Remote Utilization Management RN — Care Coordinator
Humana
- Remote job
Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and join the One Home/Home Solutions Utilization Management team, which manages post-acute care services including SNF, Home Health, and DME. The role involves applying clinical criteria to determine medical necessity, completing determinations within timeframes, #J-18808-Ljbffr Humana
- ...an experienced Registered Nurse (RN) to join our Utilization Review team in a remote capacity. The role evaluates medical necessity, reviews levels of care, and supports denial prevention and... ...collaborate with physicians, care managers, and payers to promote appropriate...Remote job
$42 - $45 per hour
...Title: Care Management Coordinator/RN Location: 100% Remote Duration: 3+ Months (FT conversion) This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle).*Must be available M-F 8:30-4:30pm for 2-3 weeks...Remote workHourly payFull timeTemporary workPart timeFlexible hoursWeekend work2 days per week- ...Position TitleAmbulatory Clinic RN Care Coordinator - Cardiology-New patient... ...- Full TimeBell Hospital, Remote Position Summary /... ...Functions Responsible for management of patient flow, triage, and... ...defining appropriate resource utilization, and working with the...Remote workFull timeWork at office
$38.66 - $58.32 per hour
...RN Care Coordinator Partnering for a stronger, healthier world. At CommonSpirit Health... ...2 Requisition ID: 2026-493468 Remote: No Weekly Schedule: Saturday and... ..., communicate, and collaborate with utilization management, nursing, physicians, ancillary departments...Remote workFull timeRelocation packageShift workWeekend workWeekday work- ...Description: Home Care & Hospice Virtual Care Center Coordinator Registered Nurse (RN) Hiring for the following... ...critical moments. Utilizing virtual platforms,... ...Leadership - Accessible managers who understand the... ...patients' conditions remotely. Develop and...Remote workFull timeTemporary workPart timeReliefLocal areaImmediate startMonday to FridayShift workWeekend work
$30 per hour
...Job Description Job Description RN/Managed Care Coordinator - Remote Job at a Glance Title: RN/Managed Care Coordinator Location: Columbia... ...to ensure coordinated care and appropriate resource utilization. Required Skills Experience providing telephonic...Remote jobContract work- UnitedHealth Group is seeking a dedicated RN Clinical Care Coordinator to manage a panel of members with complex medical and behavioral needs. You... ...support services to improve care quality and appropriate utilization. The role is field-based with a home office; travel up...Remote jobHome office
$71.1k - $97.8k
...Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who will assess and... .... Highlights Location: Remote, IN Schedule: Full-time, Monday... ...eligible for Medicare. Utilize various strategies to... ...Licensed Registered Nurse (RN) in the state of Indiana without...Remote workFull timeTemporary workWork from homeRelocation packageMonday to Friday$42 - $45 per hour
...Care Management Coordinator/RN Location: 100% Remote Duration: 3+ Months (FT conversion) This is a UM/Discharge Planning PART TIME RN position - the manager... .... Efficiently collaborates with the hospital utilization review department, attending physicians and members...Remote jobHourly payFull timeTemporary workPart time- ...RN, BH Transition of Care Coordinator Established in 1980, the Greater Lawrence Family... ..., reducing avoidable utilization (reducing total cost of care... ...role is a hybrid model with remote opportunities and onsite... ...plans and symptom management strategies. Serve as a...Remote workContract workLocal areaFlexible hours
- Back RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Oct 12, 2026 Must live in the state of South Carolina.... ...requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and...Remote jobContract workLive in
$40 - $45 per hour
Immediate need for a talented RN Care Management Coordinator . This is a 03 months Contract opportunity with long-term potential and is Remote , but the candidate must be in PA, DE, NJ... ...advanced medical knowledge to cases, utilizing specified resources and guidelines to...Remote workContract workLocal areaImmediate start- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations... ...Management team handling post-acute care services (SNF, Home Health, DME) to ensure appropriate...Remote workWork from home
$26.06 per hour
Remote Contract (4 months 29 days) Published... ...unrestricted RN license NY Medicaid... ...Responsible for overall management of member's case... ...the member's care plan to meet the member... ..., evaluation, coordination and management of... ...effective and efficient utilization of health benefits...Remote jobHourly payDaily paidContract workTemporary workFor contractorsWork experience placementLocal area1 day per week- ...RN Care Coordinator (Case Manager) BWH Care Continuum The Brigham and Women's Hospital, Inc. relies on... ...an interdisciplinary team, the RNCC utilizes patient assessment, care guidelines,... ...applicable): Shift: 40hr variable rotation. Remote Type: Onsite. Work Location: 45...Remote workHourly payWork at officeFlexible hoursShift workRotating shift
$95k - $110k
...reimagining pediatric chronic care, starting with ADHD. After... ...now on Obesity and Overweight management. Our clinical model is tech-... ...Summary The Nurse Care Coordinator (RN) is an integral member of Clarity... .... Note this is a fully remote position. Key Responsibilities...Remote workFull time- Archimedes in Earth City, MO is seeking an RN Utilization Case Manager to coordinate care among physicians, patients and pharmacies for specialty medications. The role focuses on utilization management, case review and timely access for complex cases. The ideal candidate...
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ..., which oversees post-acute care services including SNF, home... ...necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
$76k - $89k
Profile We offer remote work opportunities (AK,... ...apply! Job Summary Coordinates transition of care services for TRICARE... ...: Registered Nurse (RN) or Licensed Clinical... ...Coordination, Case Management, or equivalent Proficiency... ...Responsibilities Utilizes clinical judgment to...Remote workContract workTemporary workInterim roleWork at officeLocal areaWork from homeShift work- ...Utilization Management Registered Nurse at Humana uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care services including SNF, Home Health and DME. You...Remote work
- ...Humana, Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...UM team focused on post-acute care (SNF, Home Health, DME). The role requires a valid RN license, 1+ year of clinical RN...Remote work
$25 per hour
...IntellaTriage is seeking a compassionate registered nurse (RN) to join our after-hours hospice triage team. This remote role focuses on triaging patients and families by phone with empathy, coordinating timely care and interventions. Base pay is $25 per hour with...Remote workHourly payShift workNight shiftWeekend work$54.1k - $129.62k
...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...and one community at a time. Case Manager RN (100% Remote – Nationwide) Full‑Time | Work from... ...through personalized, high‑quality care coordination. In this fully remote role, you’ll use...Remote workHourly payFull timeTemporary workLive inLocal areaMonday to FridayFlexible hoursAfternoon shift- ...CVS Health is seeking a Case Management Coordinator in Illinois to support care teams and drive effective outcomes for members. You will assist with scheduling... ...enable better health journeys. The role requires an IL RN license, 3–5 years of clinical experience, strong...Remote workWork from home
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
$47.03 - $63.48 per hour
...enabled revenue cycle management solutions for health... ...healthcare. The RN, Senior Utilization Review Quality... ...management denials. Coordinate with service line leaders... ...experience in an acute care environment required... ...experiences This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area$100k - $120k
...reimagining pediatric chronic care, starting with ADHD. After... ...on Obesity and Overweight management. Our clinical model is tech... ...Summary The Nurse Care Coordinator Manager (RN) is an integral member of Clarity... .... Note this is a fully remote position. Key...Remote workFull time- ...Humana Inc. is hiring a Utilization Management Registered Nurse for remote work. You will apply clinical nursing expertise to interpret, coordinate, document, and communicate medical services and... ...determinations for post-acute care settings. You will make criteria...Remote work
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document... ..., and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings...Remote work
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