Remote Utilization Management RN - Medicaid Care Navigator
Santa Barbara Cottage Hospital
New York, NY
- Remote job
Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews, care coordination, and discharge planning for Kentucky Medicaid members. You will use clinical judgment to decide on level of care and communicate decisions with providers and members. The role is remote/work-from-home with weekend shifts and some travel to the Louisville office a few times annually; requires Kentucky RN license, 2+ years clinical experience, and 1+ year UM experience, plus #J-18808-Ljbffr Santa Barbara Cottage Hospital
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN - Medicaid Care Navigator in New York, NY vacancy
$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization... ...that delivers care, aided by... ...opportunity for remote work based on business... ...Nurse (RN) with a current,... ...of Medicare and Medicaid ~ Recent long-term... ...computer functionality, navigation, and software applications...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...purpose of Dignity Health Management Services Organization (... ...developing Dignity Health's Medicaid population health care management pathways.... ...Responsibilities As our UM RN (Utilization Management Registered... ...organizational resources. As a remote employee, we will provide...Remote workLocal areaWork from homeShift workWeekend work
Dignity Health Management Services
United States3 days ago $29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate... ...at a time.Utilization Management is a 24/7... ...ConsultantFully Remote- WFHSchedule : Tuesday... ...experience as an RN in the hospital setting... ...of Medicare/Medicaid- Managed care experience... ...Device & System Navigation: Comfortable...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftCVS Health
Kansas, IL1 day ago$41.72 - $105.65 per hour
...for-profit, we support patient care, research, teaching, and... ...patient problems and needs by utilizing multidisciplinary team strategies... ...patients regarding how to navigate throughout the health system.... ...Job Details (if applicable) Remote Type Remote Work...Remote workHourly payDaily paidWork at officeShift workMass General Brigham
United States2 days ago- CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote role. You will apply clinical... ...coverage, coordinate care, and collaborate with... ...requires 3+ years of Med/Surg RN experience, active RN... ...knowledge of Medicare/Medicaid and managed care is preferred...Remote jobAfternoon shift
$67.2k - $85k
...Number: 180127, Job Title: BH Utilization Manager RN, Salary: $67,200.00 - $85,00... ...) is a non-profit managed care organization (MCO), licensed... ...the following programs: Medicaid State of Texas Access Reform... ...telephone systems Work Schedule: Remote Other Requirements:...Remote workContract workWork experience placementHarris Health
Houston, TX15 days ago$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of... ...services, coordinating care, and ensuring members receive... ...Palliative Oncology Nurse Navigator (8:30AM - 5PM EST Shift) East...Remote workDaily paidContract workMonday to FridayShift workWeekend work$92.3k - $120k
Registered Nurse (RN), Home Health Utilization Management Remote - USA At Clover Health, we are committed to providing... ...seniors. We prioritize preventive care while leveraging data and... ...remote environment. Have experience navigating electronic medical records and utilization...Remote workWork at officeLocal areaFlexible hours- Overview Work remote and travel 75%. Optum... ...organization that delivers care, aided by... ...or UBH (e.g. Case Managers, Field Care Advocates... ...unrestricted RN nurse license in Massachusetts... ...industry (Medicaid, Medicare, CMS)... ...computer functionality, navigation, and software...Remote workCasual workWork at office
$68.4k
...SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure... ...Experience in UM/CM/QA/Managed Care Medicaid RN (Registered Nurse) Care Management LICENSES...Remote workFull timeFor contractorsWork at officeLocal areaFlexible hoursHighmark Health
Pennsylvania2 days ago$84.56k - $126.84k
...Regular Job Overview The Utilization Review RN participates as a... ...by Medicare, Medicaid, and other third-party... ...Department Name: Utilization Management Job Status: part time... ...will be primarily remote but there may be occasions... ...the continuity of care in conjunction with...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift$94.9k - $130.5k
Become a part of our caring community The Manager, Utilization Management Nursing... ...Registered Nurse (RN) in Virginia or enhanced... ...Excel, PowerPoint, navigating multiple systems... ...difficulties in a remote environment.... ...Prior Medicare / Medicaid experience Call center...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization... ...Nurse (UMRN). These will be completely remote positions, working entirely from the... ..., educating patients on appropriate care and managing health care costs for the...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
Spectrum Healthcare Resources
United States1 day ago - ...and monitoring the utilization of behavioral... ...closely with Case Management to address member... ...benefits, and efficient care delivery processes... ...and active NYS RN license required.... ...contracts (Medicare and Medicaid) and benefits,... ...be opportunity for remote work within all jobs...Remote workContract workWork at office
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home... ...coordination, requiring an active RN license and hospital experience. Responsibilities... ...with providers, and ensuring timely care while meeting state and federal...Remote jobWork from home
- ...Health is seeking an experienced ICM Case Manager to develop proactive care plans, coordinate services, and support members with Medicare/Medicaid in a remote, home-based role with 25-50% travel... .... The role requires active NJ RN licensure, 3+ years of clinical practice...Remote jobWork from home
- CVS Health is seeking an RN Case Manager for an Integrated Care Management role. This work-from-home position covers travel within Essex County, New... ...care for dual eligible members enrolled in Medicare and Medicaid, addressing medical and social determinants of health....Remote jobWork from home
- Sentara Health Plans is hiring an Integrated Care Manager/Registered Nurse (RN) LTSS Waiver Members/Medicaid with remote work in Northern Virginia (Fairfax, Springfield and Alexandria, VA) and surrounding areas. The role requires in-person assessments and remote/home-office...Remote jobWork at officeWork from homeHome office
- CVS Health is seeking an experienced Integrated Care Management (ICM) Care Manager to assess and coordinate care for members with Medicare/Medicaid needs. You will develop proactive plans, collaborate with healthcare teams, and leverage data to address health and social...Remote jobFull timeWork from home
$100k
...Type Contract Industry Health Care Work Experience 1-3 years Salary $100,000 Remote Job Job Description This is a remote position. The Utilization Management (UM) Nurse is responsible for... ...unrestricted Registered Nurse (RN) license in the applicable state...Remote workContract workWork experience placementYour IT & Corporate Recruiter
United States15 hours ago$29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate with... ...at a time. Utilization Management is a 24/7 operation and... ...Consultant Fully Remote- WFH Schedule : Monday... ...Surg experience as an RN in the hospital setting... ...Knowledge of Medicare/Medicaid - Managed care experience...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftCVS Health
United States2 days ago- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening... ...authorization. The successful candidate will bring 3+ years of acute care experience, knowledge of InterQual/MCG guidelines, and...Remote job
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered... ...and benefit management activities Navigate multiple systems while managing a fast-...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shiftOak St. Health
United States5 days ago$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered... ..., multitasking, and computer navigation skills. ~ Ability to work a designated...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shiftOak St. Health
United States14 hours ago- ...: Sentara Health Plansis hiring an Integrated Care Manager/ Registered Nurse (RN) LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfax, Springfield and Alexandria,... ...disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care...Remote jobPermanent employmentFull timeTemporary workHome officeShift work
- ...global organization that delivers care, aided by technology to help millions... ...people live healthier lives. The Utilization Management and Clinical Validation RN will review patient medical... ...instructions and guidelines. This role is remote from anywhere in the U.S. with an...Remote job
- ...Registered Nurse for a temporary Utilization Management role. You will ensure prior... ...contracts and participate in UM care programs. Required are an active CA RN license and at least five years... ...for experience. Hybrid work and remote- interview options are offered....Remote jobTemporary work
- 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... ...utilization reviews, support transitions of care, and ensure compliance with Medicare Advantage regulations...Remote job
- ...Healthcare seeks an experienced RN to support Arizona Plan... ...license and experience with utilization management, prior authorization, and both... ...inpatient and outpatient settings. Remote position, must reside in... ...cost-effective, quality member care through integrated #J-18808-...Remote job
- ...recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an... ...include evaluating healthcare services and coordinating care for members. Join a dynamic team and make a meaningful impact...Remote jobContract work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN - Medicaid Care Navigator. Be the first to apply!
