Remote RN - Clinical Utilization Reviewer (Alabama)
Palo Verde Community College District
Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective care within contract guidelines. Applicants must be an active RN in Alabama with at least 3 years of direct patient care experience and a BA/BS in Nursing. Experience in long-term care, provider relations, and PA reviews is valued. #J-18808-Ljbffr
- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care... ...care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role...Remote workFull timeContract work
- ...Authorization Program, the full-time RN Clinical Quality Reviewer will perform comprehensive clinical... ...determination activities, all while working remotely within the US. Key responsibilities... ...to apply clinical judgment within utilization management or prior authorization...Remote workFull time
$32 - $33 per hour
...fit into our culture. We have an opening for a: RN - Clinical Field Reviewer (Remote in Montana) The RN Clinical Field Reviewer is a remote... ..., practice cultural humility with each client, and utilize evidence-based practice as a foundation for our interventions...Remote workFull timeTemporary workLocal area- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration:... ...Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $...Remote workContract work
- ...Registered Nurse (RN) | Utilization Review Location: Pennsylvania Agency: Pyramid Consulting... ...Position Key Responsibilities ~100% REMOTE role but candidate has to be in (PA,... ...to Medical Directors with relevant clinical information, including potential discharge...Remote workWeekly payFull timeImmediate start
$85k - $92k
...TEEMA Solutions Group is seeking a Clinical Quality Reviewer to support a federal healthcare program. This... .... Candidates must have a valid RN or LCSW license with at least three years... ...clinical experience. The position may be remote or onsite based on business requirements...Remote workWork at officeHome office$38.46 - $43.27 per hour
...Clinical ReviewerAs the Clinical Reviewer, you will be responsible for the review and processing... ...Performing case reviews utilizing regulatory guidelines... ...office. Ability to work remotely one day per week after introduction... ..., required (open to any RN state license).Graduate...Remote workHourly payFull timeFor contractorsWork at office1 day per week$2,150 per week
...Healthcare Nursing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort... ...payers to ensure compliance with clinical guidelines, regulatory requirements,... ...-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT...Remote workTemporary workFor contractorsLocal areaImmediate startShift workNight shiftWeekend work- ...organization is seeking a Care Manager RN for a remote role primarily serving the state of... ...This per diem position involves crucial utilization management activities, ensuring compliance... ...RN license along with 3 years of clinical experience. The role offers competitive...Remote workHourly payDaily paidDay shift
- ...Humana Inc. is seeking an Utilization Management Nurse 2 to support coordination, documentation, and communication... ...and members to ensure optimal care in a remote Louisiana setting. The candidate must be a Louisiana-licensed RN with 3+ years of nursing experience,...Remote work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations... ...ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in...Remote work
- ...Clinical Documentation Specialist (CDS)Sanford Health,... ...with consideration of remote work after one year or... ...medical record documentation review of complex patient... ...inpatients/residents. The CDS utilizes the hospital's... ...holds an unencumbered RN license with the State...Remote workWork experience placementDay shift1 day per week
- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience... ...review. Responsibilities include conducting clinical reviews, applying evidence-based criteria for...Remote work
- ...United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...care management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
- ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
- ...RN Utilization ReviewReview patient medical records to assess the appropriateness and medical... ...providers and payers to ensure compliance with clinical guidelines, regulatory requirements,... ...hospital-based)Skilled experience with remote workLength of assignment: 13 weeksShift...Remote workWeekend work
$2,210 per week
...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 with... ...but is not limited to RN, LMSW, LMHC. Successful completion...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...Manpower Group (USA) is seeking a clinically driven RN or LPN with utilization management experience for a fully remote, temporary role. You will evaluate behavioral health and medical necessity reviews to authorize appropriate levels of care, impacting member outcomes...Remote workTemporary work
- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
- ...Molina Healthcare is seeking an RN Care Review Clinician to support Medicaid members during... ...policy adherence. Preferred candidates have utilization management or case management... ...Microsoft Office skills. This telephonic remote role follows EST hours, Monday–Friday,...Remote workWork at officeMonday to Friday
- ...NeueHealth seeks a full-time Utilization Management (UM) Prior Authorization... ...in California. You will review and authorize prior... ...collaborate with Medical Directors and clinical teams to promote quality and... ...Requirements include California RN license, 2–3 years of...Remote workFull timeContract work
$65 per hour
...RN – Utilization ReviewLocation: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30)... ...? No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- ...Job Description Job Description The utilization review and management (UM) component program... ...facilities are medically necessary, clinically appropriate, evidence-based, and delivered... ...for lunch This is an in-office, no remote work capability position Travel ~...Remote workWork at office
- ...Centene Management Company LLC is hiring for a remote RN/LPN utilization reviewer. You will evaluate patient care, determine appropriate level of care, and contribute to discharge planning while coordinating with Medical Affairs. Role requires 2+ years acute care and...Remote workMonday to Friday
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations... ..., and accurately document clinical information from medical...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Seeking a full-time remote Utilization Management RN, the successful candidate will manage medical record reviews and denial documentation, develop clinical appeal letters, and utilize clinical judgment to support healthcare provider clients. Key Responsibilities Perform...Remote workFull time
$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...Remote workHourly pay
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