Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic

$60.2k - $107.4k

divvyDOSE

Pearland, TX
  • Remote job

Concurrent Review Case Manager

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to established criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations. This position works closely with Medical Management Physician leadership and various internal departments.

4 - 10 hour shifts per week and includes every Saturday and Sunday.

The employee is required to work both Saturday and Sunday each week as part of their regular schedule (two of the four scheduled shifts).

The remaining two (2) shifts will be scheduled on weekdays (Monday through Friday) based on business needs and in coordination with management.

The assigned weekday shifts may be adjusted as operational needs dictate. Whenever possible, schedule changes will be communicated at least two (2) weeks in advance.

Shift start and end times will be established based on operational requirements and will comply with all applicable federal, state, and local employment laws and regulations.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Associate Degree in Nursing or higher
  • Active Texas RN license or multistate compact RN license
  • 5+ years of nursing experience in concurrent review
  • Managed Care knowledge

Preferred Qualifications:

  • Certification in area of specialization, BSN
  • ACP certification
  • Case Management Certification
  • 2+ years in area of specialization, 2+ years of Case Management/Utilization Review experience
  • Proven program development skills
  • Proven communication and problem-solving skills; Computer literate

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

divvyDOSE
Vacancy posted 9 hours ago
Similar jobs that could be interesting for youBased on the RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic in Pearland, TX vacancy
  • $47.69 - $94.06 per hour

     ...Description The Utilization Review (UR) Nurse has a strong clinical background blended with...  ...Utilization Management (UM), medical necessity and patient...  ...comprehensive admission, concurrent and retrospective UR...  ...Olympia Workplace Type: Remote Pay Range: $47.69 - $9... 
    Remote work
    Minimum wage
    Full time
    Local area
    Shift work

    Providence Health and Services

    Olympia, WA
    6 hours ago
  • $69.38k - $92.28k

     ...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum...  ...to transition into utilization management, requiring strong clinical judgment and excellent communication skills. The position... 
    Remote work

    MVP Health Care

    Schenectady, NY
    18 hours ago
  •  ...Centene Corporation seeks a clinical professional for their Medical Management/Health...  ...Services team. This role includes performing concurrent reviews to assess patient care, health, and...  ...experience. The position offers a flexible remote working arrangement for candidates in... 
    Remote work
    Hourly pay
    Flexible hours

    Centene Corporation

    Topeka, KS
    2 days ago
  •  ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines and support high-quality patient outcomes. The role requires current... 
    Remote work

    MVP Health Care

    New York, NY
    1 day ago
  • $69.38k - $92.28k

     ...the Opportunity As a Professional Concurrent Review RN, you'll have the opportunity to apply...  ...setting while partnering with providers and clinical leadership. You'll be part of an...  ...Where you'll be: Location: Remote Pay Transparency MVP Health Care... 
    Remote work
    Contract work

    MVP Health Care

    Rochester, NY
    4 days ago
  •  ...Job Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts...  ...prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily... 
    Remote work
    Daily paid
    Minimum wage
    Local area
    Shift work
    Day shift

    Providence Health & Service

    United States
    3 days ago
  •  ...Overview Clinical Review Nurse - Concurrent Review TX Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm-...  ...4 years is preferred. Years of experience: UM experience preferred but not required. Disqualifiers... 
    Remote work
    Contract work
    Shift work

    ESR Healthcare

    Wausau, WI
    3 days ago
  • $75k

     ...RESPONSIBILITIES Performs concurrent inpatient utilization review using InterQual...  ...Engage in clinical collaboration with attending...  ...quality issues to UM Leadership Collaborates...  ...QUALIFICATIONS RN graduate from an...  ...process. Location - Remote WNS HealthHelp (A... 
    Remote work
    For contractors
    Work at office
    Local area
    Monday to Friday
    Flexible hours

    WNS Global Services

    Houston, TX
    1 day ago
  • $60.2k - $107.4k

    Stryker Corporation is seeking a Concurrent Review Case Manager to oversee the telephonic monitoring...  ...an Associate Degree in Nursing, a Texas RN license, and at least 5 years of...  ...review nursing experience. The job offers remote work within the U.S. and a competitive salary... 
    Remote job
    Shift work

    Stryker Corporation

    Pearland, TX
    1 day ago
  • $35.62 - $52.99 per hour

     ...As our Utilization Review LVN, your focus will be...  ...facility review or in concurrent review. To be successful...  ...operational flow. As a remote employee, we will...  ...Utilization Management (UM) experience Five (5)...  ...nursing requirements in a clinical setting Knowledge of... 
    Remote work
    Contract work

    Dignity Health

    Rancho Cordova, CA
    2 days ago
  • $55 per hour

     ...Akkodis Akkodis is hiring a Concurrent Review Nurse to support our...  ...space. Location: Remote (must be based in California...  ...of three (3) years of clinical experience as a Registered...  ...within the scope of RN practice in California....  ...Out-Patient Case Manager UM LVN Delegation... 
    Remote work
    Full time
    Contract work
    Temporary work
    Local area

    Akkodis

    California, MO
    1 day ago
  • $30.37 - $59.21 per hour

     ...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...  .... Adheres to utilization management (UM) policies and procedures. Required...  ...and experience. Registered Nurse (RN). License must be active and unrestricted... 
    Remote job
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    California, MO
    1 day ago
  • $29.05 - $67.97 per hour

    Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity...  ...Michigan is not included in a compact RN license. Job Duties Facilitates...  ...prospective, retrospective, and concurrent review of appeals for denied... 
    Remote job
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Albany, NY
    1 day ago
  • $28.94 - $51.63 per hour

     ...Registered Nurse Opportunity Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the...  ...on the unit, under the supervision of a Nurse Supervisor, or RN Coordinator. The RN applies clinical nursing knowledge and utilizes... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area

    UnitedHealthcare At Home

    Houston, TX
    19 hours ago
  • $28.94 - $51.63 per hour

     ...62104 Job category: Nursing Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the...  ...roles you may be interested in. Required Qualifications: ~ RN required education ~ RN License ~ CPR/BLS ~3+ years of... 
    Hourly pay
    Daily paid
    Minimum wage
    Full time
    Work experience placement
    Summer holiday
    Local area
    Shift work

    UnitedHealth Group

    Houston, TX
    2 days ago
  • $28.94 - $51.63 per hour

     ...Explore opportunities with Kelsey-Seybold Clinic , part of the Optum family of businesses. Work with one of the nation's leading health care organizations...  ...~ Associate of Science in Nursing (ASN) or higher ~ Texas RN license ~ American Heart Association Basic Life Support (... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area

    Optum

    Houston, TX
    1 day ago
  • $28.94 - $51.63 per hour

     ...66686 Job category: Nursing Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the...  ...together. We are seeking qualified candidates for the role of RN Hematology/Oncology at varying levels (I, II). The selected... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area

    UnitedHealth Group

    Webster, TX
    18 hours ago
  • $35 - $63 per hour

     ...Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations...  ...competency in a multidisciplinary surgical environment. The RN demonstrates proficiency in delivering high-quality, age-... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area
    Shift work

    Optum

    Houston, TX
    19 hours ago
  • $28.94 - $51.63 per hour

     ...Explore opportunities with Kelsey‑Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations...  ..., organizational and professional standards. The Cardiology RN will also facilitate the cardiologists treatment plan and... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Immediate start

    Texas Health Institute

    Phoenix, AZ
    1 day ago
  • A healthcare company is seeking a Clinical Review Nurse for a remote role in Texas. This position involves...  ...The ideal candidate will have a Texas RN license and 2-4 years of related...  ...responsibilities that include performing concurrent reviews and collaborating with... 
    Remote work
    Contract work

    ESR Healthcare

    Wausau, WI
    3 days ago
  • $35 - $62.5 per hour

     ...Registered Nurse Coordinator Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the...  ...Required Qualifications: ~ Graduate from an approved RN nursing program ~ Valid and current Texas RN license ~ Current... 
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area

    Genoa Telepsychiatry

    Houston, TX
    3 days ago
  • $53.46 - $79.52 per hour

     ...RN Supervisor Um Prior Auth Inspired by faith. Driven by innovation....  ...annually through more than 2,300 clinics, care sites and 158 hospital...  ...patient care. As a remote employee, we will provide you...  ...appropriate evaluation of referral reviews, correct selection of... 
    Remote work
    Work at office

    Common Spirit Health

    Rancho Cordova, CA
    3 days ago
  • $74.29k - $111.43k

     ...Medicare, and Medicaid. NeueHealth delivers clinical care to health consumers through our...  ...experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for...  ...Qualifications Education: Registered Nurse (RN) with an active, unrestricted California... 
    Work at office

    NeueHealth

    Los Angeles, CA
    18 hours ago
  • $40 - $42 per hour

     ...currently looking for a  Care Review Clinician I to work...  ...***This is a fully remote role but candidates must have a valid RN license in Illinois***...  .... Assess and analyze clinical service requests (e.g.,...  ...prior authorizations and/or concurrent review. Assesses services... 
    Remote work
    Hourly pay
    Local area
    Monday to Friday

    AltaStaff, LLC

    Chicago, IL
    11 days ago
  •  ...UM Nurse Reviewer Under the guidance of the Utilization Management, the...  ...of pre-certification and/or concurrent requests, aligning with established...  ...medical necessity, applying clinical knowledge to ensure proper...  ...Current California RN or LVN license At least one... 
    Immediate start

    Universal Healthcare MSO, LLC

    Bakersfield, CA
    3 days ago
  •  ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates... 
    Remote work
    Work at office

    IMCS Group

    New York, NY
    4 days ago
  •  ...Management Location: 100% Remote Schedule: M-F 9:00am...  ...have an Illinois state RN license Assess and analyze clinical service requests (e.g.,...  ...medical necessity/utilization review and other utilization...  ...authorizations and/or concurrent review. Assesses services... 
    Remote work
    Contract work

    Integrated Resources

    Springfield, IL
    2 days ago
  • $1,966 per week

     ...Holidays Work-life balance. Remote/hybrid setting (once...  ...will utilize clinical knowledge and communication...  ...decision to a second level reviewer. This individual interfaces...  ...precertification and concurrent review within the...  ...but is not limited to RN, LMSW, LMHC. Successful... 
    Remote work
    Full time
    Temporary work
    Part time
    Work at office
    Work from home
    Monday to Friday
    Flexible hours

    Hines

    Rockford, IL
    18 hours ago
  •  ...Position Summary Concurrent Review Nurse is responsible for performing utilization...  ...of stay in accordance with clinical guidelines and payer...  ...Licensure Registered Nurse (RN) license, active and in good...  ...organizational skills. Work Environment Remote Equal Opportunity Employer... 
    Remote work
    Apprenticeship
    Local area

    Santa Barbara Cottage Hospital

    New York, NY
    4 days ago
  • $34 - $42 per hour

     ...UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600...  ...In this position, you will utilize your clinical judgement to approve or deny outpatient...  ...scheduled for 5 shifts per week. This is a remote position for CA-licensed nurses. Candidates... 
    Remote work
    Hourly pay
    Full time
    Live in
    Work at office
    Monday to Friday
    Shift work

    Astrana Health, Inc.

    United States
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic. Be the first to apply!