RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic
$60.2k - $107.4kUnitedHealth Group
- Remote job
Concurrent Review Case Manager
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to established criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations. This position works closely with Medical Management Physician leadership and various internal departments.
4 - 10 hour shifts per week and includes every Saturday and Sunday.
The employee is required to work both Saturday and Sunday each week as part of their regular schedule (two of the four scheduled shifts). The remaining two (2) shifts will be scheduled on weekdays (Monday through Friday) based on business needs and in coordination with management. The assigned weekday shifts may be adjusted as operational needs dictate. Whenever possible, schedule changes will be communicated at least two (2) weeks in advance. Shift start and end times will be established based on operational requirements and will comply with all applicable federal, state, and local employment laws and regulations.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Associate Degree in Nursing or higher
- Active Texas RN license or multistate compact RN license
- 5+ years of nursing experience in concurrent review
- Managed Care knowledge
Preferred Qualifications:
- Certification in area of specialization, BSN
- ACP certification
- Case Management Certification
- 2+ years in area of specialization, 2+ years of Case Management/Utilization Review experience
- Proven program development skills
- Proven communication and problem-solving skills; Computer literate
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
UnitedHealth Group$51.43 - $79.84 per hour
...Description – This is a remote role. You MUST live... .... Care Manager RN, Per diem / On call,... ...The Utilization Review (UR) Nurse has a strong clinical background blended with... ...Utilization Management (UM), medical necessity... ...admission, concurrent and retrospective UR...Remote workDaily paidLive inShift workDay shift- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines and support high-quality patient outcomes. The role requires current...Remote work
$69.38k - $92.28k
MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum... ...to transition into utilization management, requiring strong clinical judgment and excellent communication skills. The position...Remote job- ...Registered Nurse - Rapid Treatment Clinic Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family... ...effects, and overall well-being Reviews lab values and assesses for treatment... ...is notified immediately ~ RN license and all required certifications...SuggestedWork experience placementLocal areaImmediate start
$69.38k - $92.28k
...the Opportunity As a Professional Concurrent Review RN, you'll have the opportunity to apply... ...setting while partnering with providers and clinical leadership. You'll be part of an... ...Where you'll be: Location: Remote Pay Transparency MVP Health Care...Remote workContract work- MVP Health Care is seeking a Sub-Acute RN UM Reviewer for a remote position. You will be part of the Utilization Management team, conducting clinical reviews to ensure appropriate healthcare service usage and compliance with Medicare guidelines. The ideal candidate will...Remote job
$75k
...Nurse, Concurrent Review WNS, part of Capgemini, is an Agentic... ...updates Engage in clinical collaboration with attending... ...quality issues to UM Leadership Collaborates... ...Qualifications RN graduate from an... ...process. Location - Remote WNS HealthHelp (A...Remote workWork at officeLocal areaMonday to FridayFlexible hours- ...Overview Clinical Review Nurse - Concurrent Review TX Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm-... ...4 years is preferred. Years of experience: UM experience preferred but not required. Disqualifiers...Remote workContract workShift work
- ...medical facilities. Our 130+ clinics across the state of... ...As our Utilization Review LVN, your focus will be... ...facility review or in concurrent review. To be successful... ...flow. As a remote employee, we will provide... ...Utilization Management (UM) experience - Five (5...Remote workContract work
- ...Utilization Nurse utilizes clinical expertise, discretion,... ..., continued stay (concurrent), Observation days, based... ...Inpatient Care Guidelines. The UM Nurse will also be... ...for medical necessity review of incoming referrals,... ...~ Registered Nurse (RN) in the State of California...Remote workLocal area
$29.05 - $67.97 per hour
Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity... ...Michigan is not included in a compact RN license. Job Duties Facilitates... ...prospective, retrospective, and concurrent review of appeals for denied...Remote jobHourly payWork experience placementWork at office$18 - $32 per hour
...Specialist Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of... ...assisting with basic coding tasks and claim reviews under supervision. Applies foundational... ...you will have the flexibility to work remotely as you take on some tough challenges...Remote jobHourly payMinimum wageFull timeApprenticeshipWork experience placementInternshipWork at officeLocal area$69.38k - $92.28k
...About the Opportunity As a Sub-Acute RN UM Reviewer-Medicare, you will play a vital role in... ...Management team by conducting clinical reviews to ensure appropriate use of healthcare... ...Where you'll be: Location: Remote Pay Transparency MVP Health...Remote work$28.94 - $51.63 per hour
...Explore opportunities with Kelsey‑Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations... ...on the unit, under the supervision of a Nurse Supervisor, or RN Coordinator. The RN applies clinical nursing knowledge and...Hourly payMinimum wageFull timeWork experience placementLocal area$28.94 - $51.63 per hour
...Overview Explore opportunities with Kelsey‑Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health... ...Qualifications Associate of Science in Nursing (ASN) or higher Texas RN license American Heart Association Basic Life Support (BLS) 2...Hourly payMinimum wageFull timeWork experience placementLocal area- ...UM Inpatient Clinical Review Nurse page is loaded## UM Inpatient Clinical Review Nurselocations... ..., Massachusetts: Remote Work Opportunitytime type:... ...*** Performs pre-service, concurrent, and retrospective reviews... ...REQUIREMENTS:*** Current MA RN License, required* Bachelor...Remote workHourly payFull timeWork at officeMonday to FridayFlexible hoursWeekend work
$28.94 - $51.63 per hour
...Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations... ...roles you may be interested in. Required Qualifications RN required education RN License CPR/BLS 3+ years of RN...Hourly payDaily paidMinimum wageFull timeWork experience placementSummer holidayLocal areaShift work$40 - $42 per hour
...currently looking for a Care Review Clinician I to work... ...This is a fully remote role but candidates must have a valid RN license in Illinois Position... ...Assess and analyze clinical service requests (e.g.,... ...prior authorizations and/or concurrent review. Assesses services...Remote workHourly payLocal areaMonday to Friday$28.27 - $50.48 per hour
...Explore Opportunities Explore opportunities with Kelsey‑Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading... ...Associate of Science in Nursing (ASN) or higher. Valid Texas RN license. Basic Life Support certification through American...Hourly payMinimum wageFull timeWork experience placementLocal area$28.94 - $51.63 per hour
...Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations... .... We are seeking qualified candidates for the role of RN Hematology/Oncology at varying levels (I, II). The selected...Hourly payMinimum wageFull timeWork experience placementLocal area- ...Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care... ...general body CT preferred. You'll enjoy the flexibility to work remotely from anywhere within the U.S. Required Qualifications...Remote workMinimum wageWork experience placementLocal area
$74.29k - $111.43k
...Medicare, and Medicaid. NeueHealth delivers clinical care to health consumers through our... ...experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for... ...Qualifications Education: Registered Nurse (RN) with an active, unrestricted California...Work at office$75k
...WNS Global Services is seeking a fully remote Utilization Review Nurse to perform inpatient reviews and... ...criteria. This role requires strong clinical collaboration with healthcare teams and... ...physicians. The ideal candidate has an RN license, at least two years of...Remote workWork at office$31 - $38.74 per hour
...for a California Licensed RN . However, the offered base... ...Utilization Management, the UM Nurse Reviewer will leverage expertise to conduct... ...of pre-certification and/or concurrent requests, aligning with... ...medical necessity, applying clinical knowledge to ensure proper benefit...Hourly payFull timeImmediate startMonday to Friday- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Remote workWork at office
$1,966 per week
...Holidays Work-life balance. Remote/hybrid setting (once... ...will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces... ...precertification and concurrent review within the... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours$35 - $62.5 per hour
...Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations... ...in. Required Qualifications: Graduate from an approved RN nursing program Valid and current Texas RN license Current...Hourly payMinimum wageFull timeWork experience placementLocal area$28.94 - $62.5 per hour
...Per Diem RN II for Wellness, Travel & Executive Health Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...Hourly payDaily paidMinimum wageFull timeWork experience placementLocal areaShift workDay shiftAfternoon shiftEarly shift$35 - $63 per hour
...Operating Room Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the... ...competency in a multidisciplinary surgical environment. The RN demonstrates proficiency in delivering high-quality, age-specific...Hourly payMinimum wageFull timeWork experience placementLocal areaShift work- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...have an Illinois state RN license Assess and analyze clinical service requests (e.g.,... ...medical necessity/utilization review and other utilization... ...authorizations and/or concurrent review. Assesses services...Remote workContract work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic. Be the first to apply!
- prn registered nurse Pearland, TX
- pediatric rn Pearland, TX
- nurse rn Pearland, TX
- registered nurse pharmacy Pearland, TX
- public health registered nurse Pearland, TX
- travel clinic rn Pearland, TX
- registered nurse nursing home Pearland, TX
- weekend prn rn Pearland, TX
- flex rn Pearland, TX
- progressive care unit registered nurse Pearland, TX

