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
$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 organizational... ...determine the need for continued home health services in alignment with Medicare...Remote workContract workWeekend work$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 Friday$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- ...Refer a Friend Back Remote Work from Home Share This Page Share... ...Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Nursing Schedule: Day Shift Employment... ...:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns...Remote workWork from homeFull timeLocal areaMonday to FridayDay shift
$78k - $88k
Summary We are seeking a skilled Utilization Review Nurse to conduct prior... ...findings, and ensuring policy compliance. Your role in our mission Review... ...should expect in this role Home-based role available to... ...employer match, comprehensive health benefits, and educational...Remote jobWork from homeFull timeContract workWork at officeFlexible hours$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$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. Learn...Remote workWork from homeHourly payFull timeHome officeWeekend work$85.99k - $105.34k
...A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams....Remote workFull time- ...American Specialty Health Incorporated (ASH) is seeking an Examiner I to join our Credentialing department, responsible for expediting... ...according to standards and regulatory requirements. This remote, work-from-home position requires reliable internet and participation in...Remote workWork from home
- ...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
- ...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
- ...Overview Title: Clinical Review Nurse – Prior Authorization... ...Location: Fully Remote (PST Time Zone - WA/OR... ...Authorization Review to join our Utilization Management team. In... ...information in health management systems to ensure compliance with regulatory guidelines...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
$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. Description Astrana Health is looking...Remote workHourly payMonday to Friday$30 - $38 per hour
...Overview Who We Are Because health is personal. That's why... ...Job Summary We are seeking Utilization Review Nurse RN to join our team on a part... ...URAC and NCQA. Maintain HIPAA compliance per company’s policy and... ...successfully perform in a remote healthcare environment. Ability...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend work$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley... ...Peterson AFB, Colorado Military Health System Compensation:... ...no holidays, no telehealth/remote work Minimum... ...Utilization Management, Utilization Review, or Case Management ~•...Remote workContract workImmediate startMonday to Friday- ...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
$55 - $60 per hour
...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 workHourly payContract work- ...Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit...Remote work
- ...leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the... ...insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and...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-Ljbffr...Remote work
- 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
- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years... ...clinical reviews, ensure compliance with payer guidelines and regulatory... ...Experience working for hospitals, health plans, insurance companies, or managed...Remote workFull timeSecond jobWork at office
$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- ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical review and provider collaboration. The position requires an active RN license, 3+ years...Remote workFull time
- ...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
$27.02 - $48.55 per hour
...About This Role The Utilization Review Clinician - ABA at... ...reviewing members' care and health status related to... ...appropriateness and compliance with clinical... ...per hour Location: Remote, FL Schedule: Full... ...Accredited School of Nursing or Bachelor's degree...Remote workHourly payFull timeFlexible hours- ...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
- ...organization, University of Utah Health exists to enhance the health... ...Applies approved utilization criteria to monitor appropriateness... ...levels of care and continued stay review. Communication to third-... ...with payer as determined by nursing judgment and/or collaboration...Remote workWork at officeShift workNight shiftRotating shift
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!
- remote utilization review nurse part time Phoenix, AZ
- operations coordinator remote Phoenix, AZ
- remote appointment scheduler Phoenix, AZ
- content designer remote Phoenix, AZ
- remote coordinator Phoenix, AZ
- remote broker Phoenix, AZ
- remote design intern Phoenix, AZ
- remote accounts receivable Phoenix, AZ
- remote b2b sales Phoenix, AZ
- immediate hire remote Phoenix, AZ


