
- Adventist Health is seeking a skilled Registered Nurse to ensure high-quality patient care while managing medical resources efficiently. This role requires conducting... ...acute hospital experience, including two years of utilization review experience. Adventist Health champions the...
- ...quality care while efficiently utilizing medical resources. Reviews... ...Experience: Associate’s Degree in nursing or equivalent combination of... ...: Registered Nurse (RN) licensure in the state of practice... ...to the on-site care management teams when appropriate. Reviews...Remote jobPart timeWork experience placement
- A healthcare solutions company is seeking a Utilization Management Nurse Reviewer to assess the appropriateness of medical services and collaborate with healthcare professionals. This role requires a Licensed Practical/Vocational Nurse with clinical experience and skills...
- ...endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen... ...Position Title: Registered Nurse (RN) – ACO House Call Services... ...care transitions, reducing avoidable utilization, closing care gaps, and enhancing patient...Work at officeRemote workWeekday work
$69.8k - $96.2k
A leading health services company is looking for a Utilization Management Nurse 2 to utilize clinical skills, coordinate with providers and members, and ensure optimal treatment. Candidates should be licensed RNs with 3-5 years of clinical nursing experience, preferably...Remote job- ...RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN as Utilization...Full timeLocal areaWork from home
- Healthfirst is seeking a Manager of Utilization Management to provide oversight for Case Management teams, ensuring high quality and cost-effective services. Responsibilities include managing authorizations, coaching staff, and collaborating with medical professionals....Work at office
- Join Santa Barbara Cottage Hospital as a Utilization Management Nurse Lead, where you will leverage your clinical expertise to coordinate care and... ...in a remote role involving travel. A bachelor’s degree and RN license in Michigan are required. #J-18808-Ljbffr Santa Barbara...Remote job
$116.8k - $168.81k
Healthfirst, Inc. is seeking a Manager of Utilization Management responsible for overseeing Case Management teams to ensure high-quality patient care and efficient use of resources. You will manage authorizations, develop staff, and collaborate with medical professionals...$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...Hourly payPart timeRemote work$85.7k - $128.54k
## Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)Applyremote type: Fully Remotelocations: Anywhere in the U.S.time type: Full timeposted on: Posted Yesterdayjob requisition id: R2053Alignment Health is breaking the mold...Remote jobImmediate startMonday to Friday- ...and provide, ongoing coordination and management of service delivery through an integrated... ...and quality standards related to Utilization Management. Maintain and submit reports... ...degree Valid New York State Registered Nurse (RN) required. Minimum three (3) years Medical...Work at office
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