Remote Utilization Management RN - Impactful Care
Anacalifornia
- Remote job
Optum, part of UnitedHealth Group, is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters per guidelines. You will extract data, reference national criteria, and ensure accuracy and compliance. The role requires RN licensure, a relevant associate degree, and 3+ years bedside nursing (ED/Telemetry/ICU/CCU). Telecommuting is allowed within the U.S. and the schedule is Monday–Friday, 40 hours. #J-18808-Ljbffr Anacalifornia
- Texas Health Resources is seeking an Utilization Management RN - Clinical Review to support remote admissions reviews across THR facilities. You will assess initial... ...RN with an Associate's degree and inpatient acute care experience, plus Utilization Management exposure....Remote job
- ...is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will... ...healthcare services and coordinating care for members. Join a dynamic team and make a meaningful impact in patient advocacy while maintaining a...Remote workContract work
$70k - $75k
...Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to... ...Job Description The Utilization Management Registered... ...services Quality of care concerns Interfacing... ...review of cases impacting performance metrics and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one... ...services, coordinating care, and ensuring members receive... ...Ready to make a meaningful impact—without sacrificing work-...Remote workDaily paidContract workMonday to FridayShift workWeekend work- Mass General Brigham Health Plan Holding Company, Inc. is seeking an RN-based Utilization Management Nurse to support network adequacy reviews and authorization decisions for ACO, HMO, and EPO products. The role emphasizes medical necessity assessment and robust payer knowledge...Remote job
- Harris Health System, Inc. is seeking a Utilization Management Review Nurse to evaluate medical necessity, appropriateness, and efficiency of services, ensuring care aligns with evidence-based guidelines. The role involves partnering with Care Management, Physician Advisors...Remote jobFlexible hours
$68.13k - $119.52k
...regulatory requirements and manages concurrent and pre-... ...multidisciplinary care team regarding... ...in-house patients, utilizing daily commercial... ...and trends and their impact. Previous... ...Schedule: ~ Fully remote position, four 10-hour... ...Registered Nurse (RN) [Required]...Remote workFull timeWork experience placementLocal area10 hours per weekShift work$60.2k - $107.4k
...Utilization Management & Clinical Validation Rn Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work... ...development opportunities. Come make an impact on the communities we serve as you help...Remote jobMinimum wageFull timeWork experience placementLocal area$60.2k - $107.4k
...Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with... ...career development opportunities. Come make an impact on the communities we serve as you help us...Remote jobMinimum wageFull timeWork experience placementLocal areaMonday to FridayFlexible hoursWeekend workAfternoon shift$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions... ...opportunities. Come make an impact on the communities we... ...opportunity for remote work based on business... ...~ Registered Nurse (RN) with a current, active...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home... ...coordination, requiring an active RN license and hospital experience. Responsibilities... ...with providers, and ensuring timely care while meeting state and federal...Remote workWork from home
- ...Utilization Manager Registered Nurse (UMRN)Spectrum Healthcare Resources has a need for a Utilization... ...Nurse (UMRN). These will be completely remote positions, working entirely from the... ...cases, educating patients on appropriate care and managing health care costs for the...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$48.52 - $72.78 per hour
...RN Utilization Management Reviewer - Remote (OR, WA, AK) Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are. PeaceHealth is looking for a skilled and... ...AK) Ready to Make a Meaningful Impact? Bring your clinical expertise,...Remote jobFull timeLocal areaDay shift$71.1k - $97.8k
...Become a part of our caring community The Part... ...Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical... ...skills to make an impact Required Qualifications... ...Registered Nurse (RN) with compact license... .... This is a remote position. This role...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work$60.53k - $129.63k
...passionate colleagues who care deeply, innovate with purpose... ...one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Commercial) Remote | Full-Time | Weekday Schedule... ...Nurse ready to make an impact beyond the bedside? Join our...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$54.1k - $116.77k
...passionate colleagues who care deeply, innovate with... ...community at a time. NICU Utilization Management Nurse Consultant (Remote) Are you passionate about... ...~ Active, unrestricted RN license in the state of residence... ...work that directly impacts neonatal and infant...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from home- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document,... ...utilization and benefit management, ensuring appropriate care levels within state and federal requirements and...Remote workFull time
- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating... ...independent decision-making to provide appropriate care for members. This remote, patient-facing position may require occasional travel...Remote work
$71.1k - $97.8k
...Become a part of our caring community Are you passionate... ...communities? As a Utilization Management (UM) Nurse, you will... ...to make a meaningful impact, navigate complex clinical... ...Registered Nurse (RN) in Illinois with no disciplinary... ...Workstyle: This is a remote position supporting...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...Utilization Management CNADubuque, Iowa, United StatesUtilization Management AssistantLocation... ...Dubuque, IA. Also accepting remote applicants.Are you passionate about patient care and thrive in a fast-paced,... ...looking to make a meaningful impact behind the scenes. If you are...Remote workWork at office
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing... ...your skills to make an impact Required Qualifications Licensed Registered Nurse (RN) with at least 3 years prior... .... Travel: While this is a remote position, occasional...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift work- Humana Inc. is seeking a Utilization Management Nurse to review and authorize LTSS and HCBS for Illinois Medicaid members.... ...interdisciplinary teams to ensure access to appropriate care and services. The role requires an IL RN license (or eligibility), 1+ year UM/LTSS...Remote job
$54.1k - $129.63k
...by passionate colleagues who care deeply, innovate with... ...and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule... ...Registered Nurse ready to make an impact beyond the bedside? Join our...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work- ...This role is part of a multidisciplinary team focused on member care within a managed care framework. The position requires R.N. licensure in NC, five years of clinical experience, including acute care and utilization management experience. #J-18808-Ljbffr Vaya HealthRemote job
$41.72 - $105.65 per hour
...As a not-for-profit, we support patient care, research, teaching, and community service... .... Resolves patient problems and needs by utilizing multidisciplinary team strategies. Educates... .... Additional Job Details (if applicable) Remote Type Remote Work Location 265 Charles...Remote workHourly payDaily paidWork at officeShift work- ...applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...days for first week. This role will be remote BUT regular meetings/trainings require... ...Evaluates all patients, including critical care, for appropriateness of admission type...Remote workReliefWeekend work3 days per week
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct... ...utilization reviews, support transitions of care, and ensure compliance with Medicare Advantage regulations...Remote job
$54.1k - $142.58k
...Behavioral Health Utilization Management ClinicianWe're building a world of health... ...passionate colleagues who care deeply, innovate with... ...professional looking for a rewarding remote role that combines clinical... ...while making a meaningful impact on outcomes.Schedule:Saturday...Remote workHourly payFull timeShift workNight shiftWeekend work
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