Remote Utilization Management RN — Path to CM Growth

WPS Health Solutions

Remote job

WPS Health Solutions seeks an experienced Utilization Management Registered Nurse (UM RN) to evaluate efficiency, appropriateness, and medical necessity for medical services under our Health Plan. The role includes cross-training in Case Management with potential growth into a combined UM/CM position and future CM opportunities. The candidate will collaborate with Medical Directors, Health Services teams, and other departments while reviewing prior authorization requests and ensuring alignment #J-18808-Ljbffr WPS Health Solutions

Apply

Vacancy posted 1 hour ago

Similar jobs that could be interesting for youBased on the Remote Utilization Management RN — Path to CM Growth in Kansas City, MO vacancy

Remote Utilization Management RN: Path to CM Growth
$75k - $100k
WPS Health Solutions is seeking a Utilization Management Registered Nurse to evaluate medical necessity and appropriateness... ...-training in Case Management and potential growth into a combined UM/CM position. The position offers remote work in approved states, a salary range of $7...
Remote job
Cms
WPS Health Solutions
Detroit, MI
12 hours ago
Remote Utilization Management RN — Path to CM
$75k - $100k
WPS Health Solutions is seeking a Utilization Management Registered Nurse to evaluate efficiency, appropriateness... ...cross-train in Case Management with potential growth into a combined UM/CM position. The position offers remote work options in multiple states, including...
Remote job
Cms
WPS—A health solutions company
Austin, TX
1 day ago
Remote Utilization Management RN - Path to CM
...health solutions company, is seeking an Utilization Management RN to evaluate medical necessity and authorize... ...-training into Case Management, with growth toward a combined UM/CM position in the future. The position offers remote work with approved states and a strong emphasis...
Remote job
Cms
WPS—A health solutions company
Kansas City, MO
1 day ago
Remote Utilization Management RN: Path to CM
...a health solutions company, is seeking an Utilization Management RN to assess medical necessity, authorize services... ...with medical directors. The role offers remote work in multiple states and a potential path toward combined UM/CM responsibilities. There is a strong...
Remote job
Cms
WPS—A health solutions company
Columbus, OH
1 day ago
Remote Utilization Management RN — Path to UM/CM
WPS Health Solutions seeks an Utilization Management RN to evaluate medical necessity and appropriateness... ...extended hospital stays. We support remote work in multiple states and offer opportunities to grow into a combined UM/CM role. #J-18808-Ljbffr WPS Health Solutions
Remote job
Cms
WPS Health Solutions
Newark, NJ
12 hours ago
RN Team Lead (Remote)
$81.95k - $110.24k
...technology-enabled revenue cycle management solutions for health... ...in healthcare. The Lead Utilization Review RN is a key contributor to the... ...knowledge of the principles of growth and development of the life... ...required #LI-LS1 #LI-REMOTE Join an award-winning company...
Remote work
Cms
Full time
Work at office
Local area
Ensemble Health Partners
Remote
17 days ago
Utilization Review RN - Denials
$63.1k - $94.65k
...-enabled revenue cycle management solutions for health systems... ...have current compact RN license, or be willing... ...are seeking Virtual Utilization Review Specialist with... ...knowledge of the principles of growth and development of the... ...: ~ This is a remote role which requires access...
Remote work
Cms
Full time
Temporary work
Work at office
Local area
Monday to Friday
Shift work
Ensemble Health Partners
Remote
1 day ago
Remote UM RN - Growth toward Case Management
$75k - $100k
WPS Health Solutions seeks an Utilization Management RN to evaluate medical necessity and ensure appropriate... ...procedures. The position offers remote work options in approved states, a start... ...train in Case Management and grow toward CM leadership. #J-18808-Ljbffr WPS Health...
Remote job
Cms
WPS Health Solutions
Columbus, OH
12 hours ago
Senior RN, Utilization Management — Remote Leadership
Clover Health is seeking a Lead RN, Utilization Management, to coach clinical staff, oversee daily review operations, and ensure timely, accurate determinations that align with benefits, clinical criteria, and CMS requirements. You will partner with Medical Directors and...
Remote job
Cms
Clover Health
New York, NY
1 day ago
RN Care Management(Remote)
$70.2k - $120.4k
...norm and every member feels valued.The Utilization Review RN will review and document member case... ...revision of medical policies and utilization management and/or clinical appeals policies.... ...RN license requiredThis position is a Remote role. To be eligible for consideration...
Remote work
Cms
Work experience placement
Medica
Minnetonka, MN
2 days ago
Remote Prior Authorization RN - Utilization Management
Central California Alliance for Health is seeking a Prior Authorizations Nurse (RN) for a temporary, full-time role. This remote-in-California position reports to the Utilization Management Supervisor and involves ensuring PA requests comply with contracts and evidence-...
Remote job
Cms
Full time
Contract work
Temporary work
Central California Alliance for Health (Remote)
Sacramento, CA
2 days ago
Remote RN: Utilization Review & Care Decisions
$35 - $40 per hour
Sagility is hiring an RN Utilization Management Reviewer to perform day-to-day clinical and service authorization reviews for medical necessity,... ...and 2+ years in a clinical setting; CCM a plus. This fully remote US-based role offers competitive benefits, M-F 9:00-5:30 ET...
Remote job
Cms
Hourly pay
Shift work
Weekend work
Sagility
New York, NY
1 day ago
Sr. Utilization Management Nurse RN-Field Position
$72.8k - $130k
...scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional Area, the... ...Qualifications: ~ Must be a Registered Nurse (RN) with a current, active, unrestricted RN License...
Remote work
Cms
Minimum wage
Full time
Work experience placement
Casual work
Live in
Work at office
Local area
Optum
Charlton, MA
3 days ago
Remote RN Utilization Management & Appeals Reviewer (NY RN License Required)
$52 - $56 per hour
...Contract RN For New York Health Plan You've done UM. You've worked appeals. Now find a role that uses both. We're... ...ll apply the same medical necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52$56/hr based on experience Business...
Remote job
Cms
Contract work
Afternoon shift
Phaxis
New York, NY
2 days ago
RN Case Manager - Utilization Review
...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know Your Team: INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking...
Remote work
Cms
Full time
Work at office
Weekend work
INTEGRIS Health
New York, NY
3 days ago
Utilization Management RN
...Utilization Management RN (Registered Nurse)Our Utilization Management RN (Registered Nurse) evaluates... ...to cross-training in Case Management (CM), with the potential for the role to grow... ...experience. Work Location We are open to remote work in the following approved states:...
Remote work
Cms
For contractors
Work at office
Immediate start
WPS Health Solutions
Madison, WI
2 days ago
Utilization Review RN - Intensive Case Management, Medicare Advantage (hybrid-remote)
$143.68k - $185.81k
...UCLA Medical Group Utilization Review Nurse Under the direction of the Assistant Director, the Intensive Case Management Medicare Advantage Utilization Review Nurse performs utilization... ...in utilization management, Inpatient CM or clinical Experience. Strong knowledge...
Remote job
Cms
Work at office
Flexible hours
UCLA Health Careers
Los Angeles, CA
1 day ago
RN Utilization Review Care Manager PRN
$85.7k - $129.31k
...Job Description: The RN Utilization Review Care Management I leverages clinical expertise and critical thinking to perform utilization review care management... .... Experience working successfully working in a remote environment or using Advanced Microsoft Suite, including...
Remote work
Cms
Hourly pay
Relief
Work at office
Flexible hours
Shift work
Weekend work
2 days per week
Intermountain Health
Remote
3 days ago
RN Care Management(Remote)
...an authentic experience! Under the general direction of the Utilization Management Manager, the Utilization Management Nurse is responsible for... ...care experience in an acute care facility utilizing an active RN license is required. Experience in an HMO or experience in a...
Remote job
Cms
Temporary work
Flexible hours
Inland Empire Health Plan
Sacramento, CA
2 days ago
Registered Nurse Case Manager (RN)
...Registered Nurse Case Manager to join the team.... ...schedules, and remote and hybrid career... ...Registered Nurse (RN) Case Manager 1 Job... ...excess days, resource utilization, readmission rates... ...of care and care paths with physicians... ...individual professional growth and development by...
Remote work
Cms
Full time
Part time
Relief
Relocation package
Monday to Friday
Flexible hours
Weekend work
Inova Health System
Alexandria, VA
5 days ago
RN Utilization Management Reviewer
$35 - $40 per hour
...through service offerings for clinical, case management, member engagement, provider solutions,... ...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities... ...may require weekends. Location: Fully remote work at home role. Secure, private area...
Remote work
Cms
Hourly pay
Temporary work
Monday to Friday
Flexible hours
Weekend work
Sagility LLC
New York, NY
1 day ago
Utilization Management Reviewer, RN (SN LTSS & Duals)
...Utilization Management Coordinator This position is responsible for coordinating... ...degree and active NYS RN license required. Bachelors degree... ...multiple areas (i.e. UM and CM). Incumbent is required to know... ...note: The opportunity for remote work may be possible for all...
Remote work
Cms
Contract work
Work at office
Univera Healthcare
Albany, NY
2 days ago
RN Care Management(Remote)
...DescriptionJob DescriptionJob Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:" Provides health care services regarding... ...(Allscripts)Required Skills/Experience: Licensed RN (multistate or TX RN), 2 years acute care UM experience...
Remote work
Cms
3B Healthcare, Inc
Austin, TX
5 days ago
Utilization Management Nurse
...Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and... ...nursing facility. This is primarily a remote telephonic position with normal business... ...Minimum 2 years clinical experience as RN, LPN/LVN required. Minimum 1-year managed...
Remote work
Cms
Contract work
Work at office
Weekend work
AllyAlign Health
United States
5 days ago
RN Care Management(Remote)
$70k - $75k
Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance... ...as we put healthcare on a better path!! The Utilization Management... ...continued professional growth and education consistent with current...
Remote work
Bi-weekly pay
Full time
Temporary work
For contractors
Local area
Work from home
Guide-Health
Kenosha, WI
5 days ago
Nurse Care Management LPN (Virtual)
$60k
...is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual... ...~ Career development opportunities Remote Opportunities We are actively seeking new...
Remote work
Cms
Temporary work
Local area
Integra Partners
Yorktown, VA
1 day ago
Senior SEO / Head of Marketing
$190k - $210k
...Location: Remote, USA Ability to travel... ...Marketing, the Sr. Director of Growth Marketing will scale Frontline... ..., multistage, multi-path buyer journeys that... ...and tactical goals. Manage and report on campaign... ...-quality traffic. Utilize data analytics to track...
Remote work
Cms
Work experience placement
Work at office
Frontline Education
United States
2 days ago
Clinical Guide Part A: (UM) Utilization Management Nurse
$82.68k - $96.46k
...Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,... ...Schedule: This is a full-time, remote position working five 8-hour days. We are... ...skills and experience: ~ Unrestricted RN license with a minimum of 4 years of clinical...
Remote work
Cms
Full time
Contract work
Internship
Monday to Friday
Devoted Health
Remote
9 days ago
Utilization Management RN I — Remote & Growth Opportunities
A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...
Remote job
Healthcare Management Administrators
Bellevue, WA
4 days ago
Bilingual Spanish RN, Care Management (Riverside)
$44.42 - $61.2 per hour
...Registered Nurse (RN) – Care ManagementFounded in... ...with stewardship, and growth with integrity.At SCAN,... ...The Position will work remote & in the field 50% or more... ...Nurse (RN) – Care Management is a clinically accountable... ...Hospital Or ED Utilization, Adults Living In The Community...
Remote work
Cms
Local area
S C A N
Riverside, CA
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management RN — Path to CM Growth. Be the first to apply!