Remote Utilization Management Nurse — Healthcare Impact
Cambia Health Solutions
- Remote job
Cambia Health Solutions is seeking a Utilization Management Nurse to join the Clinical Services team. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and promote quality, cost-effective outcomes for members. The position requires an active RN license, 3 years in case or utilization management, and the ability to interpret policies. We offer remote work options in several western states, a competitive salary and comprehensive benefits. #J-18808-Ljbffr Cambia Health Solutions
$26.01 - $56.14 per hour
...community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | 24/7 Operations... ...coordinate, monitor, and evaluate healthcare services and benefits across the... ...nursing role Make a meaningful impact on healthcare quality and member outcomes...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for... ...Performing timely reviews of healthcare services, including precertification... ..., including review of cases impacting performance metrics and identification...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote job
$45 per hour
...Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with... ...quality, cost-effective healthcare in a fully remote managed care... ...work with real community impact Foot in the door at a...Remote workContract workTemporary workMonday to FridayWeekend work$29.1 - $62.32 per hour
...one community at a time. Utilization Management Nurse Consultant Clinical Precertification... ...RN (Medicare Home Care) Remote | Full-Time | Weekday... ...Registered Nurse ready to make an impact beyond the bedside? Join... ...with care coordination and healthcare quality, we’d love to hear...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$60.53k - $129.63k
...one community at a time. Remote UM Nurse Consultant RN Precertification... ...Nurse to join our Utilization Management team in a fully remote Precertification... ...Collaborate with healthcare providers to gather necessary... ...~ Make a clinical impact while enjoying a consistent...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to Friday$71.1k - $97.8k
...our caring community The Utilization Management Registered Nurse uses clinical nursing skills... ...your skills to make an impact Required Qualifications:... ...Experience working in a fully remote, metrics-focused role... ...wellness and smart healthcare decisions for you and your...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care... .... Come make an impact on the communities we serve... ...occasional opportunity for remote work based on business needs... ...within medical insurance and/or healthcare industries ~ Experience analyzing...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization... ...'s benefit coverage while working remotely. Primary Responsibilities:... ...parties/departments. Collaborates with healthcare partners to ensure timely review of...Remote workContract workWork at office
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization... ...Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform... ...LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy...Remote work
- ...Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning and utilization... ...and coordinates discharge planning needs with healthcare team members. May prepare statistical analysis and...Remote work
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant to apply clinical judgment and guidelines to determine appropriate... ...with providers, and coordinate referrals while promoting quality and efficient use of healthcare services. #J-18808-LjbffrRemote workFull timeWeekend workAfternoon shift
- ...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases... ..., and coordination of necessary healthcare services. Reviews Treatment Authorization... ...s home which may be in understaffed/remote areas, in the presence of pets or...Remote workFull timeWork at office
$36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will be given to current employees and candidates... ...retrospective review) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes...Remote workFull timeWork at officeImmediate startWork from homeFlexible hours$32.01 - $68.55 per hour
## Utilization Management Nurse ConsultantApply: Remote: IL - Work from home: Work At Home-Ohio: Work At Home-Texas: Work At Home-Georgia: Work At Home-West... ...and evaluate options to facilitate appropriate healthcare services/benefits for members.Gathers clinical information...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shift- CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal for individuals... ...paced environment and are looking to make a clinical impact without direct patient care. Highlights include a...Remote job
- ...week in Brighton, MA office; 1 day remote FLSA Status: Exempt About Us BrightonOne... ...social enterprise delivering healthcare, housing, and hope to veterans and... ...who served. Position Overview The Nurse Reviewer, Utilization Management performs prospective, concurrent, and...Remote workFull timeLocal area
- The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization... ...and ensure effective utilization of healthcare resources. The Utilization Management... ...coverage Hybrid Position - Primarily remote/work-from-home, with an expectation...Remote workFull timeWork from homeShift work
$60k
...LPN/LVN Utilization Management Nurse Integra is looking for a LPN/LVN experienced in the managed care... ...development opportunities Remote Opportunities We are actively seeking... ...serve by reimagining access to in-home healthcare. We connect Payers, Providers, and...Remote workTemporary workLocal area- ...perform pre-service and post-service utilization reviews and appeals within a... ...compensation with benefits, remote opportunities across multiple states... ..., and potential annual bonus. Healthcare professionals with UM experience in managed care are encouraged to apply. #J...Remote job
- CVS Health Corporation is seeking an Utilization Management Nurse Consultant to apply clinical expertise in assessing and coordinating care, ensuring appropriate healthcare services for members. The role requires collaboration with providers and internal teams within a...Remote jobShift workWeekend workAfternoon shift
- ...making a difference in the healthcare industry, and in people's... ...As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link... ...administrative compliance. Unlike remote roles, this position... ...effect change, and effectively impact timely throughput....Remote workFull timeImmediate startShift work
$45 - $51 per hour
...Position Details Position: RN Utilization Management / Utilization Review Setting: 100% Remote Schedule: 5x8-hour days Hours: 8:00... ...care coordination and appropriate utilization of healthcare resources. Manage prior authorization and...Remote workHourly payWeekend work- 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... ...experience. Responsibilities include assessing healthcare services, communicating with providers, and...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
$71.1k - $97.8k
About This Role The Utilization Management Nurse utilizes clinical nursing skills to support the coordination... ...: $71,100 - $97,800/year Location: Remote, KY Schedule: Full-time What You'll... ...Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through their insurance services...Remote workFull timeTemporary work$39 - $40 per hour
...poster from The Judge Group Lead 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 following... ...Ready to make a meaningful impact—without sacrificing work-life...Remote workDaily paidContract workMonday to FridayShift workWeekend work- Our client, a leading California healthcare organization providing medical, dental, vision, Medicare, and Medicaid health plans, seeks an experienced Utilization Management Nurse (RN) for a remote opportunity supporting inpatient utilization review, medical necessity determinations...Remote workContract workTemporary workWork at officeLocal area
$83k - $99k
...offer various high-quality, affordable healthcare plan options supported with best-in-... ...at: Role and Responsibilities The Utilization Management Nurse collaborates with external entities such... ...and a $600 wellness reimbursement Remote work and continuing education reimbursements...Remote workFull timeWork at officeFlexible hours- ...Registered Nurse: Review and EvaluationAre you a... ...integrity through compliance management. Here, you'll champion... ...care, and influence healthcare outcomes on a... ...recordsExperience in utilization review, case management... ...OrganizationMake a real impact on healthcare quality...Remote workWork from home
- ...Team Leader On-site Hospital Utilization Management (UM) Nurse How would you like to... ...a difference in the healthcare industry, and in people's... ...administrative compliance. Unlike remote roles, this position... ...and reporting, and barriers impacting utilization management workflow...Remote workShift work
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