Remote Utilization Management Nurse: Medical Review
Brighton Health Plan Solutions
Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications with providers and members.
Prerequisites include an active LPN license, proficiency in Microsoft Office, and 2+ years in UM within managed care. Prior experience in various reviews and knowledge of URAC/NCQA are a plus.
#J-18808-Ljbffr$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson... ...no holidays, no telehealth/remote work Minimum... ...Utilization Management, Utilization Review, or Case Management... ...Ambulatory, Case Management, or Medical-Surgical (ANCC or NCQA)...Remote workMedicalContract workImmediate startMonday to Friday$26.01 - $56.14 per hour
...-5:00pm EST Location: 100% Remote (U.S. only) About Us American... ..., is a URAC-accredited medical management organization founded in 1993... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you’ll play a vital role in...Remote jobMedicalHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work- ...Plan clinical member services review processes. The role requires... ...license and experience with utilization management, prior authorization, and... ...inpatient and outpatient settings. Remote position, must reside in... .... The incumbent will verify medical necessity, ensure alignment...Remote jobMedical
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$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97470,... ...POSITION PURPOSE The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-...Remote workMedicalFull timeWork at officeLocal areaImmediate startMonday to Friday$77.96k - $120.37k
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$84.56k - $126.84k
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