Remote Utilization Review Nurse - Home Health & Compliance
IntePros
- Remote job
A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have a nursing license in Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are essential. This is a contract position that offers a chance to make a direct impact on patient outcomes. #J-18808-Ljbffr IntePros
- ...healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities... ...and have experience in utilization review or home health. This contract role offers a chance to...Remote workContract work
$78k - $88k
Gainwell Technologies is seeking a skilled Utilization Review Nurse to perform prior authorization across prospective, concurrent, and... ...medical necessity, documenting findings and ensuring policy compliance. This home-based role supports providers, uses InterQual/MCG...Remote job$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison,... ...meet patients’ needs while ensuring compliance with federal, state, and... ...to determine the need for continued home health services in alignment with Medicare...Remote workContract workWeekend work$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful... ...findings, and ensuring policy compliance. Your role in our... ...should expect in this role Home-based role available to applicants... ...match, comprehensive health benefits, and educational...Remote workWork from homeFull timeContract workWork at officeFlexible hours$35 - $45.94 per hour
...Utilization Review Nurse Remote Hi, we're Oscar. We're hiring a Utilization Review... ...be completed from your home office, occasional travel... ...engagement when needed Compliance with all applicable laws and... ...re on a mission to change health care -- an experience made...Remote workWork from homeHourly payFull timeHome officeWeekend work$66.83k - $111.38k
...ShiftFirst (Days)Overview:Sentara Health Plansis hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote!Status: Full-time,permanent... ...setting reviews to ensure compliance with applicable criteria,... ...xhyhwjd Remote working/work at home options are available for...Remote workWork from homePermanent employmentFull timeTemporary workShift workDay shift$1,966 per week
...first 25 applicants Nurses - are you looking... ...able to work from home 50% of the time... ...personalized managed health care, focused on... ...Work-life balance. Remote/hybrid setting (once... ...individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces...Remote workWork from homeFull timeTemporary workPart timeWork at officeMonday to FridayFlexible hours$40.12 - $62.19 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty service... ...line of physician advisors, nurses, and support staff who... ...information. This is a Full-time remote position.... ...wellness programs and mental health support 403(b) retirement...Remote workFull time- ...company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...authorization requests, ensuring compliance with Medicare guidelines, and collaborating... ...review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine...Remote workFlexible hours
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley... ...Peterson AFB, Colorado Military Health System Compensation: $1,600... ...no holidays, no telehealth/remote work Minimum Qualifications... ...Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to Friday- ...Excellus Health Plan Inc. in Albany, NY is seeking a qualified candidate to coordinate... .... The position involves clinical reviews ensuring compliance with health standards. Applicants should... ...with Microsoft Office. Opportunities for remote work may be available based on...Remote workWork at office
$90k - $107k
...Mass General Brigham Health Plan Holding Company, Inc. is seeking a Remote UM Nurse to support network adequacy review and authorization activities for members in ACO, HMO, and EPO products. The role requires clinical knowledge to review prior authorization requests, assess...Remote work$40 per hour
...reside in TX Full time remote Candidates must be... ...initial, concurrent review activities; discharge care... ...information regarding utilization management requirements... ...facilities. Registered Nurse (RN) with valid,... ...hospital/surgical setting or health care insurance company....Remote workFull timeContract workWork at office$41 per hour
...Medical Review Nurse (RN) Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract... ...Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims...Remote workContract work- ...seeking an experienced Utilization Management (UM) Registered Nurse to support outpatient utilization review and prior... ...while maintaining compliance with regulatory standards... ...clinical guidelines and health plan policies.... ...independently in a remote environment. Comfortable...Remote workContract work
- ...MCI is looking for a Licensed Life and Health Insurance Specialist in a remote, work-from-home capacity. This role involves educating customers about various... ...policies to meet their needs while ensuring compliance with regulations and achieving sales targets. The...Remote workWork from home
- ...time position entails administering assessments, ensuring compliance with regulations, and leading professional development.... ...South Carolina educator certification. Benefits include health care, work-from-home flexibility, and retirement options. All staff must reside...Remote workWork from homeFull time
- ...Performs medical record review for severity of... ...review agencies to ensure compliance with regulations affecting... ...and Training: Nurse, Registered (RN)... ...preferred. 2-5 years previous Utilization Review experience... ...Details: Days, Primarily remote; onsite orientation...Remote workShift workWeekend work
- ...Company, is seeking credentialing specialists to join our remote team focused on provider credentialing and health plan operations. You will verify credentials,... ...a compliant provider experience while working from home. This full-time remote role offers weekly pay and...Remote workWork from homeWeekly payFull timeFlexible hours
- ...Location: 100% Remote Schedule: M-F... ...Works with the Utilization Management team primarily... .../utilization review and other utilization... ...effectiveness and compliance with all state and... ...State Registered Nursing (RN) license in good... ...Job function Health Care Provider Industries...Remote workContract work
- ...Currently seeking a Utilization Management RN . Please... ...below: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact to include... ...medical record review to determine medical necessity... ...patients, and ensure compliance with federal, state,...Remote workImmediate startDay shift
$35 - $43 per hour
....00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must reside in... ...Concurrent Review will perform utilization management functions to ensure members... ..., and medical determinations in health management systems. Educate...Remote work- ...Utilization Review NurseWe are seeking a detail-oriented and experienced... ...Utilization Review Nurse to evaluate the... ...clinical reviews, ensure compliance with payer guidelines... ...for hospitals, health plans, insurance companies... ...management department. Remote, hybrid, or on-site opportunities...Remote workWork at office
- ...overall experience of Evry Health's members. The incumbent strives... ...are required to address utilization review cases. Roles and Responsibilities... ...current, unrestricted Texas nursing license or Compact License.... ...This is a remote position. Our whole company...Remote workLive inFlexible hoursWeekday work
- ...Coyne & Associates is seeking a Remote Bilingual BCBA Program Supervisor to lead in-home ABA services for children, with the flexibility to work from home.... ...programs, coordinate with a scheduling team, and ensure compliance while training staff in real-life sessions....Remote workWork from home
- ...summary: Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and... ...per week in the office and three days remote. Candidates must also have flexibility... ...dimension of your life, from your health and finances to your family and future...Remote workWork at officeImmediate startFlexible hours2 days per week
- ...American Health Plans, a division of Franklin, Tennessee-based... .... In partnership with nursing home operators, these Medicare Advantage... ...JOB SUMMARY: The Utilization Review Nurse is to assess the medical... ...medical services in compliance with medical and regulatory...Remote workFull timeTemporary workLocal area
$35 - $43 per hour
...Who We Are Because health is personal. That's why... ...decisions, one review at a time? Why This... ...matters: Maintain HIPAA compliance and confidentiality using... ...of an accredited nursing program (ADN or diploma... ...similar setting) ~ Utilization review/utilization management...Remote workHourly payImmediate startMonday to FridayFlexible hours- Visualutions, Inc. is seeking a Certified Medical Coder to work 100% remotely from home while covering the Spring, TX area. The role reviews clinical documentation, assigns codes, and ensures compliant billing with established guidelines and procedures. The ideal candidate...Remote jobWork from home
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