Inpatient Care Manager RN (Remote MO) | Utilization Review
Optum
- Remote job
Optum is seeking an Inpatient Care Management Nurse in Missouri with remote-work flexibility. You will review inpatient cases, collaborate on care plans, and support discharge planning while ensuring compliance with evidence-based guidelines. Required MO RN license, 3+ years of hospital nursing, and solid computer skills. Bachelor’s degree preferred; compact license and managed care experience are a plus. Salary ranges are provided with full benefits. #J-18808-Ljbffr Optum
- ...Description Join our team as a remote (Oklahoma City) full time... ...and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health,... ...to appropriate levels of care as indicated by clinical needs... ...settings (e,g. home health, inpatient, physician office, clinic)...Remote workFull timeWork at officeWeekend work
- UnitedHealth Group is seeking an Inpatient Care Management Nurse in Missouri. You will assess inpatient cases, apply evidence-based criteria, and... ...across clinical services. The position requires an MO RN license and 3+ years of hospital nursing experience, with proficiency...Remote job
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will collaborate with the patient... ...ensure appropriate, cost-effective care at the right level. Requirements include a CA LVN/RN license, minimum 3 years in case...Remote work
- Medix Staffing Solutions, Inc. is seeking an experienced California RN or LVN with strong Utilization Management and inpatient review experience for a 100% remote role focused on inpatient clinical review, UM, and discharge planning. You will apply MCG criteria and Medicare...Remote job
- Partner Company is seeking a Case Manager - Utilization Review Specialist for a fully remote position based in the United States. You will oversee admission and... ...necessity, and coordinate appeals to support patient care and financial performance. You will apply clinical...Remote job
- CorVel is seeking a Utilization Review Case Manager to gather demographic and clinical data for in-patient and outpatient reviews, certify... ...supporting the Case Management department’s goals. This remote role requires RN licensure and 4+ years of clinical experience. The...Remote job
- CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills. Responsibilities include...Remote job
- ...Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across the continuum. This... ...inpatient nursing, and 2+ years in utilization management or discharge planning, with an...Remote workWork from homeMonday to FridayWeekend work
$89.54k - $136.47k
...Plans is hiring an Integrated Care Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia! Status:... ...and commercial insurance Review clinical denials (non-... ...Experience/knowledge in Rev Cycle, Utilization Review (UR) and Case...Remote workPermanent employmentFull timeTemporary workShift work- ...and therapists in home care, hospice, and case management for over 30 years. We offer... ...need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an... ...activities for members in an inpatient setting. Candidates MUST...Remote workContract workMonday to FridayFlexible hours
- ...integrated health care plans and... ...LTSS department. RN will be responsible... ...providing case management services and... ...and concurrent review. Provides monthly... ...necessity of inpatient admissions, outpatient... ...setting by utilizing the applicable... ...*possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
$113.73k - $170.46k
...that patients receive high-quality care while efficiently utilizing medical resources. Reviews patient medical records,... ...Certifications: ~ Registered Nurse (RN) licensure in the state of... ...communication variances to the on-site care management teams when appropriate. Reviews...Remote workFull timeWork experience placement- HonorHealth is seeking a Utilization Review RN Specialist to review and monitor health care utilization, ensuring medical necessity across inpatient and outpatient settings. You will coordinate... ...payers, working with the Care Management team to optimize resource use and...Remote jobDaily paid
- HealthEdge Software, Inc. is seeking a motivated Utilization Review RN to perform prospective, concurrent, and retrospective review of inpatient and outpatient services to ensure medical necessity and appropriate level of care. This role involves coordinating discharge...Remote jobContract work
- ...seeking a Registered Nurse - Review Analyst for a remote contract role. The... ...least 2 years of acute care nursing experience and an active RN license.... ...documentation review, applying utilization management criteria, and supporting inpatient care determinations. Start...Remote jobContract workImmediate start
$38 - $40 per hour
...Title: RN -- Review Analyst Location: Remote Duration: 12 months with possible... ...concurrent, and retrospective utilization reviews for inpatient, outpatient,... ...length of stay, level of care, and intensity of services... ...includes Utilization Management (UM) , Case...Remote workHourly payWork at officeMonday to FridayShift work$63.1k - $94.65k
...enabled revenue cycle management solutions for... ...current compact RN license, or be willing... ...seeking Virtual Utilization Review Specialist with... ...of health care resources and assists... ...location Provides inpatient and observation (... ...: ~ This is a remote role which...Remote workFull timeTemporary workWork at officeLocal areaMonday to FridayShift work$3,268 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler San... ...hiring an RN Case Manager with inpatient case management and... ...2 days onsite and 3 days remote per week Floats between... ...preferred ~ Experience with care coordination, concurrent...Remote workWeekly payContract workLocal areaShift workNight shiftDay shift3 days per week- Highmark Health is seeking a remote Care Manager RN to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) plus three weekdays, focusing on reviewing services, applying criteria, and improving member outcomes...Remote jobWeekend workWeekday work
- Highmark Health is seeking a full-time Remote Utilization Management/Case Management RN. The role reviews care appropriateness, applies criteria for resource use, refers to Health Coach/case management when needed, and analyzes data to improve provider and member satisfaction...Remote jobFull timeWeekend workWeekday work
$41.2 - $62.17 per hour
...Job Description: The RN Hospital Care Manager I delivers comprehensive care... ...departments, including both Inpatient and Outpatient areas.... ...experience in case management, utilization review, value-based care, and/or... ...expectations. If applying for a remote or hybrid role, this...Remote workHourly pay$81.95k - $110.24k
...enabled revenue cycle management solutions for health... ...healthcare. The Lead Utilization Review RN is a key contributor... ...-oriented, patient care delivery system, which... ...location. Provides inpatient and observation (if indicated... ...#LI-LS1 #LI-REMOTE Join an award-winning...Remote workFull timeWork at officeLocal area$52 - $56 per hour
...Contract RN For New York Health Plan You've done... ...necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52$... ...investigation, clinical review, decision and... ...community-based or long-term care background (not inpatient only) ~ Working...Remote jobContract workAfternoon shift- Highmark Inc. is seeking a Remote Care Manager with full-time commitment, weekend availability... ...weekdays. You will implement utilization management strategies, review appropriateness of care, and... ...improve member outcomes. Requires RN licensure, 3 years of clinical experience...Remote jobFull timeWeekend workWeekday work
- Highmark Inc. is seeking a full-time remote Health Care Manager to implement effective utilization management strategies, review care appropriateness, and identify opportunities for Health Coach/case management referrals. This role requires weekend availability (Saturday...Remote jobFull timeWeekend workWeekday work
- Highmark Health is seeking a full-time remote RN Care Manager to implement utilization management strategies and oversee care management reviews. The role includes collaborating with providers, coaching members, and improving provider and member satisfaction. Weekend availability...Remote jobFull timeShift workWeekend workWeekday work
$143.68k - $185.81k
...UCLA Medical Group Utilization Review Nurse Under the direction of the... ...Director, the Intensive Case Management Medicare Advantage Utilization... ...regulations and contracts, care coordination and continuity... ...in utilization management, Inpatient CM or clinical Experience....Remote jobWork at officeFlexible hours- Highmark Inc. in the United States is seeking a full-time RN care manager for a remote position requiring weekend availability (Saturday... ...in addition to three weekdays. The role focuses on utilization management, reviewing care appropriateness, applying criteria, and...Remote jobFull timeWeekend workWeekday work
- Highmark Inc. is seeking a full-time remote care manager in California to support utilization management across weekends and weekdays. The role reviews care appropriateness, applies criteria to optimize resource use, coordinates with Health Coaching and case management...Remote jobFull timeWeekend workWeekday work
$77.91k - $116.86k
...the mold in conventional health care, committed to serving seniors and... ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse... ...valid, and unrestricted LVN or RN license in California (Non-...Remote jobImmediate startMonday to Friday
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