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 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$40 - $50 per hour
Utilization review Registered Nurse ( Post service Medical Review 3) Working Shift - (08:00 AM - 05:00 PM) Remote in California 6+ Months Summary: The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing...Remote workContract workWork at officeLocal areaShift work- Utilization Review Nurse Auditor (33034)# Utilization Review Nurse Auditor (33034)Fully Remote • Mount Laurel, NJ 08054## OverviewSalary Range$33.00 - $46.00 HourlyPosition TypeFull... ...integrity and that all work is in full compliance with client contractual agreements,...Remote workLocal areaMonday to Friday
$35 - $45.94 per hour
...Oscar. We're hiring a Utilization Review Nurse to join our... ...Location: This is a remote position, open to candidates... ...completed from your home office, occasional travel... ...when needed Compliance with all applicable laws... ...is an authentic Oscar Health job opportunity. At...Remote workWork from homeHourly payFull timeHome officeWeekend work$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- ...Remote role but will need to go to Newark, NJ to pick... ...1. Conducts on-site reviews at participating provider... ...physicians medical records, and compliance with documentation... ...improvement and health management. 4. Assists... ...Requires License Practical Nurse License or an active...Remote work
- ...Registered Nurse: Review and EvaluationAre you a registered nurse ready... ...program integrity through compliance management. Here, you'll champion... ...the freedom of working from home, the flexibility and... ...medical recordsExperience in utilization review, case management, quality...Remote workWork from home
- ...HIRING: Utilization Review Nurse | Remote | UM Training Provided 5 Clinical Nurses Wanted for an Exciting UM Pilot Program! Have you been working... ...~ Reliable, quiet, dedicated, and HIPAA-compliant home office ~ Adaptable attitude and genuine interest in learning...Remote workFull timeContract workHome officeShift work
- You will be reviewing clinical documentation to ensure accuracy, completeness, and regulatory compliance Work directly with physicians and clinical staff to clarify documentation... ...interested in learning more! xhyhwjd Remote working/work at home options are available for this role.Remote workWork from homeContract workShift work
- ...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
$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 package- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the... ...necessary with other members of the health care team to ensure the above... ...intellectual property; assures compliance with national health information...Remote workFull time
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning. Requires... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central...Remote work
- ...Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities... ...critical care and/or medical/surgical nursing At least 2 years utilization... ...Expectations Comfortable with remote work arrangements and virtual...Remote workFull timeFor contractorsWork at officeShift workWeekend workWeekday work
$35 - $40 per hour
...experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience... ...clinical quality review and AI model development... ...Fri, 40 hrs/week Fully Remote Position Pay Range: $... ...program, legal support, auto, home insurance, pet insurance...Remote workHourly payLocal areaShift work- ...Rheumatology Associates, P.C. is seeking a Clinical Research Nurse to manage unblinded protocols, prepare... ...and travel to multiple sites. The CRN will ensure compliance with protocols and SOPs, and may work from home when not needed on site. The role requires RN or LPN...Remote jobWork from home
- ...Gainwell Technologies LLC is seeking a skilled Utilization Review Nurse for a remote role based in the United States. The position reviews medical necessity... .... Benefits include flexible vacation, 401(k) match, health benefits, and professional development opportunities....Remote workContract workFlexible hours
- 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
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license...Remote workContract work
- ...patients, develop treatment plans, and prescribe medications when needed, while ensuring compliance with regulations and ethics. The role supports clinicians working remotely from home, with flexible scheduling and regular virtual team meetings. Collaboration with a...Remote jobWork from homeFlexible hours
- ...treatment plans, and prescribe medications as needed, while ensuring compliance with regulations and ethical standards. The role offers... ...with regular virtual team meetings and the opportunity to work from home on a flexible schedule. #J-18808-Ljbffr BlueSky TelepsychRemote jobWork from homeFlexible hours
- ...clinical oversight and developing patient-centered care plans. This remote role may report to the CEO/President and requires an active... ...and a bachelor’s degree in a clinical field. You will work from home or Office on occasion, document activities in our CareVitality...Remote workWork from homeWork at office
- ...platform that connects licensed mental health professionals with clients seeking flexible, remote care. You provide the expertise;... ...handle scheduling, billing, and compliance. We’re seeking experienced... ...nationwide network. Work from home, set your hours, and earn...Remote workWork from homeHourly payWeekly payFlexible hours
- Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy,...Remote jobWork from home
- ...Credentialing Specialists to join a remote team serving health plans. You will ensure timely, accurate... ...provider credentialing and maintain compliance with internal standards and external... ...experience. The role offers a work-from-home setup, weekly pay, and schedules...Remote jobWork from homeWeekly pay
- Broadway Ventures is seeking a Medical Reviewer (1099 contract) on a remote basis for the United States. The role involves reviewing PCR packages... ...licensure and 2+ years in clinical work, including home health or utilization review, are essential; ICD coding proficiency is a...Remote jobWork from homeContract work
- ...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 job
- .... You will train families and caregivers on home-based strategies and supervise client programming, while maintaining compliance with Medicaid requirements and state guidelines... ...distances, hybrid for mid-distance, and remote for longer distances, with flexibility to support...Remote jobWork from homeLong distance
- ...Physician to join our telehealth team on a remote contractor basis. You will provide expert... ..., with documentation and regulatory compliance across platforms. The role requires 3-5 years... ...licensure, and the ability to work from home. Minimum 24 hours per month, remote, with...Remote jobWork from homeFor contractors
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