Remote RN: Care Review & Utilization (AZ)
Molina Healthcare
Molina Healthcare is seeking a Registered Nurse (RN) for a remote position supporting the Arizona state plan. The candidate will assess inpatient services, analyze clinical requests, and collaborate with multidisciplinary teams to ensure quality care. A strong background in hospital acute care and experience with prior authorization is preferred. Candidates must have an active Arizona RN license and at least 2 years of relevant experience, with skills in critical thinking and communication. A competitive benefits package is included. #J-18808-Ljbffr
- ...achieve optimal health, access to care and appropriate utilization of resources, balanced with the... ...to Central Utilization Review LVN/LPN Case Manager and/or Central... ...Location DAYS: Tuesday thru Saturday schedule. Remote, but you must live locally in AZ. #J-18808-Ljbffr...Remote workWork at office
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...system, and need for services for care plan development. Monitor delivery...Remote workHourly payFull timeContract workImmediate startShift work3 days per week$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...system, and need for services for care plan development. Monitor delivery...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
- ...telephonic and e-referral case review and authorization of services utilizing established mental health... ...to provide quality care appropriate to clinical needs... ...position is full-time, fully remote (work from home) and... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...A leading healthcare organization is seeking a remote RN to ensure appropriate administration of hospital resources and quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations. The ideal candidate...Remote work
- ...Memorial Hospital, Inc. is seeking a full-time RN UR Specialist in Albany, GA. Responsibilities... ...notifications and certifications for Utilization Review, ensuring compliance with regulations while supporting patient care. Candidates should possess an Associate Degree...Remote workFull time
- ...COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services... ..., alongside a minimum of 3 years of direct patient care experience. The role involves applying Medicaid...Remote workFull time
$23.76 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...care model. • Adheres to utilization management (UM) policies and procedures... .... • Registered Nurse (RN). License must be active and...Remote workHourly payWork experience placementWork at office- ...Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including... ...Licenses in Oregon and Washington. This role encompasses care coordination and discharge planning, along with various compliance...Remote work
$1,949.74 per month
...Nurse Specialty Utilization Review Job ID 17979666... ...Title Utilization Review RN Weekly Pay $1949.7... ...Job Description Remote Utilization Review RN responsible... ...hospital guidelines in an acute care setting. Client Details...Remote workWeekly payShift work- ...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
- ...healthcare organization is seeking a registered nurse for a remote position focused on utilization review. Candidates should have 2 years of experience in a... ...medical necessity. Responsibilities include assessing care levels and ensuring efficient use of healthcare...Remote work
$47.06k - $70.24k
...A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting... ...claims examiners. Candidates must have a current RN license and at least four years of clinical...Remote work- ...MVP Health Care is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team. In this remote role, you will conduct clinical reviews to ensure compliance with Medicare guidelines and support high-quality patient outcomes. The ideal candidate...Remote work
$23.76 - $51.49 per hour
...Clinical Member Services Reviewer Provides support for clinical member... ...integrated delivery of care across the continuum. Contributes... ...Molina care model. Adheres to utilization management (UM) policies and... .... Registered Nurse (RN). License must be active and unrestricted...Remote workHourly payWork experience placementWork at office- ...Providence is seeking an experienced RN for Utilization Review to provide essential patient care while working remotely in Irvine, California. This role involves conducting clinical reviews and managing utilization efficiently in a dynamic regulatory environment. The...Remote workDaily paid
$49.34 - $76.59 per hour
...A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse... ...manages medical management programs to optimize patient care. Competitive salary range for Portland is $49.34 - $76.5...Remote work$45.9 - $71.4 per hour
...Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development...Remote workHourly payLocal area$45.9 - $71.4 per hour
...Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan... ...thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your...Remote workMinimum wageLocal areaShift work- ...completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees... ...for 6-8 weeks. This role will be remote, including most training but monthly... ...patients, including critical care, for appropriateness of admission...Remote workRelief3 days per week
$35.29 - $47.37 per hour
...and their work-life balance Remote work options and Flexible scheduling... ...the Quadruple Aim of health care reform: member engagement and... ...hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed... ...Work Location: OR, CA, AZ, TX, FL Salary: $35.29 - $47....Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours- ...RN Utilization Review Manager, responsible for overseeing the daily operations of Utilization Management staff in a full-time, salaried position... ...required; BSN preferred) 1-2 years of experience in care management or utilization management 1+ year of informal leadership...Remote workFull time
- ...Job Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective... ...thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect....Remote workDaily paidMinimum wageLocal areaShift workDay shift
- ...Health Partners is looking for an RN Concurrent Review nurse to guide utilization management efforts in our mission-driven... .... This role offers hybrid or fully remote arrangements, with major... ...transforming healthcare from sickness care to wellness guidance. #J-18808-Ljbffr...Remote job
$57.28 - $88.92 per hour
...Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective,... ...and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your...Remote workDaily paidMinimum wageLocal areaShift workDay shift- Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New York Tri-State Area. The successful candidate will be responsible for assessing member needs and ensuring high-quality...Remote jobFull time
$51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in Utilization...Remote workDaily paidLive inShift workDay shift- A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...Remote jobFlexible hours
- BJC HealthCare is seeking a Full-time Remote RN to support its various units. The ideal candidate will have at least 2 years of experience in Utilization Review and providing care to hospitalized patients. This role includes no direct communication with patients, emphasizing...Remote jobFull time
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