Remote Utilization Review Nurse - UM & Care Coordination
$85k - $105.34kUmpqua Health
Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure quality care. This role includes conducting prior authorizations, collaborating with healthcare teams, and ensuring compliance with regulations. The ideal candidate will have an RN license, 5 years of experience, and skills in clinical assessments and communication. The position provides a competitive wage of $85,000 - $105,340 with a comprehensive benefits package. #J-18808-Ljbffr
- ...This position has a remote option for those living... ...as needed. The Utilization Review Nurse is responsible for determining... ...appropriateness of care provided to patients... ..., and retrospective UM related reviews and... ...needs for coordination of the beneficiary's...Remote workFull time
- ...Martin's Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong background in clinical nursing and utilization management to ensure quality, cost‑efficient medical outcomes. Responsibilities include reviewing prior authorization...Remote work
- ...Utilization Review Nurse Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering... ..., establishes discharge plans, coordinates transitions of care to lower/higher... ...experience in a health plan UM department Required License...Remote workWork at office
$85k - $105.34k
UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as needed... ...—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving... ...Medicare, and applicable regulations. The UM Nurse collaborates with...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday$64.17k - $96.26k
...management. The Utilization Management Nurse and the Personal... ...facilitating quality health care through the most... ...utilization review/pre-certification... ...plans of care; coordinate services; educate... ...(5) years of UM/CM experience preferred... .... ~ Remote Work Environment...Remote workLocal areaRelocation packageFlexible hoursWeekend work- ...remote position in any state except, NY, CA, HI, or AK max... ...Responsible For Performing Discharge Care Coordination And Review Activities For Determining... ...Information Regarding Utilization Management Requirements And... ...information regarding UM requirements and operational...Remote workContract work
- ...Responsibilities: • Reviews documentation and... ...Quality of Care issues based on clinical... ...• Independently coordinates the clinical resolution... ...• Registered Nurse in state of residence... ...authorization utilization experience • Able... ...knowledge. • MUST HAVE UM experience,...Remote work
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment... ..., accurate, and compliant care decisions in accordance... ...processes. Assist with coordination of peer reviews and communication... ...working independently in a remote or office-based setting....Remote workWeekly payContract workWork at officeMonday to Friday$35 - $40 per hour
...5.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’... ...effective, and compliant delivery of home health care. This role monitors admissions,...Remote workContract workFlexible hoursWeekend work$69.89k - $106.91k
...Categories: Case Coordination Job Status: Full-Time... ...opportunity for a local remote position. There is no... ...experience performing care for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing... ...Education ~ Nursing Diploma/Associate's -...Remote workHourly payFull timeWork experience placementLocal areaWork from homeMonday to FridayFlexible hoursShift work$40 per hour
...in TX Full time remote Candidates must... ...insurance or managed care industry using... ...initial, concurrent review activities; discharge care coordination for determining efficiency... ...regarding utilization management requirements... ...facilities. Registered Nurse (RN) with valid,...Remote workFull timeContract workWork at office- ...Utilization Review Nurse (Ur Nurse) Join our team at Cobalt Benefits Group and start an exciting new... ...healthcare services, procedures, and levels of care in accordance with established criteria... ...1 year of Utilization Management (UM) or Utilization Review (UR) experience....Remote workFull timeTemporary workSummer workWork at officeFlexible hours
$41 - $45.5 per hour
...Government Clients Role: Nurse Case Management... ...Analyst Location: Remote (within plan... ...planning, implementing, coordinating, monitoring, and... ..., high-quality care and supports members... ...education, and utilization management. Key Responsibilities... ...and retrospective reviews for inpatient,...Remote work$35 - $43 per hour
.../hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must... ...Concurrent Review will perform utilization management functions to... ...receive the right care at the right time. This... ...to ensure timely coordination between care levels and...Remote work$55 per hour
...is hiring a Concurrent Review Nurse to support our client in... ...space. Location: Remote (must be based in California... ...for ensuring that member care is provided at the most... ...in case management, utilization management, or discharge... ...Out-Patient Case Manager UM LVN Delegation...Remote workFull timeContract workTemporary workLocal area$35.29 - $47.37 per hour
...their work-life balance ~ Remote work options and Flexible... ...the Quadruple Aim of health care reform: member engagement... ...hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed nurse... ...care principles in the coordination of care. Prepares any case...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours$34 - $40 per hour
...range $34.00/hr - $40.00/hr Remote (Compact Licensure Required)... ...Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health... ...services. In this role, you will coordinate and review patient...Remote workFull time- ...staff position, please review this tip sheet ( . The Case Manager RN (U) coordinates the overall interdisciplinary plan of care for patients, from admission... ...Enter Ancillary notes utilizing the templates for care... ...Utilize Case Manager nurse driven protocols to facilitate...Remote workFull timeTemporary workWorldwide
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 60936 Overview... ...of in person and remote considered) GENERAL SUMMARY... ...ensures safe transitions of care. GIBSON AREA HOSPITAL &... ...RESPONSIBILITIES Coordinate and facilitate patient progression...Remote workHourly payFull timeWork at officeRelocation packageShift work- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor... ...cost-effective patient care. Working collaboratively within... ...medical necessity, and coordinates with healthcare providers... ...required for facility based staff; optional for remote staff.Remote workWork at office
- Currently seeking a Utilization Management RN .... ...below: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact to... ...clinical judgment to review medical records, validate care plans, and... ...providers, support care coordination, ensure regulatory...Remote workImmediate startWeekend workDay shift
- Overview Title: Clinical Review Nurse - Prior Authorization... ...Location: Fully Remote (PST Time Zone - WA/OR... ...Authorization Review to join our Utilization Management team. In... ..., providers, and care management teams to support... ...authorized care Coordinates as appropriate with healthcare...Remote workContract work
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange... ....00 - $34.00 / hour Department: HS - UM This is a fully remote position.... ...Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence...Remote jobHourly payMonday to Friday- A health system in Maryland is seeking a Utilization Review Nurse RN to conduct chart reviews and coordinate care for optimal patient outcomes. Responsibilities include assessing clinical records, monitoring denials, and collaborating with care teams. The ideal candidate...Weekend work
- 4004 Aetna Medicaid Administrators is looking for an Integrated Care Manager based in New Jersey. The role involves assessing, planning, and coordinating member care to enhance overall wellness. Candidates should have a minimum of 3 years of clinical experience and a valid...Remote workWork from homeFlexible hours
- Mass Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure...
- ...is seeking an experienced Licensed Practical Nurse (LPN) to facilitate value-based care for patients. This fully remote position offers the chance to work from home,... ...role includes conducting health assessments, coordinating resources, and assisting with medication management...Remote workWork from home
- ...Management Location: 100% Remote Schedule: M-F 9:00... ...Works with the Utilization Management team primarily... ...necessity/utilization review and other utilization management... ...members with the right care at the right place at... ...IL State Registered Nursing (RN) license in good...Remote workContract work
$21 per hour
CareHarmony, Inc. is seeking an experienced Licensed Practical Nurse (LPN) to manage patient care and coordinate resources remotely. The candidate must have at least 3 years of direct patient-facing experience and an active LPN license. Responsibilities include patient...Remote workWork from home
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