Remote Utilization Review Nurse - Home Health & Compliance
IntePros
Phoenix, AZ
- 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
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Nurse - Home Health & Compliance in Phoenix, AZ vacancy
- ...and Blue Shield of Kansas City is looking for a Clinical Review Nurse to utilize clinical expertise in managing healthcare services efficiently... ...conducting utilization management reviews and ensuring compliance with medical guidelines while effectively communicating with...Remote work
Blue Cross and Blue Shield of Kansas City
Kansas City, MO3 days ago - ...insurance group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and ensure compliance with guidelines. Candidates should have a BSN... .... The position offers options for remote work, health insurance, and other competitive benefits....Remote workFull time
Berkshire Hathaway Homestate Companies
Omaha, NE2 days ago - ...Summary Responsible for reviewing electronic medical records,... ...and analyze data, supporting compliance with regulatory and... ...data and reports. Supports utilization review processes by planning... ...interprets reports for physicians, nursing, and ancillary services. •...Remote workFull timePart timeReliefInternshipShift work
UK St Claire
United States2 days ago $85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR... ...TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than... ...transitions across care settings, ensuring compliance with Oregon Health Plan (OHP),...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayUmpqua Health
United States8 days ago- ...Utilization Management Nurse Review patient medical records to determine the medical necessity... ...software. Ensure compliance with payer requirements, regulatory... ...independently in a remote environment and proficient... ...from the comfort of your home. Consistent Monday-...Remote workMonday to FridayShift workDay shift
Protouch Staffing
United States2 days ago - ...patient needs and that encourages compliance with medical advice.... ...days. Enter Ancillary notes utilizing the templates for care facilitation... ...patient care plans and review medical needs for continued hospital... .... Utilize Case Manager nurse driven protocols to...Remote work
University of Miami
United States22 hours ago - ...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 jobContract work
$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$34.73 - $45.15 per hour
...Performs medical record review for severity of... ...to ensure compliance with regulations affecting... ...and Training: Nurse, Registered (RN) licensure... ...-5 years previous Utilization Review experience... ...: Days, Primarily remote; onsite... ...we care about your health and well-being and...Remote workFull timePart timeWork experience placementFlexible hoursShift workWeekend work- ...Join a stable work from home team. This is a great... ...for a local remote position. Schedule... ...commercial, behavioral health, inpatient, etc). Requirements... ...: ~2 years of staff nurse experience performing... .... ~2 years of utilization review (UR) experience reviewing...Remote workWork from homeReliefLocal areaMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO5 days ago $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 hoursHines
Rockford, IL4 days ago$43 - $63 per hour
...Job Description Job Description The Utilization Review Nurse plays a key role in evaluating patient admissions to ensure appropriate levels of care, efficient resource utilization, and compliance with third-party payer requirements. This position involves reviewing...Relocation packageLancesoft INC
Las Vegas, NVa month ago- ...Registered Nurse - Utilization Review (Nursing) Location: Aurora, CO. Location: Colorado Military Health System – Buckley AFB and Peterson AFB. Labor... .... Tele-health/work from home is not an option. Legal... ...cost effectiveness. Ensure compliance with standards of care and...Remote workWork from homeContract workMonday to FridayNight shift
Software Technology Inc
Aurora, CO4 days ago - ...Intern will engage in clinical reviews, support decision-making for... ...services, and ensure compliance with regulations. This role requires... ...and two years of behavioral health experience. Candidates should... ...the opportunity to work from home in a supportive environment....Remote workWork from homeInternship
Humana
Saint Paul, MN5 days ago - ...records for medical service legitimacy and ensure compliance with reimbursement policies. The role requires a nursing diploma or associate's degree, along with three... ...improvement processes. This position is work from home, based in Fort Smith, AR, and involves effective...Remote workWork from home
AFMC
Fort Smith, AR2 days ago - ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical... ..., and document determinations in compliance with standards. Two or more years in...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC5 days ago $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 FridayJ Edward Staffing LLC
Aurora, CO4 days ago- ...firm is seeking a professional to review title packages remotely. You will ensure compliance with quality standards and verify important... ...offers flexibility to work from home, a competitive salary, and a range of benefits including health insurance and paid time off. #J-188...Remote workWork from home
O.R. Colan Associates
Houston, TX5 days ago - ...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-Ljbffr...Remote work
Medix
New York, NY3 days ago - ...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
Cyber Academy of South Carolina
Columbia, SC1 day ago - ...Utilization Review Registered Nurse Excel. Empower. Advance. Shine. Belong. Explore.... ...Hopkins! Johns Hopkins Health Plans (JHHP) is the managed... ...-life balance - This is a remote role! Candidates in the following... ...JHHP is the place to call home. Salary Range: Minimum...Remote workLocal areaMonday to Friday
Johns Hopkins Medicine
United States3 days ago - ...Posted On 06/29/2026 Job Information Health Care City Kearney State/Province... ...near Lexington, Nebraska is seeking Utilization Review Registered Nurse to join their team! Utilization Review... ...utilization review, quality data collection, compliance, and accurate medical documentation...Full timeMonday to Friday
Ironside Human Resources
Kearney, NE2 days ago - 340B Health is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, Texas. This role involves technical and administrative work to ensure efficient utilization of medical services while promoting quality care. The UMRN collaborates with various teams to achieve...Remote workFlexible hoursWeekend work
340B Health
Bellaire, TX1 day ago - ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours... ...combination of in person and remote considered) General... ...facilitates safe transition to home or extended care facility.... ...referral for home health, hospice, durable medical...Remote workFull timeShift work
Gibson Area Hospital
Gibson City, IL3 days ago - .... Responsibilities: Reviews documentation and evaluates Potential... .../information to determine compliance with clinical policy,... ...experience as an RN ~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience...Remote work
US Tech Solutions
United States4 days ago - ...Clinical Director, the Registered Nurse oversees primary caseload of... ...by the physician and in compliance with the Hospice Medicare Conditions... ...with current hospice, home health, medical, surgical or critical... ...Displays a willingness to utilize problem-solving techniques to...Remote workWork from homeWork experience placementWork at office
Allied Services Integrated Health System
United States4 days ago - ...Chicago, IL (3 days onsite / 2 days remote) We're seeking an experienced Registered Nurse (RN) with a background in managed... ...subcontracted providers reviewing adherence to regulatory and contractual... ...years managed care experience or health plan operations experience Experience...Remote workFor subcontractorWork at office
Integrated Resources
Chicago, IL5 days ago $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 workHireOps Staffing LLC
United States3 days ago- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
Insight Global
Raleigh, NC3 days ago - ...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
MCI
Topeka, KS1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review Nurse - Home Health & Compliance. Be the first to apply!
Related searches
- remote utilization review nurse part time Phoenix, AZ
- quality assurance manager remote Phoenix, AZ
- frontend internship remote Phoenix, AZ
- remote broker Phoenix, AZ
- remote healthcare analyst Phoenix, AZ
- excel remote Phoenix, AZ
- software testing remote Phoenix, AZ
- marketing intern remote Phoenix, AZ
- data entry specialist remote Phoenix, AZ
- remote support engineer Phoenix, AZ