Remote RN - Behavioral Health Utilization & Care Coordination
HealthEdge Software, Inc.
- Remote job
HealthEdge is seeking a Registered Nurse to coordinate utilization/benefit management for health plans in a remote US role. The candidate will review authorizations, coordinate care plans, and communicate with providers to ensure medical necessity and appropriate levels of care. Strong clinical judgment and regulatory knowledge are essential. The role emphasizes collaboration across time zones in a hybrid/remote work setting, with emphasis on documentation, education, and care coordination #J-18808-Ljbffr HealthEdge Software, Inc.
- HealthEdge in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity reviews across... ...year in Behavioral Health/utilization management; remote work across time zones as #J-18808-Ljbffr WellframeRemote job
- CVS Health is seeking an experienced Registered Nurse to support 24/7 Utilization Management, reviewing cases, assessing medical necessity, and coordinating care from a remote home office. Candidates must hold an active RN license and have at least 2 years of acute or...Remote jobHome office
- HealthEdge is seeking a Telephonic Utilization Management RN to coordinate, document, and communicate all aspects of the utilization/benefit management... ...clinical needs, review authorization requests, and ensure care plans align with medical necessity across inpatient and...Remote job
- Cook Children’s Health Plan (CCHP) is seeking a Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer to coordinate clinically appropriate, fiscally responsible care for members. You will collaborate with the Department Manager and Team Lead...Remote job
- AllMed is seeking a Clinical Quality Assurance Coordinator (RN) to lead quality utilization reviews and ensure medical necessity in accordance with evidence-based guidelines. The role is 100% remote, requiring a strong knowledge of HIPAA, URAC standards, and regulatory...Remote job
- ## RN - Inpatient Behavioral HealthApply: Onsite: Northampton... ...support patient care, research, teaching... ...directs and coordinates all nursing care... .... The Behavioral Health Nurse is a Registered... ...determining how to utilize the milieu to... ...Franklin counties.**Remote Type**Onsite**...Remote workHourly payPart timeWork from homeShift workNight shift
$33.52 - $50.28 per hour
...The 7M Medical / Behavioral Unit is a... ...comprehensive care for adult patients... ...occurring behavioral health needs, and... ...treatment. The RN provides... ...patient care and coordinates care delivery for... ...outcomes and resource utilization. Serves as a... .../Schedules Remote Work Options...Remote workWork experience placementRelocationFlexible hours$65k - $88.6k
...Become a part of our caring communityThe Licensed Behavioral Health Utilization Management Professional... ...skills to support the coordination, documentation, and communication... ...Registered Nurse ( RN ) – Multi-State Compact... ...and resolve within a remote environment...Remote workFull timeTemporary workApprenticeshipWork from homeHome officeMonday to Friday- ...Psych Health Associates seeks a Remote Behavioral Health Coordinator (BHC) for its Post-Acute Care program. This full-time, fully remote role requires MA, LPN, or RN licensure, and entails census monitoring, enrollment and consent management, and cross-facility coordination...Remote workFull time
$65k - $85k
...infrastructure for health insurance... ...Telephonic coordination and delivery of clinical behavioral health services... ...service and level of care, including appeal... ...candidate will utilize clinical skills... ...experience as RN required.... ...Responsibility: Remote, US Type of...Remote workPermanent employmentFull timeWork at officeLocal area$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’s managed care health plan client based out of Redding or Fairfield, CA. Anticipating to be temporary for at least...Remote workContract workTemporary workMonday to FridayWeekend work$35.84 - $58.84 per hour
...State MN Remote NO Department... ...than any other care provider according... ...Care Coordination & Assessment... ...including mental health screening tools... ...the Integrated Behavioral Health Care Coordinator... ...& Education Utilize motivational... ...registered nurse (RN) is accountable...Remote workFull timeMonday to FridayFlexible hoursWeekend workDay shift$29.1 - $62.32 per hour
## Utilization Management Nurse Consultant - Behavioral Health (Remote)Apply: Remote/Hybrid: AZ - Work from home: Full time: Posted... ...surrounded by passionate colleagues who care deeply, innovate with purpose,... ...Associate's degree in nursing (RN) required, BSN preferred. **...Remote jobHourly payFull timeTemporary workWork experience placementWork from homeMonday to FridayFlexible hoursShift workWeekend work- ...Insight Global seeks a Clinical Care Coordinator to support case management, assist with appointment... ...requires at least 2 years in behavioral health or related fields and experience in... ...care, with a strong ability to work remotely and communicate effectively with colleagues...Remote workWork from home
- ...of the largest health benefits companies... ...health care plans and related... ...dental, vision, behavioral health benefit... ...LTSS department. RN will be responsible... ...setting by utilizing the applicable... ...providers for care coordination. Works with... ...Info: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
$30 per hour
...Description Registered Nurse (RN) Care Management Specialist Location: Remote- Onsite for Training... ...management, and health advocacy services.... ...medical and behavioral health requests, coordinating care, promoting quality... ...risk health concerns. Utilize motivational...Remote jobMonday to FridayAfternoon shift- ...Comagine Health is seeking a remote clinical reviewer to support behavioral health services across Oregon. You will evaluate documentation for medical... ...functional needs assessments, and coordinate home and community-based care. You will manage referrals, reviews,...Remote workWork from home
$29.1 - $62.32 per hour
...building a world of health around every... ...passionate colleagues who care deeply, innovate... ...Join our Utilization Management team as... ...from providers. Remote Work Expectations... ...3+ years of acute behavioral health and/or substance... ...degree in nursing (RN) required, BSN preferred...Remote workHourly payFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift workWeekend work$101.72k - $198.36k
...California - Ability to work remote, but selected candidate... ...requires California RN Licensure. Candidates... ...following functions: utilization management, care management, behavioral health and other programs. Leads... ..., planning and coordinating integrated delivery of...Remote workFull timeContract workWork at officeLocal area- ...as needed). The Utilization Review Nurse... ...cost-effective care while adhering... ...The Utilization RN will also serve as the care coordinator and discharge planner... ...of onsite and remote work. ESSENTIAL... ...Ferry County Health employees are... .... STANDARDS OF BEHAVIOR The Standards of...Remote workWork experience placementReliefLocal area
- Summary Responsible for the coordination and efficient utilization of health care resources for Cook... ...Case Manager (UM/ECM - RN) Reviewer facilitates clinically... ...met for CCHP. Location Remote - TX Department... ...coordinate members needing Behavioral Health and outpatient procedures...Remote workShift workDay shift
$60.2k - $107.4k
...Optumcare Medical Behavioral Integration Nurse... ...planning, implementing, coordinating, monitoring, and... ...to meet members' health needs. Highlights... ...conditions for care management services... ...CMS regulations. Utilize advanced clinical... ...and unrestricted RN license required Experience...Remote jobFull timeDay shift$40 - $45 per hour
...need for a talented RN Care Management Coordinator . This is a 03 months... ...potential and is Remote , but the candidate... ...employee benefits include health insurance, 401(k)... ...knowledge to cases, utilizing specified resources... ...plan. Utilize the behavioral health criteria of InterQual...Remote workContract workLocal areaImmediate start- ...Humana is seeking a Licensed Behavioral Health Utilization Management Professional 2 to coordinate, document, and communicate medical... ...for members. This remote role requires a Louisiana-resident... ...licenses, to support coordinated care. Candidates should have 3+ years...Remote work
$24 - $36 per hour
The primary purpose of the Care Coordinator for the Behavioral Authorization Team (BAT) is to coordinate Fast... ...Hospitalization) for mental health and substance abuse disorder services... ...providers to ensure proper access and utilization of benefits. Must be available to...Remote jobHourly payFull timeWork experience placementLocal areaWork from home- CVS Health is seeking a remote Behavioral Health Clinician to provide high-quality mental health care from a home-based setting. This independent, licensed professional will assess, plan, and coordinate care for members with complex behavioral health and substance use...Remote jobWork from home
- ...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...Remote workWork from home
- ...Job Title: Behavioral Health Care Coordinator Location: Remote + Field Visit, IL (Will and Kendall County) Duration... ...behavioral health diagnoses, and utilizing knowledge of medical necessity... ...: ~ Registered Nurse (RN) with active, current license or...Remote workContract workWork at officeShift work
- ...Humana is seeking an Utilization Management... ...Nurse to interpret and coordinate medical services and... ...determinations for post-acute care. You will work remotely, reporting to the... ...support SNF, home health, and DME coordination... ...Requirements include an active RN license in your...Remote work
- Elevance Health is seeking a Wound Care Utilization Management RN to work primarily virtually with periodic in-person training sessions. The role requires an... ...years in diverse health care settings. The RN will coordinate care plans, review home-based services, and...Remote jobWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN - Behavioral Health Utilization & Care Coordination. Be the first to apply!



