Remote Utilization Review Nurse - Acute Care Expert
Insight Global
- Remote job
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 policies. The ideal candidate has over 2 years of experience in utilization review and significant clinical experience in an acute setting. Strong written and verbal communication skills are essential. #J-18808-Ljbffr Insight Global
- Netsmart is seeking a Remote Utilization Review Nurse to evaluate ED admissions using InterQual/MCG criteria and apply evidence-based guidelines... ...Ideal candidates have an active RN license, 3+ years in acute care (ER/ICU/medical-surgical), and 2+ years UM experience, plus...Remote job
- ...Incorporated is seeking a Peer-to-Peer Utilization Review Nurse to join the central... ...on concurrent level-of-care denials and supports physician... ...to-peer discussions through expert clinical analysis and standardized... ..., and care management, with remote work options and a 32-hour...Remote job
- Providence St. Vincent Medical Center is seeking a Clinical Nurse Educator for acute perinatal services. This full-time, exempt role is on-site in Portland with a Monday-Friday day schedule and no remote work. The position offers an $8,000 hiring bonus plus relocation assistance...Remote workFull timeRelocation packageMonday to Friday
- Centene is seeking a Clinical Review Nurse to perform concurrent reviews of members to... ...planning. This role targets nurses with acute care experience and a strong understanding of utilization management processes. The position is remote with NY location indicators and...Remote jobFull time
- ...Utilization Review Registered NurseJohns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins... ...Review Registered Nurse for Johns Hopkins... ...balance - This is a remote role! Candidates in... ...years' experience as an acute care RN1+ years'...Remote workMonday to Friday
$35 - $45.94 per hour
...we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review... ...records and speak with care providers regarding treatment... ...Work Location: This is a remote position, open to candidates... ...year clinical practice in an acute care setting, i.e., ER or hospital...Remote workHourly payFull timeWork from homeHome officeWeekend work- ...Hopkins Health Plans is seeking a Utilization Review Registered Nurse to apply clinical, managed care and utilization review... ...improve member outcomes. This remote role supports the organization... ...license (or compact) and 3+ years acute care experience plus 1+ year UR...Remote job
$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR,... ...we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving... ...planning for members transitioning from acute, long-term, or residential care Conduct...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- Sentara Health Plans is seeking a Utilization Review Nurse/ RN for Medicaid to work remotely. The role includes pre-... ...inpatient and concurrent reviews, and care coordination across the patient care... ...preferred, and at least 3 years of acute care experience. NCQA knowledge...Remote jobWeekend work
$1,966 per week
...25 applicants Nurses - are you looking... ...managed health care, focused on... ...-life balance. Remote/hybrid setting... ...individual will utilize clinical knowledge... ...a second level reviewer. This individual... ...3 years recent acute clinical... ...in a new way. Experts add insights directly...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours- Currently seeking a Utilization Management RN .... ...below: Position is remote - candidate must... ...active PA license or a Nurse Licensure Compact... .... ** Previous Acute Hospital Utilization... ...medical record review to determine medical... ...appropriate care settings. Report...Remote workImmediate startDay shift
- Responsibilities Responsible for utilization review work for emergency... ...years clinical experience in acute care setting in emergency room, critical... ...and/or medical/surgical nursing At least 2 years utilization... ...Expectations Comfortable with remote work arrangements and...Remote workFor contractorsWork at office
- ...community-driven Coordinated Care Organization (CCO) committed... ...Health. Position Title Utilization Review Nurse Department Umpqua Health Job... ...Pacific Standard Time) Location Remote position Salary Wage Band 2... ...members transitioning from acute, long-term, or residential...Remote workFull timeWork at officeLocal areaMonday to FridayFlexible hours
- ...Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with... ...license, at least 3 years of nursing in acute or outpatient settings, and 2+ #J-1880...Remote job
- ...Adult-Gero Acute Care NP Subject-Matter Expert - Contractor (Remote) Hours: 5–15 hours per week Location: Remote Type:... ...as an Adult-Gerontology Acute Care Nurse Practitioner. Contracted writers will write, edit, review and/or categorize nurse practitioner...Remote workHourly payContract workTemporary workFor contractors
- ...disease management, and patient care will help ensure AI systems... ...reliability. Provide structured, expert feedback that informs next‑... ...internal medicine’s full spectrum — acute care, chronic disease, and... ..., with possible extension Remote: Fully remote, collaborative environment...Remote jobContract workFor contractorsFreelance
- Ensemble Health Partners is seeking an Acute Coding Appeals Specialist to review and write appeals for inpatient DRG denials, applying ICD-10-CM/PCS, HCPCS... ...and a willingness to travel to client sites as needed; remote work options available. A high school diploma is...Remote job
- ...Health is seeking a Cath Lab Tech for a travel assignment in an acute care hospital setting. Candidates must have at least two years of... ...scheduling and support from a dedicated placement team to help you manage licensure and onboarding. #J-18808-Ljbffr Origin Travel NursesRelocation package
- ...maintaining patient safety and comfort. Requires CA license, ARRT CT, ARRT R, BLS, and at least 2 years of experience, with 40-hour weeks. You will collaborate with the healthcare team in an acute care setting and document in Cerner. #J-18808-Ljbffr Cynet HealthStaff
- ...Palo Alto, CA. The role focuses on evaluating and treating patients with communication, cognitive, and swallowing disorders in an acute care setting. The SLP will develop treatment plans, conduct diagnostic assessments, and collaborate with interdisciplinary teams to...
- ...Health is seeking a Cath Lab Tech for a travel assignment in an acute care hospital setting. Must have at least two years of cath lab... ...our travelers with a comprehensive benefits package and competitive compensation from day one. #J-18808-Ljbffr Origin Travel Nurses
- US Acute Care Solutions in Exeter, NH is seeking an experienced Emergency Medicine Physician Assistant or Nurse Practitioner to join a physician-led, patient-focused ED team. You will deliver compassionate, high-quality care alongside physicians and leverage APP leadership...Daily paidRelief
$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges... ...nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build...Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include... ...degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
- ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical review and provider collaboration. The position requires an active RN license, 3+ years of...Remote workFull time
- ...Job Title This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and...Remote workContract work
$36 - $40 per hour
## Expert Coach II - CDCESApplylocations: USA... ...- Any Location (Remote)time type: Full timeposted... ...of virtual care.**At Teladoc... ...experience, from acute and primary care to... ...appropriate coaching utilization and meet member needs... ....* Seeks out and reviews research findings...Remote workBi-weekly payFull timePart timeWork experience placementVisa sponsorshipWork visa$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley... ...no holidays, no telehealth/remote work Minimum Qualifications... ...experience in direct patient care • 12 consecutive months in Utilization... ...Management, Utilization Review, or Case Management...Remote workContract workImmediate startMonday to Friday- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements... ...(combination of in person and remote considered) General Summary The Utilization... ...teams ensures safe transitions of care. Responsibilities Coordinate and...Remote workFull timeShift work
- ...Management Location: 100% Remote Schedule: M-F 9:00... ...Works with the Utilization Management team primarily... ...necessity/utilization review and other utilization management... ...members with the right care at the right place at... ...IL State Registered Nursing (RN) license in good...Remote workContract work
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