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
- Truman Medical Centers is seeking a Utilization Management RN for a part-time position working from home. The role involves partnering with interdisciplinary... ...regulatory standards. Applicants should have a BSN or a Nursing graduate degree, an active RN license in Missouri, and at...SuggestedRemote jobPart timeWork from home
- 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 jobFlexible hoursWeekend workDay shift
- Job Summary/Purpose Conducts utilization reviews to determine if patients are receiving care... ...and Education Bachelor's degree in Nursing from an accredited school of nursing and... ...including two years of utilization / case management experience in a hospital setting....SuggestedWork experience placementRotating shiftDay shift
$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...SuggestedRemote 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...SuggestedRemote work
$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication... ...Qualifications Must hold a Compact Registered Nurse (RN) license in your state of residence. Greater than one...Bi-weekly payTemporary workRemote work$71.1k - $97.8k
A leading health solutions company is seeking a Utilization Management Registered Nurse to join their remote team. This role involves using clinical nursing... ...manage post-acute care. Candidates must hold a Compact RN license and possess over one year of clinical experience...Remote job- ## Clinical Denials Utilization Review RN - FT - Day - Utilization Resource Management Pennington NJApplylocations: RMCtime type: Full timeposted on: Posted Todayjob... ...significant investments in our exceptional physicians, nurses and staff, as well as advanced technology....Full timeTemporary workPart timeFlexible hours
- About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working...Contract workWork at officeRemote work
- Santa Barbara Cottage Hospital is seeking a qualified nurse for utilization review responsibilities. The role requires a Bachelor's degree in... ...experience, with at least two years in utilization or case management. Excellent communication skills are essential, along with...Full timeShift work
$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- Curana Health, Inc. is seeking a Utilization Management Nurse to join their remote team. In this role, you will review healthcare services' utilization to ensure cost-effective care while actively coordinating transitions and discharges for patients. You will engage closely...Remote job
$71.1k - $97.8k
A leading health organization is seeking a Utilization Management Registered Nurse to support coordination and documentation of medical services. The ideal candidate holds a Compact RN license and has over one year of clinical experience. Responsibilities include interpreting...Remote job$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- 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
$26.01 - $74.78 per hour
...Summary CVS Health Aetna has an opportunity for a full‑time Utilization Management (UM) Nurse Consultant. As a Utilization Management Nurse Consultant,... ...utilization. Required Qualifications Registered Nurse (RN) with current unrestricted US licensure required. 2+ years...Hourly payFull timeTemporary workWork at officeLocal areaFlexible hours$60k
...is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual... ...: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include but are not limited...Temporary workLocal areaRemote work- 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
- A healthcare provider in the United States is seeking a Utilization Management Nurse to work remotely. This role involves performing clinical utilization reviews, collaborating with healthcare partners, and adhering to national standards and regulations. Candidates must...Remote jobWork at office
- ...Healthcare Solutions is currently seeking a motivated Nurse Supervisor who will be responsible for overseeing Utilization Management activities. This full-time position involves... .... Required qualifications include an active RN license, an Associate's Degree with a preferred...Full time
- A healthcare organization is seeking a dedicated Utilization Management LVN to ensure timely access to care. This remote role involves coordinating authorization workflows, reviewing clinical documents for CPT verification, and supporting high-needs members. Required qualifications...Remote job
- ...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...
- ...bring your talents to our team! POSITION OVERVIEW Candidate should reside in Texas Harbor Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN supports prior authorization and utilization review activities to ensure timely and appropriate access...Remote jobLocal areaMonday to FridayShift work
$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...
- ...Inc. in Georgia is seeking a Registered Nurse UR Specialist. Key responsibilities include managing insurance notifications, obtaining... ...years in acute care and 1-2 years in utilization review. This position requires a Georgia RN license and a commitment to effective...
$26.01 - $68.55 per hour
4062 Aetna Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant to work remotely. The role requires an active RN license and a minimum of 3 years of RN experience. Responsibilities include reviewing clinical information, making...Remote jobHourly payFull time$26.01 - $68.55 per hour
Medicare Precertification Utilization Management Nurse Consultant (Remote) Schedule: Monday-Friday, 9:00AM - 6:00PM (local time); includes occasional... .... About the Role We’re seeking a Registered Nurse (RN) with strong clinical judgment to join our Utilization Management...Hourly payFull timeWork at officeLocal areaRemote workMonday to FridayAfternoon 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- 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
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