Utilization Review RN - Remote
$45.9 - $71.4 per hourProvidence Health & Services
- Remote job
Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. The RN Care Coord-Qual Med Mgmt will provide administration of medical management programs for prior authorization. These programs are developed to manage medical expense, determine medically appropriate services and define clinical criteria for decision making. This position offers 100% remote work for candidates residing in Oregon . Required Qualifications: Upon hire: Oregon Registered Nurse License 5 years clinical nursing experience Experience working with physicians in collaboration and management of patient care Preferred Qualifications: Bachelor's Degree in Nursing or healthcare Utilization review, discharge planning and/or managed care experience Salary Range by Location: Oregon: Non-Portland Service Area: Min: $45.90, Max: $71.40 Oregon: Portland Service Area: Min: $49.34, Max: $76.59 Why Join Providence Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Equal Opportunity Employer Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. #J-18808-Ljbffr Providence Health & Services
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...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time$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- ...City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plansis hiring an Utilization Review Nurse/RN- Remote in Virginia Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: Remote...Remote workPermanent employmentFull timeTemporary workShift work
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...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35... ...paced environment. Comfortable working independently in a remote or office-based setting. Working Conditions: May...Remote workWeekly payContract workWork at officeMonday to Friday- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery of appropriate, efficient, and cost-effective... ...preferred. • Basic Life Support (BLS) certification as required for facility based staff; optional for remote staff.Remote workWork at office
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...personifyhealth.com. Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis, working a minimum... ...communication skills to successfully perform in a remote healthcare environment. Ability to perform the essential job...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend work- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
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...RN-Utilization Review/Case Manage Nurse - RFT Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position Type Full... ...REQUIREMENTS: Full time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review/...Remote workHourly payFull timeWork at officeRelocation packageShift work$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote jobHourly pay$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.00 - $45... ...-paced environment. Comfortable working independently in a remote or office-based setting. Working Conditions May on occasion...Remote workWeekly payContract workWork at officeMonday to Friday$45k - $70k
...A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote work- ...COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workFull time
$23.76 - $51.49 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures.... ...education and experience. • Registered Nurse (RN). License must be active and unrestricted...Remote workHourly payWork experience placementWork at office$45 - $50 per hour
...Utilization Management Nurse - Medicare Remote | California RN Required | Must sit in CA We're partnering with a missiondriven healthcare organization seeking... ..., concurrent, and retrospective utilization reviews for Medicare members Apply evidencebased clinical...Remote workContract workTemporary workWork from home$23.76 - $51.49 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...the Molina care model. Adheres to utilization management (UM) policies and procedures.... ...education and experience. Registered Nurse (RN). License must be active and unrestricted...Remote workHourly payWork experience placementWork at office- ...health, access to care and appropriate utilization of resources, balanced with the patient’... ...oversee work delegated 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-188...Remote workWork at office
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...Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review RN Weekly Pay $1949.74 Shift... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift work$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 Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual...Remote workMinimum wageLocal areaShift work$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work$50 per hour
...an experienced Registered Nurse Clinical Reviewer for a fully remote position with an hourly rate of $50. This role involves conducting utilization reviews and ensuring healthcare... ...Candidates should have an active New York State RN license and 1-3 years of experience in acute...Remote jobHourly pay- ...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
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...a Registered Nurse to perform inpatient utilization reviews, ensure compliance with medical necessity... ...outcomes. This role requires a current RN license, two years of acute care experience... ...schedule and the possibility of remote work, with a base salary starting at $75...Remote workFlexible hours$45.9 - $71.4 per hour
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...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...Remote workMinimum wageFull timeLocal areaShift work$50 per hour
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