Remote Utilization Management Nurse - Impactful Care
Cambia Health Solutions
- Remote job
Cambia Health Solutions seeks an experienced Utilization Management Nurse to ensure medical necessity and cost-effective outcomes for members. You will review cases prospectively, concurrently, and retrospectively, applying evidence-based criteria and consulting with physician advisors as needed. Join a collaborative team focused on transitions of care, member advocacy and timely responses to inquiries. A current RN license and state licensure in applicable states are required. #J-18808-Ljbffr Cambia Health Solutions
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for... ...outpatient services, Quality of care concerns. Interfacing routinely... ...packets, including review of cases impacting performance metrics and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal... ...and are looking to make a clinical impact without direct patient care. Highlights include a remote role in VA with Virginia...Remote job
$29.1 - $62.32 per hour
...Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) We... ...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...you a Registered Nurse ready to make an impact beyond the bedside? Join our team and...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shift- Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote job
- Cambia Health Solutions is seeking a Utilization Management Nurse to join the Clinical Services team. You will perform prospective, concurrent, and... ..., and the ability to interpret policies. We offer remote work options in several western states, a competitive salary...Remote job
$45 per hour
...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... ...driven work with real community impact Foot in the door at a company...Remote workContract workTemporary workMonday to FridayWeekend work$29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate with purpose... ...one community at a time. Utilization Management Nurse Consultant Clinical Precertification... ...RN (Medicare Home Care) Remote | Full-Time | Weekday... ...Registered Nurse ready to make an impact beyond the bedside? Join...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$54.1k - $129.63k
...by passionate colleagues who care deeply, innovate with purpose... ...one community at a time. RN Utilization Management Nurse Consultant (Medicare – Joint Procedures) Remote | Full-Time | Monday–Friday (... ...Registered Nurse looking to make an impact beyond the bedside? Join a...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$71.1k - $97.8k
Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and... .... Use your skills to make an impact Required Qualifications: Must hold... .... Experience working in a fully remote, metrics-focused role Experience...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...opportunities. Come make an impact on the communities we serve... ...occasional opportunity for remote work based on business needs....Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area$26.01 - $62.32 per hour
...by passionate colleagues who care deeply, innovate with... ...and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule... ...Registered Nurse ready to make an impact beyond the bedside? Join our...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- ...CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote position. You will review medical necessity, facilitate discharge planning, and... ..., 2+ years acute hospital experience, UR/Managed Care experience, and an active RN license. The role involves...Remote work
- ...Humana is seeking a Utilization Management Nurse to leverage clinical nursing skills in coordinating, documenting, and communicating medical service... ...across providers and members to ensure appropriate care. The position expects RN licensure with no disciplinary...Remote work
- ...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization... ...'s benefit coverage while working remotely. Primary Responsibilities:... ...ensure timely review of services and care. Provides referrals to Case management...Remote workContract workWork at office
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management... ...while supporting transitions of care and ensuring patients receive... ...(LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy...Remote work
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...months RN experience in direct patient care • 12 consecutive months in Utilization...Remote workContract workImmediate startMonday to Friday- ...Health Solutions in Medford, OR is seeking an experienced Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews... ...and collaborate with physician advisors to optimize member care and appropriate payments. The role requires an Associate...Remote work
- Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho... ...ensure medical necessity and promote cost-effective care. The candidate will collaborate across...Remote job
- Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization Management and collaborate with...Remote job
- ...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases... ...Management team on coordinating patient care to ensure patients can access the... ...'s home which may be in understaffed/remote areas, in the presence of pets or family...Remote workFull timeWork at office
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant to apply clinical judgment and guidelines to determine appropriate benefits across the continuum of care. This full-time role supports a 24/7 operation, with scheduled weekends, holidays and...Remote workFull timeWeekend workAfternoon shift
- CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient... ...services, collaborate with providers to authorize care, and elevate cases when needed while maintaining...Remote job
$36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will be given to current employees and candidates... ...a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated...Remote workFull timeWork at officeImmediate startWork from homeFlexible hours- Cambia Health Solutions seeks an experienced Utilization Management Nurse to support member care across multiple states. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and optimal outcomes, coordinating with clinical teams...Remote job
- Cambia Health Solutions is seeking an experienced Utilization Management Nurse to support clinical reviews and care coordination across Oregon, Washington, Idaho, and Utah. This role emphasizes medical necessity determinations and collaboration with physician advisors to...Remote job
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate will...Remote jobWeekend work- CVS Health Corporation is seeking a Nurse Consultant to join our Utilization Management team. The role focuses on applying clinical judgment and evidence-based... ...inpatient and outpatient services, authorizing care, and escalating cases when needed. The position requires...Remote job
- Cambia Health Solutions seeks an Utilization Management Nurse to conduct reviews (prospective, concurrent, retrospective) and ensure medical necessity... ...with interdisciplinary teams to improve transitions of care and patient outcomes. The role emphasizes applying evidence...Remote job
- The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization... ...to promote appropriate patient care, support regulatory and payer requirements... ...coverage Hybrid Position - Primarily remote/work-from-home, with an expectation to...Remote workFull timeWork from homeShift work
$32.01 - $68.55 per hour
## Utilization Management Nurse ConsultantApply: Remote: IL - Work from home: Work At Home-Ohio: Work At Home-Texas: Work At Home-Georgia: Work At Home-West Virginia... ..., you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shift
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