Remote Utilization Review Nurse
Centene Corporation
Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation. Responsibilities include documenting findings, coordinating with Medical Affairs, and guiding discharge planning. The position offers competitive pay and comprehensive benefits, with compensation reflecting experience and #J-18808-Ljbffr
$65k - $78k
...learning, and career development. Your Role In Our Mission Review admissions, procedures, services, and supplies for medical... ...rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines....Remote workFull timeWork at officeWork from homeFlexible hours- ...Centene Management Company LLC is seeking a qualified nurse reviewer to conduct concurrent inpatient and pediatric/adult case reviews... ...Medicaid members. Responsibilities include educating providers on utilization processes, sharing feedback with leadership for process...Remote work
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with...Remote work
- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation...Remote workMonday to Friday
- ...Remote role but will need to go to Newark, NJ to pick up equipment and orientation one day... ...Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess... .... 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
- Description: Nurses – are you looking for a change? Want to work no... ...~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces with...Remote workTemporary workWork at officeMonday to FridayFlexible hours
$35 - $45.94 per hour
...Utilization Review Nurse Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role:... ...Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida...Remote workHourly payWork from homeHome officeWeekend work- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
- ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded insurance options to our clients...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail-oriented and experienced Utilization Review Nurse to evaluate the medical necessity, appropriateness, and...Remote workFull timeSecond jobWork at office
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
- ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
- ...Apply Refer a Friend Back Remote Work from Home Share This Page... ..., Hanover, MD 21076 Category: Nursing Schedule: Day Shift Employment Type... ...hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- ...Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities... ...critical care and/or medical/surgical nursing At least 2 years utilization... ...Expectations Comfortable with remote work arrangements and virtual...Remote workFull timeFor contractorsWork at officeShift workWeekend workWeekday work
$77.08k - $119.47k
...19,466.00 Responsible for Utilization Management, Quality Screening... ...Characteristics 1. Registered nurse with a New York State current... ...applicable to utilization review process. 8. Excellent... ...the work cannot be done from a remote location. Other...Remote workShift work$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to Friday- ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...Must have a current, unrestricted Texas nursing license or Compact License. Please include... ...Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
$40 per hour
...Managed Care Industry Registered Nurse (RN) $40/hour - Contract... ...reside in TX Full time remote Candidates must be based in TX... ...performing initial, concurrent review activities; discharge care... ...Provides information regarding utilization management requirements and operational...Remote workFull timeContract workWork at office$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license...Remote workContract work
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring...Remote workFull time
$33.6 - $51.4 per hour
...This is a great opportunity for a local remote position. There is no communication... ...for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions... ...Minimum Requirements Education ~ Nursing Diploma/Associate's - Nursing...Remote workHourly payFull timeWork experience placementReliefLocal areaMonday to FridayFlexible hoursShift work$35 - $40 per hour
...Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of...Remote workContract workFlexible hoursWeekend work$35 - $40 per hour
...are seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior... ...day Mon - Fri, 40 hrs/week Fully Remote Position Pay Range: $35 - $40 per...Remote workHourly payLocal areaShift work- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
- ...A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
- ...Gainwell Technologies LLC is seeking a skilled Utilization Review Nurse for a remote role based in the United States. The position reviews medical necessity and appropriateness of services, using InterQual/MCG criteria and contract guidelines, with documentation in management...Remote workContract workFlexible hours
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