Remote Clinical Review Nurse - Utilization & Discharge
Centene Corporation
Centene Corporation is seeking a remote Utilization Review Nurse to perform concurrent reviews and validation of appropriate care levels. You will assess inpatient services, discharge planning, and coordination with Medical Affairs across Medicaid and Marketplace programs.
Ideal candidates hold an RN or LPN license with Michigan licensure, have 2+ years acute care experience, and familiarity with utilization management processes. Remote, with time-zone flexibility for Central/Eastern regions.
#J-18808-Ljbffr$27.02 - $48.55 per hour
...Centene is seeking a Clinical Review Nurse to perform concurrent reviews to assess... ...necessity, and contribute to discharge planning according to care... ...acute care experience and strong utilization management knowledge. You will work remotely in North Carolina, with a...Remote workHourly payFull timeDay shift- ...Centene Corporation is seeking a Nurse Reviewer for remote work in the United States. The role involves performing concurrent reviews to determine appropriate level of care and discharge planning, with emphasis on medical necessity and care setting. Requires active...Remote work
- ...Centene Corporation is seeking a remotely based Registered Nurse to perform concurrent reviews, assess acuity, and validate medical necessity... ...include documenting findings, assisting with discharge planning, and educating providers on utilization #J-18808-LjbffrRemote work
- ...Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health... ...necessity, and appropriate care levels, contributing to discharge planning within care policies and guidelines. Ideal candidates...Remote work
- ...Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS... ...medical necessity, and contribute to discharge planning according to care policies. The...Remote workContract work
$27.02 - $48.55 per hour
...Business Area: Clinical & Care Management... ...Performs concurrent reviews, including determining... ...contributing to discharge planning according... ...This position is remote/work from home. Prefer... ...compact nursing license and Michigan... ...systems according to utilization management policies...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hoursWeekend work- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... ...from an accredited Registered Nursing Program; RN preferred. 2....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...Position Title: Clinical Review Nurse - Concurrent Review Work Location: Remote (EST preferred but will consider CST) Assignment... ..., and contributing to discharge planning according to care policies... ...systems according to utilization management policies and guidelines...Remote workWeekend work
- ...Job Title: Clinical Review Nurse - Concurrent Review Location:Remote- Nationally but must have Compact license if not in... ...necessity, and contributing to discharge planning according to care policies... ...systems according to utilization management policies and guidelines...Remote workShift work
- ...Position Title Clinical Review Nurse - Concurrent Review Work Location Remote (EST preferred but will consider CST)... ...necessity, and contributing to discharge planning according to care policies... ...systems according to utilization management policies and guidelines...Remote workWeekend work
- ...About This Role The Clinical Review Nurse-Concurrent Review performs concurrent... ...and a strong understanding of utilization management processes. Highlights Location: Remote, OK Schedule: Full Time, Monday... ...review findings and discharge plans in health management systems...Remote workFull timeWork at officeMonday to FridayFlexible hoursWeekend work
$27.02 - $48.55 per hour
...flexibility to work remotely from their home anywhere... .... This team performs clinical reviews for medical and... ...member’s transfer or discharge plans to ensure a timely... ...interdepartmental teams on utilization processes to promote... ...Accredited School of Nursing or Bachelor's degree...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical... ...and concurrent review of hospitalizations and extended... ...manual changes Evaluate discharge planning risks and facilitate... ...- Prior Authorization Remote Registered Nurse (Remote...Remote workFull timeWork at officeWork from homeNight shift- ...Accredited School of Nursing or Bachelor's... ...experience. Clinical knowledge and... .... Knowledge of utilization management processes... ...necessity and clinical reviews of authorization... ...'s transfer or discharge plans to ensure a... ...supportive; Team is REMOTE but team relies heavily...Remote work
- ...Friend Back Remote Work from Home... ...MD 21076 Category: Nursing Schedule: Day Shift... ...- 5:00 PM As a Utilization Review Registered Nurse for... ...opportunity to use your clinical, managed care, utilization... ...involved Initiate discharge planning of members...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
$63.1k - $94.65k
...partner is looking for a Utilization Review RN based in the United... ...operations. In this part-time, remote role, you will apply your clinical expertise to evaluate... ...for a registered nurse who combines strong clinical... ...in utilization review, discharge planning, medical necessity...Remote workTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning. Requires an Iowa license (or compact... ...and educating providers on utilization processes. Schedule is Mon-Fri, 8...Remote work
- ...is seeking an Inpatient Utilization Management Clinician to... ...treatment, and support discharge planning across care teams. This fully remote, full-time role... ...an active RN license, nursing degree, and experience... ...management to ensure timely reviews, document outcomes, and...Remote workFull time
- ...Management Company LLC is seeking a qualified nurse reviewer to conduct concurrent inpatient and... ...documenting findings, coordinating discharge plans, and collaborating with medical... ...include educating providers on utilization processes, sharing feedback with leadership...Remote work
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing... ...management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license in New...Remote workContract work
- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members.... ...findings, coordinating with Medical Affairs, and guiding discharge planning. The position offers competitive pay and comprehensive...Remote workMonday to Friday
- ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and... ...Experienced RNs with ICU/ED/OR background, strong clinical judgment, and a mindset that embraces AI tools to streamline...Remote work
- ...Maryland, Virginia, (or) DC states Role: HEDIS Clinical Review Nurse W2 Contract: 5 Months Location: Primarily remote ~ Requires mandatory on-site training in... ...during the first two weeks of assignment. Utilize EMR systems (such as Epic, Athena) and...Remote workContract workWork at officeLocal area
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident)... ...Authorization Review to join our Utilization Management team. In this... ...authorization reviews, ensure timely discharges, and collaborate with...Remote workContract work
- ...5 months Work Location: Primarily Remote (Hybrid focus for candidates residing... ...leading healthcare organization as a Clinical Medical Review Nurse supporting the annual HEDIS retrospective... ...first two weeks of assignment. Utilize EMR systems (such as Epic, Athena)...Remote workContract workWork at officeLocal area
$40 per hour
...Industry Registered Nurse (RN) $40/hour - Contract... ...in TX Full time remote Candidates must be... ...initial, concurrent review activities; discharge care coordination... ...divisions. Collects clinical and non-clinical data... ...regarding utilization management requirements...Remote workFull timeContract workWork at office- ...sites across the U.S. from clinics and hospitals to home-based... ...Responsibilities As our Utilization Review RN, you will meticulously review... ..., concurrent, and post-discharge reviews, ensuring compliance... ...Required Associate's Degree in Nursing Minimum two (2) years of...Remote work
- ...Job TitleLocation: 100% Remote – Any US State Shift:... ...letters based on review outcomes in accordance... ...improvement.Performs clinical review of outcomes including... ...needed within the utilization management team based... ...accredited school of nursing or A.D. or bachelor's...Remote workLocal areaShift work
- Description: Nurses – are you looking for a change... ...Work-life balance. ~ Remote setting ROLE... ...This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual... ...aftercare needs, implements discharge planning and/or case...Remote workTemporary workWork at officeMonday to FridayFlexible hours
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