Remote Utilization Review Nurse - Post-Acute Care
Centene Corporation
- Remote job
Centene Corporation is hiring a nurse reviewer to perform concurrent reviews for Medicaid and Marketplace post-acute care from a fully remote role. Ideal candidates reside in Central, Mountain, or Pacific Time Zones and hold compact licensure with 5+ years of nursing experience, including LTACH/IPR/SNF settings. Typical schedule is Mon–Fri, 8am–5pm based on your time zone with rotating Saturdays and holidays. Eligible for competitive pay and benefits. #J-18808-Ljbffr Centene Corporation
- ...staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client... ...role involves evaluating patient care cases and ensuring requested services... ...clinical experience in an acute setting. Strong written and verbal...Remote work
- ...Management Company LLC is seeking a remote Nurse Reviewer to perform concurrent... ...appropriate levels of care across Medicaid and Market Place... ...while educating providers on utilization processes. The ideal candidate... ...experience, including acute care, and preferably compact...Remote job
- ...Technologies, Inc. is seeking a Registered Nurse with utilization management experience to review ED admissions and apply... ...candidates have 3+ years in acute care nursing and 2+ years in utilization... ...in EMR and MS Office. Remote work arrangements are supported...Remote job
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...experience, including acute care exposure. The role... ...educating providers on utilization processes. Schedule is...Remote work
- ...Responsible for utilization review work for emergency admissions... ...experience in acute care setting in emergency room... ...and/or medical/surgical nursing At least 2 years... ...Comfortable with remote work arrangements and... ...Netsmart policy, all post-offer candidates are required...Remote workFull timeFor contractorsWork at officeShift workWeekend workWeekday work
- ...personalized managed health care, focused on what's... ...-life balance.Remote settingRole... ...This individual will utilize clinical knowledge... ...and acceptable nursing practice guidelines... ...to a second level reviewer. This individual interfaces... ...of 3 years recent acute clinical practice...Remote workTemporary workWork at officeMonday to FridayFlexible hours
- Currently seeking a Utilization Management RN .... ...below: Position is remote - candidate must... ...active PA license or a Nurse Licensure Compact... .... ** Previous Acute Hospital Utilization... ...medical record review to determine medical... ...appropriate care settings. Report...Remote workImmediate startDay shift
- Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday-Friday schedule and occasional weekend/holiday rotation...Remote jobMonday to Friday
$35 - $45.94 per hour
...Oscar. We're hiring a Utilization Review Nurse to join our... ...records and speak with care providers regarding treatment... ...Location: This is a remote position, open to candidates... ...practice in an acute care setting, i.e.,... ...are listed in the job posting. Voluntary Self-Identification...Remote workHourly payFull timeFor contractorsWork from homeRelocationHome officeWeekend work- ...necessity, appropriate level of care, and benefit coverage. Review outpatient, inpatient, and post-service requests across care... ...Graduate of an accredited LVN/LPN nursing program with a current U.S.... ...recent clinical experience in acute care, med-surg, ICU/ED, or similar...Remote job
- ...Remote role but will need to go to Newark, NJ to pick up equipment and orientation... ...: 1. Conducts on-site reviews at participating provider offices... ...business experience, preferably health care industry. 2. Requires License Practical Nurse License or an active New Jersey...Remote work
- ...HIRING: Utilization Review Nurse | Remote | UM Training Provided 5 Clinical Nurses Wanted for an Exciting UM Pilot Program! Have you been working... ...reviews Review medical records and assess patient care Communicate with care providers regarding treatment when...Remote workFull timeContract workHome officeShift work
$40 per hour
...Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for... ...reside in TX Full time remote Candidates must be based in... ...performing initial, concurrent review activities; discharge care... ...information regarding utilization management requirements...Remote workFull timeContract workWork at office- ...Performs medical record review for severity of illness... ...Monitors all levels of care for appropriateness and... ...and Training: Nurse, Registered (RN) licensure... .... 2-5 years previous Utilization Review experience preferred... ...: Days, Primarily remote; onsite orientation...Remote workShift workWeekend work
- ...Insight Global is looking for a Utilization Review Registered Nurse to sit remotely with one of their large health insurance... ...for evaluating 3.5 patient care cases per hour (both inpatient and... ...years of clinical experience in an acute environment (not behavioral health...Remote workHourly pay
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital... ...the clinical appropriateness of care provided to patients and ensuring... ...provider outreach to address post-hospital discharge services, redirection...Remote workFull time
$150 per hour
...Work From Home Nurse Practitioner (Remote Acute Visits, $210/hr) Join to apply for the Work From Home Nurse... ...- $210.00/hr A nationwide virtual care group is expanding its telehealth... ...acute and primary care conditions Review labs and clinical records when available...Remote workWork from homeFlexible hours$150 per hour
...Nurse Practitioner – Work From Home Acute Care (Nationwide) Base pay range: $150.00/hr - $210.00/hr A growing virtual... ...across the U.S. This fully remote role blends acute care visits with... ...treat acute & primary care conditions Review labs, prior records, and risk factors...Remote workHourly payContract workWork from home- ...healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include... ...and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr Medix™Remote job
- 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 jobContract work
$41.41 per hour
...healthcare and dependent care flexible spending... ...Evaluates effectiveness of nursing interventions and revises... ...decision-making regarding the utilization of evidence- based... ...consists of a broad range of acute to complex medical conditions with remote telemetry capabilities....Remote workFull timeTemporary workPart timeFlexible hoursShift workNight shiftWeekend workAfternoon shift- TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote job
$38.22 - $57.33 per hour
...Evaluates, plans, treats and implements care for patients in accordance with professional... ...would benefit patient care Inpatient Acute Care: ~ Coordinate and deliver durable medical... ...FTE requirements FTE: 0.6 Possible Remote/Hybrid Option: Shift Rotation: FTE...Remote workWork from homeFlexible hoursShift workWeekend workWeekday work- ...Management Company LLC is seeking a qualified nurse reviewer to conduct concurrent inpatient and... ...necessity and appropriate level of care. The position involves documenting findings... ...include educating providers on utilization processes, sharing feedback with leadership...Remote job
- OverviewTitle: Clinical Review Nurse - Prior Authorization ReviewLocation: Fully Remote (PST Time Zone - WA/OR Resident)Duration... ...Review to join our Utilization Management team. In this role,... ...medical directors, providers, and care management teams to support high...Remote work
$35 - $43 per hour
...0/hr - $43.00/hr Job Title Clinical Review Nurse - Concurrent Review Location: Remote (California only - must reside in CA... ...Nurse - Concurrent Review will perform utilization management functions to ensure members receive the right care at the right time. This role focuses...Remote work- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside... ...seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)... ...medical necessity and appropriateness of care Apply evidence-based criteria to assess...Remote workFull timeContract work
- ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity...Remote work
- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...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 standing...Remote workContract work
- ...applicants This is full-time remote, but candidates must reside in... ...working in the insurance or managed care industry using medically... ...performing accurate and timely medical review of claims suspended for... ...skills. Registered Nurse (RN) with unrestricted license...Remote workFull timeContract work
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