Remote RN Utilization Management Coordinator (WI)
Network Health Plan (Wisconsin)
Network Health WI in Wisconsin is seeking an RN Coordinator Utilization Management responsible for reviewing authorization requests for medical necessity and care appropriateness. This role allows for remote work, but candidates must reside in Wisconsin. Occasional travel to Menasha is required, especially for in-person training. Applicants should have a minimum of four years of nursing experience and a current registered nurse license in Wisconsin. The role offers a full-time work schedule of 40 hours per week, Monday to Friday, starting August - September 2026. #J-18808-Ljbffr
- ...Network Health Administrative Services, LLC in Menasha, WI is seeking an RN Coordinator for Utilization Management. This role involves reviewing authorization requests and ensuring compliance with payment guidelines while coordinating with providers to optimize patient...Remote workFull timeWork from home
- ...Network Health in Wisconsin seeks an RN Coordinator for Utilization Management. The role involves reviewing authorization requests, educating stakeholders about utilization processes, and collaborating with other departments to ensure quality care. Candidates must hold...Remote workFull timeWork at office
- ...Locations Menasha, WI 54952, USA (remote location available). Description The RN Coordinator Utilization Management reviews authorization requests, evaluates medical necessity, appropriateness of care, and benefit eligibility. The position ensures compliance with payment...Remote workFull timeWork from homeWeekend work
- ...with our team and our clients. Position Summary: The Utilization Management Coordinator reports to the Director of Claims. This position is... ...interruptions. Working Conditions: This is a fully remote position. If work is performed offsite, location must...Remote workTemporary workWork at officeImmediate startShift work
- ...currently hiring for a Case Management Coordinator to join BlueCross BlueShield... ...00am‑5:00pm EST and will be remote in South Carolina. The ideal... ...regarding health care delivery, utilization on networks, and benefit... ...Certificate Active, unrestricted RN license from the United...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaMonday to Friday
$20 - $30 per hour
...industry by delivering exceptional care, utilizing state-of-the-art facilities, and... ...: SeniorDirector of Revenue Cycle Management Department/Location: Remote FLSA Status: Exempt Travel... ...with the primary treating clinicians. Coordinate Peer-to-Peer (P2P) Review preparation...Remote work- ...Case Management Coordinator We are currently hiring for a Case Management Coordinator... ...00am-5:00pm EST and will be remote in South Carolina. Our ideal... ...member-centered coaching utilizing motivational interviewing... ...: An active, unrestricted RN license from the United...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaMonday to Friday
- ...Consociate-Health is offering a remote Utilization Management Coordinator position responsible for coordinating appeal activities and the UM process. Candidates should have strong administrative skills, excellent communication abilities, and a High School diploma or GED...Remote work
$19 per hour
...The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director)... ...-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB... ...Career development opportunities Remote Opportunities We are actively seeking...Remote workTemporary workLocal area- ...Job Title Responsible for providing administrative and coordination support within utilization management processes, including benefit verification, authorization management, and claims-related inquiries. The role involves reviewing authorization requests, supporting...Remote jobWork at office
$37.21 - $57.68 per hour
Join to apply for the RN Bed Management Coordinator - (Part-time, Day) role at Virtua Health Location: Pennsauken - 6991 North Park Dr. Remote Type: On-Site Employment Type: Employee Employment... ...assignments, ensuring efficient utilization of resources, and supporting...Remote workHourly payFull timeTemporary workPart timeLocal areaFlexible hoursShift workDay shift$20.24 - $24.24 per hour
...Utilization Management Coordinator Pay Range: $20.24hr - $24.24hr The Utilization Management Coordinator will provide administrative and operational support for utilization management activities, including authorization processing, benefit verification, claims inquiries...Remote jobWork at office$31.6 - $47.4 per hour
...PeaceHealth is seeking a Utilization Management Coordinator Non RN for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $31.60 - $47.40. The hiring rate is dependent upon several factors, including but not limited to education...Full timeWork experience placementLocal area- 4004 Aetna Medicaid Administrators is seeking a Utilization Management Nurse Consultant for a crucial role in a 24/7 operation based in Florida.... ...The ideal candidate will have clinical experience, an active RN license, and a commitment to high-quality healthcare service....Remote workWork from home
- SIERRA VISTA HOSPITAL in Sacramento is seeking a Full-time Utilization Management Coordinator (Registered Nurse) to join the Utilization Management... ...master's degree in a related field is preferred, along with RN licensure. Join a dedicated healthcare team focused on serving...Full time
- ...Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote workFlexible hours
- ...Industrial Asset 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 clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
- CommonSpirit Health is seeking a Supervisor of Utilization Management (UM). This remote position requires overseeing the Pre-Authorization team while ensuring compliance with guidelines. Your leadership will be essential in promoting quality patient care. The ideal candidate...Remote job
- ...provider in California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-... ...utilization management. You'll manage staffing, coordinate referrals, and facilitate team meetings. A California RN license is required. This position offers a...Remote job
- ...Acentra Health, LLC is seeking a Clinical Supervisor – RN – Full-time to oversee Utilization Management activities. This remote position requires strong clinical and leadership skills to manage UM processes, improve care management, and ensure compliance with standards...Remote workFull time
- ...A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...Remote workFlexible hours
$55 per hour
...Amerit Consulting is seeking a remote Utilization Management Nurse to support Medicare utilization review activities. Candidates must be California-based RNs with a minimum of 5 years of direct patient care in a hospital setting and strong clinical skills. This contract...Remote workHourly payContract work$59.5k - $116.6k
...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 and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr...Remote work
- ...to provide operational 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 quality oversight and staff development...Remote job
- Summary We are currently hiring for an RN Case Management Coordinator to join BlueCross BlueShield of South... ...8:30am-5:00pm EST and will be fully remote. What You’ll Do: Provides active care... ..., provides member-centered coaching utilizing motivational interviewing techniques...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaMonday to Friday
- ...Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote work
$75.3k - $135.4k
...professional on our Medical Management/Health Services team. Centene... ...Supervises day-to-day activities of utilization management team. Monitors and... .... License / Certification RN - Registered Nurse - State... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours- ...Brigham is seeking a Peer-to-Peer Utilization Review Nurse to join the Central Utilization Management team. This role involves... ...Bachelor's of Science in Nursing, an RN license, and extensive experience... ...utilization review. The position offers a remote work model with a flexible...Remote workFlexible hours
$77.91k - $116.86k
...E2E Alignment Healthcare USA, LLC is seeking a remote Utilization Management Nurse to review prior authorization requests for medical necessity. The role requires a valid LVN or RN license in California, along with experience in nursing and utilization management. Successful...Remote work
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