Remote Utilization Management Nurse - Clinical Review
Brighton Health Plan Solutions
Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful candidate will collaborate with healthcare partners, triage cases, and prepare determinations for medical director oversight, ensuring regulatory compliance and quality standards are met. #J-18808-Ljbffr
Vacancy posted 1 day ago
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Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to make high-quality care...Remote job- ...Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical... ...week. This role will be remote BUT regular meetings/trainings... ...Qualifications * Bachelor of Science in Nursing * Previous experience with...Remote workReliefShift workWeekend work3 days per week
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...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... ...an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate will work...Remote workWeekend workkozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ4 days ago- ...integrating, and monitoring the utilization of behavioral health (BH... ...Medical Director for review and works closely with Case Management to address member needs.... ...and post-service clinical reviews to determine the... ...may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
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...transforming the lives of the seniors we serve while providing ample opportunities for growth and innovation. Utilization Management Nurse Lead Responsibilities Reviews reporting to assign tasks to UM Nurses for completion of time sensitive items. Works closely as a liaison...Remote jobImmediate start
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