Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Utilization Management RN — Care Coordinator

Humana

Brooklyn, NY
  • 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

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN — Care Coordinator in Brooklyn, NY vacancy
  •  ...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

    Medix™

    Columbus, OH
    4 days ago
  • $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 work
    Hourly pay
    Full time
    Temporary work
    Part time
    Flexible hours
    Weekend work
    2 days per week

    Alpha Business Solutions

    United States
    3 days ago
  •  ...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 work
    Full time
    Work at office

    The University of Kansas Health System

    Remote
    12 days ago
  • $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 work
    Full time
    Relocation package
    Shift work
    Weekend work
    Weekday work

    CommonSpirit Health

    Colorado Springs, CO
    16 hours ago
  •  ...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 work
    Full time
    Temporary work
    Part time
    Relief
    Local area
    Immediate start
    Monday to Friday
    Shift work
    Weekend work

    Trinity Health

    Remote
    6 days ago
  • $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 job
    Contract work

    CEI

    Columbia, SC
    19 days ago
  • 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 job
    Home office

    UnitedHealth Group

    Bridgewater, MA
    4 days ago
  • $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 work
    Full time
    Temporary work
    Work from home
    Relocation package
    Monday to Friday

    Humana

    Indiana, PA
    4 days ago
  • $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 job
    Hourly pay
    Full time
    Temporary work
    Part time

    Alpha Business Solutions

    Philadelphia, PA
    6 days ago
  •  ...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 work
    Contract work
    Local area
    Flexible hours

    Greater Lawrence Family Health Center

    Methuen, MA
    3 days ago
  • 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 job
    Contract work
    Live in

    CEI

    Columbia, SC
    4 days ago
  • $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 work
    Contract work
    Local area
    Immediate start

    Pyramid Consulting, Inc

    New York, NY
    5 days ago
  •  ...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 work
    Work from home

    Humana

    Columbia, SC
    21 hours ago
  • $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 job
    Hourly pay
    Daily paid
    Contract work
    Temporary work
    For contractors
    Work experience placement
    Local area
    1 day per week

    Elevance Health

    New York, NY
    2 days ago
  •  ...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 work
    Hourly pay
    Work at office
    Flexible hours
    Shift work
    Rotating shift

    Mass General Brigham

    Roxbury Crossing, MA
    3 days ago
  • $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 work
    Full time

    Clarity Pediatrics

    California
    2 days ago
  • 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... 

    Archimedes

    Earth City, MO
    2 days ago
  •  ...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-Ljbffr
    Remote work

    Humana

    United States
    1 day ago
  • $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 work
    Contract work
    Temporary work
    Interim role
    Work at office
    Local area
    Work from home
    Shift work

    TriWest Healthcare Alliance

    Phoenix, AZ
    4 days ago
  •  ...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

    Jackson, MS
    20 hours ago
  •  ...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

    Humana

    Jackson, MS
    1 day ago
  • $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 work
    Hourly pay
    Shift work
    Night shift
    Weekend work

    Intellatriage

    United States
    20 hours ago
  • $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 work
    Hourly pay
    Full time
    Temporary work
    Live in
    Local area
    Monday to Friday
    Flexible hours
    Afternoon shift

    CVS Health

    Texas
    3 days ago
  •  ...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 work
    Work from home

    CVS Health

    United States
    3 days ago
  •  ...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

    Cleveland Clinic

    New York, NY
    5 days ago
  •  ...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 work
    Flexible hours
    Weekend work
    Day shift

    The Judge Group

    United States
    4 days ago
  • $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 work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    Ohio
    5 days ago
  • $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 work
    Full time

    Clarity Pediatrics

    California
    2 days ago
  •  ...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

    Humana

    United States
    5 days ago
  •  ...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

    Guidehealth

    Gary, IN
    20 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management RN — Care Coordinator. Be the first to apply!