Remote Utilization Review Nurse
Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City is looking for a Clinical Review Nurse to utilize clinical expertise in managing healthcare services efficiently. Candidates must have at least 3 years of direct patient care experience and an Associate degree in nursing, along with RN licenses in Missouri and Kansas. This role involves conducting utilization management reviews and ensuring compliance with medical guidelines while effectively communicating with various stakeholders. A competitive rewards package will be offered. #J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Nurse in Kansas City, MO vacancy
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New York, NY5 days ago - ...Astrana Health Management is seeking a CA-licensed UM Review Nurse to review outpatient medical services. Candidates should have 1+ years of outpatient Utilization Management experience, work remotely, and maintain availability for shifts 8 AM – 8 PM PST, Monday through...Remote workShift work
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Monterey Park, CA4 days ago - ...A national insurance group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and ensure compliance with guidelines... ...accurate documentation. The position offers options for remote work, health insurance, and other competitive benefits. #J-...Remote workFull time
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Omaha, NE2 days ago $34 - $42 per hour
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New York, NY2 days ago- ...Oregon Health & Science University is looking for a Utilization Management Nurse to join their team. In this role, you will assess the medical necessity of hospital admissions and ensure appropriate utilization of resources. Strong skills in negotiation, communication...Remote work
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New York, NY2 days ago $78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced RNs aiming to utilize their clinical expertise without direct patient care. The role involves...Remote workTalentLNX LLC
New York, NY2 days ago- ...yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees with...Remote workWork at office
Martins Point Health Care
United States4 days ago $30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. Description Astrana Health is looking...Remote workHourly payMonday to FridayAstrana Health
California, MO5 days ago- ...Baystate Medical Center is seeking a full-time UM Inpatient Clinical Review Nurse for a remote role based in Springfield, Massachusetts. This position involves performing clinical reviews for inpatient services, determining health needs, and collaborating with healthcare...Remote workFull time
Baystate Health
Springfield, MA5 days ago - ...agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Utilization Review Nurse to perform frequent case reviews, check medical records, and communicate with care providers regarding treatment as needed...Remote workTemporary workLocal areaFlexible hours
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A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting findings, and communicating with claims examiners. Candidates must have a current RN license and at least...Remote job$1,966 per week
...among the first 25 applicants Nurses – are you looking for a... ...Holidays Work-life balance. Remote/hybrid setting (once trained)... ...DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hoursHines
Rockford, IL4 days ago- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
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Washington DC3 days ago $35 - $45 per hour
...Base pay range $35.00/hr - $45.00/hr Direct message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs while ensuring compliance with federal,...Remote workContract workWeekend workIntePros
New York, NY3 days ago- ...first 25 applicants This is full-time remote, but candidates must reside in IL or TX... ...performing accurate and timely medical review of claims suspended for medical necessity... ...and prioritization skills. ~ Registered Nurse (RN) with unrestricted license in state...Remote workFull timeContract work
Innovative Systems Group
Richardson, TX5 days ago - ...Essential Functions Applies approved utilization criteria to monitor appropriateness of... ...levels of care and continued stay review. Communication to third-party payers... ...clinical review with payer as determined by nursing judgment and/or collaboration with the payer...Remote workWork at officeShift workNight shiftRotating shift
University of Utah
United States2 days ago - ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
The Judge Group, LLC
New York, NY1 day ago $30.64 - $45.8 per hour
...CA Utilization Review Nurse I Job Category: Case Management This is a remote position. Description The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment...Remote workHourly payFull timeWork at officeLocal areaFlexible hoursCorVel
United States2 days ago$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than a healthcare organization...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayUmpqua Health
United States8 days ago- ...Remote Registered Nurse Position Join a stable work-from-home team! This is a great opportunity for a local remote position. There is... ...performing care for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions for medical...Remote workFull timeReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
BJC
United States2 days ago - ...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
Nexus Health Systems
Houston, TX4 days ago - ...Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and appropriateness of medical services. The UMRN utilizes clinical expertise to ensure care aligns with industry standards, works with healthcare teams to resolve denials...Remote workFlexible hours
Case Management Society of America Inc
United States2 days ago $30.64 - $45.8 per hour
...The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and... ...the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hoursCorVel
Rancho Cucamonga, CA5 days ago- ...A prominent healthcare provider in Bellaire is seeking a PRN Utilization Management Review Nurse. This role involves evaluating medical services, ensuring appropriate care levels, and collaborating with healthcare teams. Candidates must hold a Bachelor's in Nursing and...Remote workReliefShift work
Direct Jobs
United States4 days ago - ...yourcommission is looking for a Utilization Management Review Nurse to evaluate and ensure the effectiveness of medical services in Texas. This role supports the healthcare system by leveraging clinical expertise and management skills. Candidates should possess a Bachelor...Remote workFlexible hours
yourcommission
United States2 days ago - ...Management Location: 100% Remote Schedule: M-F 9:00am to 5... ...Summary Works with the Utilization Management team primarily responsible... ...necessity/utilization review and other utilization management... ...IL State Registered Nursing (RN) license in good standing...Remote workContract work
Integrated Resources
Springfield, IL1 day ago - 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 workContract work
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Phoenix, AZ5 days ago - ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
IntePros
New York, NY2 days ago
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