Remote Utilization Management RN | Admissions & Authorizations
Santa Barbara Cottage Hospital
- Remote job
ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers, apply payer rules for authorizations, and collaborate with clinicians to optimize resource use and care quality. Qualifications include a NLN-accredited nursing program, at least 3 years acute care nursing, and an active RN license in the hire state. You will work from home, with states restrictions noted in the posting. #J-18808-Ljbffr Santa Barbara Cottage Hospital
- WPS—A health solutions company is seeking an experienced Utilization Management RN to evaluate medical necessity, authorize appropriate care, and refer cases to medical directors when needed. The role supports Health Services by reviewing prior authorizations, monitoring...Remote job
- Allmed Staffing Inc is seeking a qualified Utilization Management LPN to support daily utilization management operations. The position involves reviewing authorization requests, ensuring compliance, and maintaining operational efficiency in a collaborative team environment...Remote jobFull time
$39.83 - $59.74 per hour
...Utilization Management RN Robbinsdale, MN Posting Date: Jul 10 202... ...to determine an appropriate admission status. They provide clinically... ...Call Requirement: None Remote or On-site: Hybrid Remote-... ...must be currently authorized to work in the United States...Remote workFull timeContract workPart timeFor contractorsFor subcontractorLive inWork at officeShift workWeekend work- ...provider in California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-Authorization team. This role requires 5+ years of clinical... ...referrals, and facilitate team meetings. A California RN license is required. This position offers a...Remote work
- WPS Health Solutions in Georgia seeks a Utilization Management RN to evaluate medical necessity and authorize services using evidence-based criteria. You will refer questionable... ...and strong coordination with health care teams. Remote work options are available in several states,...Remote job
$39 - $40 per hour
...Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the... ...Management RN experience, including Prior Authorization and Concurrent Review Experience working...Remote workDaily paidContract workMonday to FridayShift workWeekend work- WPS Health Solutions seeks a Utilization Management RN to assess medical necessity and authorize services using evidence-based criteria. You will refer cases to medical... ...and strong analytical and communication skills. Remote work options available within approved states,...Remote job
$80k - $95k
...population health, and utilization management. IntusCare empowers... ...PACE program service authorization policies, ensuring that... ...of all hospital admissions (observation and inpatient... .... ~ Current RN license ~ Proven experience... ...: This is a fully remote role based in the...Remote work- CommonSpirit Health is seeking a Supervisor of Utilization Management (UM). This remote position requires overseeing the Pre-Authorization team while ensuring compliance with guidelines. Your leadership will be essential in promoting quality patient care. The ideal candidate...Remote job
- WPS Health Solutions is seeking an Utilization Management RN to evaluate medical necessity and efficiency... ...plan services. The role involves authorizing appropriate services and escalating... ...criteria are not met. The position supports remote work in approved states, including...Remote job
- ...in the United States is seeking an experienced Utilization Management RN to evaluate medical necessity and authorize services for our Health Plan. This role uses clinical... ...support quality care while controlling costs. Remote work is available in many states; expect...Remote job
- WPS Health Solutions is seeking an experienced Utilization Management RN to evaluate medical necessity, authorize services, and coordinate patient care for our Health... ...questionable cases to medical directors. This remote-friendly role requires strong clinical judgment,...Remote job
$35.58 - $51.44 per hour
WellSense Health Plan is seeking a Prior Authorization Clinician to join their team. This role... ...the necessary care. The position is fully remote, providing you with a robust... ...of prior authorization experience in a managed care setting. Strong communication skills...Remote jobHourly pay- Centene Corp. is seeking a Supervisor, Utilization Management to lead the clinical review teams in a remote Missouri capacity, overseeing prior authorization, concurrent and retrospective review... ...candidates hold a nursing degree, RN licensure, and 4+ years of UM experience...Remote job
$75k - $100k
Description Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness... ...services with evidence-based criteria, authorize requested services as appropriate.... .... Work Location We are open to remote work in the following approved states...Remote workFor contractorsWork at officeLocal areaImmediate start$75.3k - $135.4k
...professional on our Medical Management/Health Services team.... ...: Supervises Prior Authorization, Concurrent Review,... ...-to-day activities of utilization management team. Monitors... ...License/Certification RN - Registered Nurse -... ...approach to work with remote, hybrid, field or office...Remote workFull timePart timeWork at officeFlexible hours- ...FOR A 2 YEAR COMMITMENT**JOB TITLE: UTILIZATION REVIEW/CASE MANAGEMENT – NurseDEPARTMENT: CASE MANAGEMENT (... ...Hybrid (combination of in person and remote considered)GENERAL SUMMARYThe... ...directly responsible for review of patient admissions for severity of illness and...Remote workFull timeSecond jobWork at officeRelocation packageShift work
- ...Conducts reviews to determine prior authorization/financial responsibility for Molina and... ...the Molina care model. Adheres to utilization management (UM) policies and procedures. Required... ...and experience. Registered Nurse (RN). License must be active and unrestricted...Remote job
$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States... ...assessing inpatient admission and continued stays,... ...discrepancies in care. Authorization & Payer Communication... ...: Registered Nurse (RN) or Licensed... ...Corporate office preferred / remote may be considered...Remote workHourly payWork at office- Centene is seeking a Supervisor of Utilization Management to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams to ensure appropriate... ...focus on regulatory compliance. The position offers remote work in Missouri with a full-time day shift,...Remote jobFull timeDay shift
$35 - $40 per hour
...offerings for clinical, case management, member engagement,... ...countries. Job title: RN Utilization Management Reviewer Job... ...timely clinical and service authorization review for medical necessity... ...weekends This is a fully remote work at home role. You must...Remote workHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- Join to apply for the Oncology Prior Authorization Case Manager, Non-RN - Remote role at University of Miami 3 days ago - be among the first 25 applicants... ..., staff position. Pay Grade H8. Remote. Job Summary Utilization Review Case Manager responsible for initial,...Remote jobFull timeWork experience placement
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...validate care plans, and authorize services that meet established... ...necessity for inpatient admissions, continued stays,...Remote workImmediate startWeekend workDay shift
- ...days during the first week. The role is remote but requires regular onsite meetings... ...applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...critical care, for appropriateness of admission type and setting within 24 hours or next...Remote workReliefWeekend work3 days per week
$88.85k
...required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing... ...planning process, including providing clinical review and authorization for alternate levels of care, home health, durable...Full timeAll shiftsShift workNight shiftAfternoon shift$34.98 - $42.85 per hour
...Utilization Management Nurse I, RN Huntington Beach Office - Huntington Beach, CA 92647 Overview... ...Position Type Full Time Description Remote in California only Are you ready... ...I - RN performs clinical review of authorization requests to determine medical...Remote workHourly payFull timeWork at office$51.43 - $79.84 per hour
Overview Description - This is a remote role. You MUST live in the state... ...(WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical... ...for determining the appropriate admission status based on regulatory and...Remote workDaily paidLive inShift workDay shift- ...Utilization Review Case Manager The University of Miami Health System Department of UMHC SCCC Business... ...Review Case Manager to work to work remote. The incumbent conducts initial,... ...reviews for clinical utilization and authorization. The Utilization Review Case Manager...Remote jobFull timeWork experience placementWorldwide
$71.1k - $97.8k
...A healthcare solutions company is looking for a Utilization Management Registered Nurse to interpret and coordinate medical services. This fully remote position requires a Compact RN license and over a year of clinical experience. The role focuses on improving consumer...Remote work- The Oncology Institute, Inc. is seeking a UM Authorization Analyst II to ensure timely processing of medical authorizations. This... ...extensive knowledge of healthcare insurance, and experience in utilization management. You will lead daily interactions with clinicians and...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN | Admissions & Authorizations. Be the first to apply!

