Remote Utilization Review Nurse - Acute Care Expert
Insight Global
Raleigh, NC
- 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
Vacancy posted 20 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Nurse - Acute Care Expert in Raleigh, NC vacancy
- ...staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client... ...role involves evaluating patient care cases and ensuring requested services... ...clinical experience in an acute setting. Strong written and verbal...Remote work
Insight Global
United States4 days ago $72.8k - $130k
...Coding Subject Matter Expert Optum Insight is improving... ...alignment between care providers and payers,... ...with prebill reviews, such as, HAC/PSIs. The... ...the flexibility to work remotely * from anywhere within... ...process standardization, utilization of best practices, work...Remote jobMinimum wageFull timeContract workWork experience placementLocal area- ...driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity... ...records to ensure timely and compliant care determinations. Key responsibilities Conduct... ...years of recent clinical experience in acute care, med-surg, ICU/ED, or similar...Remote workFull time
Virtual Vocations Inc
United States1 day ago - ...a Friend Back Remote Work from Home Share... ...MD 21076 Category: Nursing Schedule: Day Shift... ...(JHHP) is the managed care and health services... ...- 5:00 PM As a Utilization Review Registered Nurse for Johns... ...' experience as an acute care RN ~1+ years' experience...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD3 days ago - ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization... ...requirements while working remotely. Key responsibilities:... ...degree is required 2+ years of Acute Hospital Care experience is required...Remote workFull time
Virtual Vocations Inc
United States4 days ago $93.18k - $136.95k
...Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse . The Utilization Review Nurse... ...) Experience: • 3 years of acute care clinical experience (required... ...For positions that are available as remote work, Sentara Health employs associates...Remote workFull timeTemporary workShift workSentara Healthcare
United States2 days ago- Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...experience, including acute care exposure. The role... ...educating providers on utilization processes. Schedule is Mon...Remote job
$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 workOscar Health
Dallas, TX16 days ago$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$45 - $50 per hour
Join Our Team as a Utilization Management RN -... ...dedicated Registered Nurse passionate about optimizing patient care and ensuring... .... Whether working remotely or in a flexible hybrid... ...play a key role in reviewing authorization... ...outpatient, and post-acute services utilizing...Remote workHourly payWork at officeFlexible 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
- 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 jobMonday to Friday
- ...Minnesota, United StatesCompany: UnitedHealth GroupPosted: 2026-09-30UnitedHealth Group seeks a Certified Sr. (IP) Acute Edits Medical Coder to work remotely from anywhere in the U.S. You will determine and record correct codes for treatments, ensuring documentation...Remote work
UnitedHealth Group
Eden Prairie, MN1 day ago - ...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
Higher Learning Technologies
Coralville, IAmore than 2 months ago - ...in Newark NJ rest of role will be remote This position is responsible... ...: 1. Conducts on-site reviews at participating provider offices... ...experience, preferably n health care industry. 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
Winston Medical Staffing
Newark, NJ2 days ago - ...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
- ...experience and at least 1 year in auditing/DRG validation, with strong accuracy in diagnostic and procedure coding.Candidates should have acute-care inpatient and trauma coding experience, preferably from Academic Medical Centers or Trauma Centers, and will#J-18808-Ljbffr
Next Level Business Services
New York, NY2 days ago - UT Southwestern Medical Center in Dallas, TX seeks an experienced Acute Care Nurse Practitioner or Physician Assistant for inpatient pain management at CUH and Zale Lipshy Hospital. Preference for a background in inpatient pain management or addictionology. Monday-Friday...Monday to FridayWeekend work
$130k - $165k
...this role, you will provide key clinical support in a skilled nursing facility, including diagnosing and managing conditions, collaborating... ...flexible scheduling and a comprehensive benefits package while making a difference in post-acute care. #J-18808-Ljbffr Altea HealthcareFlexible hours- Banner University Medical Center Phoenix is seeking an Acute Care Nurse Practitioner (ACNP) for its Nocturnal Critical Care team. The ACNP will manage critical care patients and work with a dedicated team focused on growth and career development. This full-time role includes...Full timeRotating shift
- ...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-Ljbffr...Remote work
Medix
United States4 days ago $55 - $65 per hour
...: Adult Inpatient Nurses (RN) Type: Contract... ...Location: Remote Role Responsibilities Review and evaluate AI-generated... .... Provide expert feedback on nursing... ...California) Recent adult acute care inpatient bedside... ...improvement, utilization review, CDI, or clinical...Remote workContract workSummer workMercor
San Francisco, CA3 days ago$150 per hour
...Telehealth Nurse Practitioner – Remote Acute Care (Work From Home – Nationwide) Join to apply for the Telehealth Nurse Practitioner – Remote Acute Care... ...messaging Diagnose and treat acute & primary care conditions Review labs, prior records, and risk factors when available...Remote workWork from homeNPHire
United States4 days ago- ...Director on driving the decrease in care variance, to ensure timely... ...to the Health Plan Manager of Utilization Management. This position will... ...: 1. Current Registered Nurse license issued by the state in... ...and implements care management review processes (Prior Authorization...Remote workCasual workWork at officeShift work
Peak Healthcare
United States12 hours ago $40 per hour
...Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for... ...reside in TX Full time remote Candidates must be based in... ...performing initial, concurrent review activities; discharge care... ...information regarding utilization management requirements...Remote workFull timeContract workWork at officeHireOps Staffing LLC
United States1 day ago- ...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
IntePros
United States3 days ago - Mass Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure...
- ...LA-area hospital known for comprehensive care across cardiovascular, surgical, orthopedics... ..., and mental health. The Registered Nurse provide safe patient care in the Emergency... ...certifications, and at least one year of acute care experience; ED experience is #J-1880...
$150 per hour
...Work From Home Nurse Practitioner (Remote Acute Visits, $210/hr) Join to apply for the Work From Home Nurse... ...- $210.00/hr A nationwide virtual care group is expanding its telehealth... ...acute and primary care conditions Review labs and clinical records when available...Remote workWork from homeFlexible hoursNPHire
United States4 days ago- Wellstar Health System in Georgia is seeking an RN Acute Care - Ortho Surgical for a full-time Day shift. The role involves delivering high-quality, patient-centered nursing care within an interdisciplinary team under Nurse Managers and Wellstar governance. You will apply...Full timeDay shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review Nurse - Acute Care Expert. Be the first to apply!
Related searches
- remote utilization review nurse part time Raleigh, NC
- guest service support expert Raleigh, NC
- fulfillment expert Raleigh, NC
- technology expert Raleigh, NC
- remote property manager Raleigh, NC
- remote sales consultant Raleigh, NC
- medicare sales agent remote Raleigh, NC
- remote engineering internship Raleigh, NC
- software engineer internship remote Raleigh, NC
- immediate hire remote Raleigh, NC