Senior RN - Utilization Review Quality Lead (Remote)
Ensemble Health Partners
- Remote job
Ensemble Health Partners is seeking an RN Utilization Review quality professional to lead QA efforts within the VUR team. You will mentor staff, evaluate QA processes, and drive improvements across multiple clients and systems. The role requires an unrestricted RN license, at least three years of acute care nursing experience, and knowledge of medical necessity review criteria. Remote work with travel to client sites is expected, and opportunities for professional development are provided. #J-18808-Ljbffr Ensemble Health Partners
$47.03 - $63.48 per hour
...a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue... ...possible in healthcare. The RN, Senior Utilization Review Quality will play an essential role in reviewing... ...and client experiences This is a remote position; however, candidates must...Remote workQualitySeniorTemporary workWork at officeLocal area- Gainwell Technologies LLC is seeking a Senior Nurse Reviewer to perform reviews of medical records,... ...review experience, with potential utilization review responsibilities. Home-based position... ...US, supporting a flexible, quality-driven team environment. #J-18808-Ljbffr...Remote jobQualitySeniorWork from homeFlexible hours
- KVC Health Systems, Inc. in Kansas City, MO is seeking a dedicated Utilization Review Manager (URM) to obtain and review clinical and medical service authorizations, supporting high-quality behavioral healthcare for children and families. You will liaise with treatment...Remote jobQuality
$100k - $130k
...to providing high-quality, affordable, and easy... ...for America’s seniors. We prioritize preventive... ...it most. The Utilization Management (UM)... ...guidelines. As the Lead RN, Utilization... ...staff, oversee daily review operations, and... ...Additionally, we embrace a remote-first culture that...Remote workQualityFull timeWork experience placementWork at officeFlexible hours- ...Utilization Management Concurrent Review Nurse The Utilization Management Concurrent Review team reviews the... ...equipment, and post service needs to ensure quality and cost appropriate DC planning... ...maintain an active, unrestricted CA RN license Associate's degree in...Remote workQualitySeniorFull timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week
- ...is seeking a Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer to coordinate the efficient utilization... ...members and ensure timely, quality care throughout the continuum.... ...Department Manager and Team Lead, you will assess clinical information...Remote workQuality
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team... ...Managers, and field clinicians Support quality assurance and regulatory compliance...Remote workQualityMonday to FridayWeekend workWeekday work- ...OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations... ...records, apply evidence-based criteria, and participate in quality improvement initiatives while maintaining regulatory alignment...Remote workQualityRelief
- Methodist Hospital for Surgery in Addison, TX is seeking an RN Utilization Review Coordinator in the Case Management department. The role performs... ..., and contribute to quarterly utilization reports and quality initiatives. A Texas RN license and 5+ years of relevant experience...Quality
- ...Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient... ...-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT -... ...helping healthcare organizations provide quality patient care that continually evolves...Remote workQualityTemporary workShift workWeekend work
$75k - $88k
...application process. Clinical Reviewer RN - Alabama Alabama, US 3... ...has engaged in health care quality consulting and quality... ...patient outcomes. Our talented remote workforce spans the country... ...We are seeking Clinical Utilization Review Nurses (RN) based in...Remote workQualityFull timeContract work$63.1k - $94.65k
...Ensemble! Ensemble is a leading provider of technology... ...have current compact RN license, or be willing... ...Information: Our Utilization Review team provides coverage... ...Monitor for readmissions Quality/Revenue Integrity... ...Required: This is a remote role which requires...Remote workQualityTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$40.12 - $62.94 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty... ...or improving quality of care. Summary:... ...This is a Full-time remote position. Responsibilities... ...The Utilization Review RN reviews the medical record... ...care anchored by five leading centers in Maryland....Remote workQualityFull time$63.1k - $94.65k
...next steps. Our partner is looking for a Utilization Review RN based in the United States. Join... ...operations. In this part-time, remote role, you will apply your clinical expertise... ...denials. You will also contribute to quality improvement initiatives, regulatory compliance...Remote workQualityTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift$2,150 per week
...Healthcare Nursing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort... ...-based) Skilled experience with remote work LENGTH OF ASSIGNMENT - 13 weeks... ...healthcare organizations provide quality patient care that continually evolves...Remote workQualityTemporary workLocal areaImmediate startShift workNight shiftWeekend work$45 - $50 per hour
...for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby...Remote jobQualityHourly pay$38.46 - $43.27 per hour
IPRO in Jericho, NY is seeking a Clinical Reviewer (RN) to perform utilization and quality reviews, support Medical Review Analysts and Physicians, and ensure accurate processes. Duties include chart reviews, data collection, and guiding staff through procedures. Required...QualityHourly payWork at office- Medix™ is seeking an experienced Registered Nurse (RN) to join our Utilization Review team in a remote capacity. The role evaluates medical necessity, reviews... ...utilization and regulatory compliance, while delivering high-quality patient outcomes. #J-18808-Ljbffr Medix™Remote jobQuality
- ...Description Job Description The utilization review and management (UM)... ...recognizing our commitment to quality, safety, and excellence in... ...records. Serves as the medical lead during joint commission... ...This is an in-office, no remote work capability position...Remote workQualityWork at office
$63.1k - $94.65k
...Registered Nurse to perform hospital utilization reviews, assess medical necessity,... ...levels of care. This remote role partners with physicians... ...revenue cycle teams to promote quality outcomes, prevent denials, and... ...Skills: Current unrestricted RN license required; RN compact...Remote workQualityTemporary workWork at officeLocal areaShift workAfternoon shift- ...delivers a number of leading health benefit... ...LTSS department. RN will be responsible... ...members to promote quality member outcomes, to... ...and concurrent review. Provides monthly... ...treatment setting by utilizing the applicable medical... ...Info: *possible remote opportunity after...Remote workQualityContract workMonday to FridayFlexible hours
- We are seeking an experienced Registered Nurse (RN) to join our Utilization Review team in a remote capacity. This role is responsible for evaluating medical... ...will play an important role in supporting quality patient outcomes, regulatory compliance, and revenue...Remote workQualityTemporary workWork at office10 hours per weekShift workWeekend workDay shiftAfternoon shift
- ...Job Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Job... ...managing patient care without impacting quality or outcomes. Participates in collecting...Remote workQualityFull timeWork at officeWeekend work
- ...population. This includes utilization management,... ..., and monitoring quality indicators to demonstrate... ...accuracy.The Team Lead of On-site UM is... ...expected that all RN Clinical Nurses... .... Unlike remote roles, this position... ...Medical Necessity Reviews: Use criteria like...Remote workQualityFull timeImmediate startShift work
$2,784 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Bethel, Alaska, United... ...Participates in design, execution, quality assurance, and assessment of public... ...Hospital housing provided in a remote area with shared common spaces and...Remote workQualityWeekly payWork experience placementShift workDay shift- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J-18808-Ljbffr...Remote workQualityContract work
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the... ...levels of care while maintaining safety and quality. The role requires a CA LVN/RN license, 3+ years in case management, and experience...Remote workQuality
$72.8k - $130k
...occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the... ..., and promoting quality patient care. Responsibilities... ...to discuss care details, reviewing clinical information for... ...: Registered Nurse (RN) with a current, active,...Remote workQualitySeniorMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...Medix™ seeks an experienced Utilization Review Nurse Specialist for a fully remote role in the United States. You will evaluate medical necessity, determine... ...leveraging AI-enabled workflows to streamline processes while upholding HIPAA and high-quality #J-18808-LjbffrRemote workQuality
- ...Telenett is seeking a Remote Utilization Review Nurse to review medical records from a home office and... ...compliant care plans and ensure high-quality, cost-efficient services for clients nationwide... .... Ideal candidates have a Texas RN license, 3+ years of clinical...Remote workQualityHome office
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