Remote RN: Medical Review & Utilization Auditor
$29.05 - $67.97 per hourMolina Healthcare of Illinois
- Remote job
Molina Healthcare is seeking a qualified clinical review professional in Louisville, Kentucky, focused on ensuring medical necessity and reimbursement accuracy. Candidates must possess an active RN license and at least 2 years of clinical nursing experience, including utilization review and medical claims review. The position offers a salary range of $29.05 - $67.97 per hour, along with a comprehensive benefits package. This role demands strong analytic, organizational, and communication skills. #J-18808-Ljbffr Molina Healthcare
- Molina Healthcare in Chandler, Arizona is looking for a RN Utilization Review Nurse. This role focuses on utilizing clinical expertise to ensure documentation meets medical necessity and coding standards. Responsibilities include facilitating medical review for authorization...Remote jobMedical
$29.05 - $67.97 per hour
...Healthcare is seeking a Clinical Nurse Reviewer in Albany, NY, responsible for reviewing medical documentation to ensure medical... ...Candidates must hold an active RN license and have at least 2... ...nursing experience, particularly in utilization review. Molina offers...Remote jobMedicalHourly pay$29.05 - $67.97 per hour
...Healthcare in Cincinnati, Ohio, seeks a Clinical Reviewer to leverage clinical knowledge for ensuring medical necessity and appropriate levels of care.... ...of clinical nursing experience, including utilization review, and an active RN license. Molina offers competitive...Remote jobMedicalHourly pay$29.05 - $67.97 per hour
Molina Healthcare is seeking a qualified Registered Nurse with clinical experience to perform utilization reviews and ensure medical necessity of claims. The role involves reviewing medical documentation, facilitating appeals for authorizations, and validating claims coding...Remote jobMedicalHourly pay- ...seeking a qualified Registered Nurse to evaluate medical documentation for authorization and reimbursement. You will review claims, ensure compliance with regulations,... ...experience, with a strong background in utilization review and coding. We offer a competitive compensation...Remote jobMedical
$29.05 - $67.97 per hour
...Antonio, Texas, to join their team for clinical review responsibilities involving medical necessity and claims processing. This role... ...nursing experience and knowledge in utilization review. Candidates must hold an active RN license and demonstrate proficiency in billing...Remote jobMedicalHourly pay- ...clinical professional in Miami to perform utilization reviews and ensure proper coding for... ...regulations. The candidate will evaluate medical claims and facilitate appeals, contributing... ...assurance and regulatory compliance. An active RN license is essential, along with...Remote jobMedical
$29.05 - $67.97 per hour
...Healthcare in Bellevue, WA is looking for a clinical reviewer with at least 2 years of nursing experience. The role involves validating medical records and determining the medical... ...of claims. Candidates should have an active RN license, knowledge of coding, and strong analytical...Remote jobMedicalHourly pay$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain subject... ...necessary.* Experience with utilization management systems or... ...to work independently in remote setting with minimum supervision... ...*** Active unrestricted RN license #J-18808-Ljbffr...Remote workMedicalFlexible hours- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position... ...'ll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workMedicalContract workWork from home
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...partner with top-tier hospitals and medical institutions nationwide, helping you...Remote workMedicalHourly payFull timeContract workImmediate startShift work3 days per week- ...Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a... ...flexible scheduling with benefits that include medical, dental, and retirement contributions...Remote workMedicalWork from homeFlexible hours
- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workMedicalFull time
$1,949.74 per month
...Nurse Specialty Utilization Review Job ID 17979666... ...Title Utilization Review RN Weekly Pay $1949.7... ...Job Description Remote Utilization Review RN responsible for concurrent reviews, medical necessity determinations, prior...Remote workMedicalWeekly payShift work- ...BJC HealthCare (New) is seeking a remote RN with Utilization Review experience. This role involves evaluating the appropriateness and efficiency of... ...offers comprehensive benefits from the first day, including medical, dental, and retirement contributions. Ideal candidates...Remote workMedical
- ...We are seeking an experienced Utilization Review Nurse to join our team in a... ...Nassau County (Hybrid: In Office/Remote) Schedule: Monday to Friday,... ...to ensure appropriate use of medical resources. Evaluate patient... ...meetings. Qualifications Active RN license in the state of New...Remote workMedicalWork at officeMonday to FridayFlexible hours
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workMedicalHourly payPart time$47.06k - $70.24k
...healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting findings,... ...claims examiners. Candidates must have a current RN license and at least four years of clinical...Remote workMedical- ...Utilization Management Position Provide health care services regarding admissions, case... ...management, discharge planning and utilization review. Review admissions and service... ...prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement...Remote workMedical
- ...Epidemiologists is seeking a Clinical Review Supervisor to provide... ...supervision of clinical staff conducting utilization review activities. This fully remote position requires an RN license and relevant experience in patient care and medical management. The role focuses on...Remote workMedical
$30 - $34 per hour
...healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in... ...management. Responsibilities include approving or denying medical services based on established criteria. Competitive...Remote workMedicalHourly pay$75k
...WNS Global Services is seeking a fully remote Utilization Review Nurse to perform inpatient reviews and ensure compliance with medical necessity criteria. This role requires strong... ...with physicians. The ideal candidate has an RN license, at least two years of experience...Remote workMedicalWork at office$75k
...seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical necessity reviews and collaborating with... ...informed decisions. Candidates must hold an active RN license and have experience in acute care settings...Remote workMedical- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching... ...and maximize client savings by reviewing medical bills from a nurse... ...treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves...Remote workMedicalImmediate start
- ...Weekend Requirements - UR RN 4 weekend shifts (days) in a six-week period but can be more Job Description... ...: 1:40 • Years of experience REQ: 3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group...Remote workMedicalImmediate startShift workWeekend work
$2,210 per week
...and benefits, including medical, dental, vision, long-... ...Holidays Work-life balance. Remote/hybrid setting (once... ...: This individual will utilize clinical knowledge and... ...to a second level reviewer. This individual interfaces... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workMedicalFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical necessity criteria to... ...position is full-time, fully remote (work from home) and... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workMedicalFull timeWork from homeShift workWeekend workAfternoon shift
$75k
...seeking a Registered Nurse for the role of Utilization Review Specialist. The position involves... ...Successful candidates must possess an active RN license and have at least two years of... ...annually, with additional benefits including medical, dental, and paid time off. #J-18808-...Remote jobMedical- Humana is seeking a Utilization Management Behavioral Health Registered Nurse (RN) Intern to join their National Medicaid... ...role involves conducting medical necessity reviews for behavioral health services... ...license. This position supports remote work, providing work-life...Remote jobMedicalInternship
$57.28 - $88.92 per hour
...Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective... ...CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required...Remote workMedicalDaily paidMinimum wageLocal areaShift workDay shift
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