RN Utilization Review - Per Diem - REMOTE
$57.28 - $88.92 per hourProvidence Service
Description
RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts.
Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
- Associate's Degree - Nursing.
- California Registered Nurse License upon hire.
- 2 years - Experience working in a remote UR environment or working as an acute hospital case manager.
Preferred Qualifications:
- Bachelor's Degree - Nursing.
- Master's Degree - Nursing.
- Experience working with Interqual guidelines.
- Experience in a multi-hospital and/or integrated healthcare system.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
About the Team
The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 433667
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Per-Diem
Job Shift: Day
Career Track: Nursing
Department: 7000 UTILIZATION MGMT REMOTE
Address: CA Mission Hills 15031 Rinaldi St
Work Location: Providence Holy Cross Medical Ctr-Mission Hills
Workplace Type: Remote
Pay Range: $57.28 - $88.92
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
$51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in...Daily paidRemote workLive inShift workDay shift- 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...Daily paidRemote workHourly payDay shift
$39 - $40 per hour
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- ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
$57.28 - $88.92 per hour
...Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and... ...Management Job Function: Revenue Cycle Job Schedule: Per‑Diem Job Shift: Variable Career Track: Nursing Department: 7520 UTIL...Daily paidWork at officeLocal areaShift work- ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
- ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
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- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workFull time
- Air Combat Effectiveness Consulting Group, LLC in Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and liaising with health plans to ensure...Daily paid
$69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare... ...Ideal candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote work$60.2k - $107.4k
...Stryker Corporation is looking for a Utilization Review Nurse, RN, based in California. As part of this role, you'll manage inpatient utilization... ...clinical guidelines. The position offers the flexibility of remote work within the U.S., alongside responsibilities like...Remote work- ...Humana is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship and is... ...military spouses. Interns will conduct clinical reviews, communicate with providers, and document...Remote workInternship
- ...Utilization Review Clinician, Advocate, Remote We are an equal employment opportunity employer. All qualified applicants will receive consideration for... ...Review Clinician/Advocate needed for remote Per Diem position. The Utilization Review Clinician/Advocate provides...Daily paidRemote job
- ...BJC HealthCare (New) is seeking a remote RN with Utilization Review experience. This role involves evaluating the appropriateness and efficiency of hospital resources to ensure quality patient care. Candidates must have 2 years of RN experience and live within one hour...Remote work
$2,210 per week
...Holidays Work-life balance. Remote/hybrid setting (once... ...: This individual will utilize clinical knowledge and... ...to a second level reviewer. This individual interfaces... ...but is not limited to RN, LMSW, LMHC. Successful... ...Registered Nurse - $2,210 per week Utilization Review...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...Humana is offering a remote internship for a Utilization Management Behavioral Health Registered Nurse (RN) Intern. This role supports the National Medicaid team, focusing on clinical reviews and patient care. Candidates must be transitioning military service members...Remote workInternshipWork at officeWeekday work
$23.76 - $51.49 per hour
...Molina Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly pay- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
- ...Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New York Tri-State Area. The successful candidate will be responsible for assessing member needs and ensuring high-quality...Remote workFull time
- ...Description We are seeking an experienced Utilization Review Nurse to join our team in a hybrid role... ..., Nassau County (Hybrid: In Office/Remote) Schedule: Monday to Friday, 8:30 AM - 5... ...coordination meetings. Qualifications Active RN license in the state of New York....Remote workWork at officeMonday to FridayFlexible hours
$2,700 per week
...Lancesoft is seeking an experienced Utilization Review Registered Nurse for an exciting Travel Nursing... ...Pending License accepted: No Fully Remote Position Hospital Highlights Type... ...Required: 1 year Certs Required: BLS, WA RN License About Lancesoft:...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work$47.06k - $70.24k
A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting... ...claims examiners. Candidates must have a current RN license and at least four years of clinical...Remote work- ...TurningPoint Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be a Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking skills and attention to detail. The...Remote work
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift:... ...the time of submittal. Guaranteed Hours: 72 hours per 2 week period Hospital Highlights Type of...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work- ...in Nevada seeks a Supervisor, Clinical Review to supervise clinical staff conducting utilization reviews. Ideal candidates will have an active RN licensure in Alabama, with 3+ years of... ...skills are crucial. The position offers a remote work option along with comprehensive...Remote work
- ...safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is... ...varied clinical settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant...Daily paidLocal area
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