Behavioral Health Utilization & Appeals Nurse - Remote
Harris Health System
Harris Health System, Inc. is looking for a Behavioral Health Utilization Manager to perform concurrent reviews on patients and coordinate care for medically complex individuals. The successful candidate will ensure justification for admissions and maintain quality standards for case reviews. Applicants must possess a Bachelor's degree in nursing and be a current Registered Nurse. This position requires two years of relevant experience, and the role can be performed remotely, offering flexibility in work schedules. #J-18808-Ljbffr
Vacancy posted 8 hours ago
Similar jobs that could be interesting for youBased on the Behavioral Health Utilization & Appeals Nurse - Remote in Houston, TX vacancy
$40 per hour
...Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through Saturday, 8:00 AM - 5:00 PM PST Compensation: $40 per hour...Remote workHourly payPermanent employmentTemporary workWork at officeMorgan Stephens
United States1 day ago$50 per hour
...Drips.com is looking for an Appeals RN (Temporary) to handle grievances and... ...role requires a Bachelor’s degree in nursing and a current RN license, along... ...skills and a strong background in utilization management. The position is remote and offers a salary of $50/hr. In...Remote workTemporary workDrips
New York, NY2 days ago- Humana is seeking a Utilization Management Behavioral Health Registered Nurse (RN) Intern to join their National Medicaid team. This role involves conducting medical... ...an active RN license. This position supports remote work, providing work-life balance while contributing...Remote jobInternship
- ...a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals and validating claims to ensure medical... ...nursing experience, including utilization review, and a valid RN license in Florida...Remote jobFull time
- ...an experienced Registered Nurse (RN) – Utilization Management / Case Management... ..., prior authorizations, appeals, and member care coordination... ...Management background Behavioral Health or Adult Care experience Experience... ...weeks depending on role) Remote/hybrid flexibility...Remote workContract workLocal area
Talent Software Services
Columbia, SC9 hours ago - Humana is looking for a Utilization Management Behavioral Health Registered Nurse (RN) Intern to support the National Medicaid team. The role includes conducting... ...behavioral health experience. The position allows remote work and offers a weekday schedule. #J-18808-Ljbffr...Remote jobInternshipWeekday work
- Humana is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship and is targeted at transitioning military service members or military spouses. Interns will conduct...Remote jobInternship
$44.64 - $71.24 per hour
...Spending Accounts & Health Saving Accounts... ...Summary Performs utilization review in accordance... ...reconsideration, appeal, administrative rate... ...Standards of Behavior and adhere to the... ...Associate's Degree in Nursing. Three (3) years experience... ...setting with remote work as well as in...Remote workHourly payContract workWork at officeFlexible hoursShift workConfluence Health
Wenatchee, WA8 hours ago$60.52k - $129.62k
...’re building a world of health around every individual... ...is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you... ...expedited), MPO, Coding, or Behavioral Health appeals. This is... ...Appeals, Managed Care, or Utilization Review experience....Remote workHourly payFull timeTemporary workLocal areaMonday to FridayShift workHispanic Alliance for Career Enhancement
Brooklyn, NY3 days ago- ...Cambia Health Solutions is seeking an Appeals Clinician I to join the Clinical Services team. This role will utilize clinical expertise to manage the clinical aspects of appeals, ensuring... ...include a Bachelor's degree in nursing, a current RN license, and a minimum of...Remote workWork from home
Cambia Health Solutions
Lewiston, ID8 hours ago $38.17 - $57.25 per hour
...Nurse Appeals-RN (California) Nurse Appeals RN Locations: Woodland... ...and regulatory entities. Utilizes leadership skills and serves... ...RN license to practice as a health professional within the... ...associates. Our values and behaviors are the root of our culture....Remote workFull timeTemporary workWork at officeLocal area1 day per weekElevance Health
United States3 days ago- ...Cambia Health Solutions is seeking an Appeals Clinician I to join their Clinical Services team. This role involves utilizing clinical expertise to support the appeals process for members and... ...will possess a Bachelor’s Degree in Nursing, hold an active RN license, and have...Remote workWork from homeFlexible hours
Cambia Health Solutions
Medford, OR9 hours ago - ...Cambia Health Solutions is looking for an Appeals Clinician I to utilize clinical expertise in resolving appeals for members and providers. This position allows a... ...-home option and requires a Bachelor's Degree in Nursing along with a valid RN license in select states. The...Remote workWork from homeFlexible hours
Cambia Health Solutions
Coeur D Alene, ID8 hours ago $35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour Shift... ...will include 80% travel. Remote role. Will require a driver... ...resolving complaints and appeals. Licensed Clinical Social...Remote workHourly payFull timeContract workImmediate startShift work3 days per weekMindlance Health
Corpus Christi, TX20 days ago$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour Shift... ...will include 80% travel. Remote role. Will require a driver... ...resolving complaints and appeals. Licensed Clinical Social...Remote workHourly payFull timeContract workImmediate startShift work3 days per weekTravelNurseSource
Corpus Christi, TX20 days ago- ...Cambia Health Solutions is looking for an Appeals Clinician I to work remotely from Oregon, Washington, Idaho, or Utah. This critical role will utilize nursing expertise to resolve member and provider appeals efficiently. The ideal candidate has a Bachelor’s Degree in...Remote work
Cambia Health Solutions
Vancouver, WA8 hours ago - ...Confluence Health is seeking a Utilization Review Specialist to ensure compliance with state regulations... ...setting and an Associate's degree in Nursing. The ideal candidate will coordinate... ...position allows for flexibility between remote and in-office work. #J-18808-Ljbffr...Remote workWork at office
Confluence Health
Wenatchee, WA9 hours ago $76.5k - $103.5k
...Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise in resolving member and provider appeals. This role is integral to making... ...easier for members and requires a Bachelor's Degree in Nursing, an active RN license, and relevant clinical...Remote workCambia Health Solutions
Renton, WA8 hours ago$50k
...Employer Industry: Behavioral Healthcare Management Why... ...reviews, and internal utilization review assessments Consult... ...urgent/expedited appeals Staff individual cases... ...Bachelor’s degree in a health or behavioral health-related... ...(e.g., Registered Nurse, Licensed Practical...Remote workAdvanced Recovery Systems LLC
New York, NY2 days ago- ...Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise for resolving member and provider appeals. The role emphasizes compliance... ...teams. Candidates should have a Bachelor's Degree in Nursing, 3 years of relevant experience, and an active RN...Remote work
Cambia Health Solutions
Salt Lake City, UT9 hours ago - ...yourcommission is seeking a PRN Utilization Management Review Nurse in Bellaire, Texas to perform evaluations on medical services for necessity and efficiency. Responsibilities include handling appeals, conducting peer reviews, and ensuring quality outcomes through collaboration...Remote workReliefFlexible hours
yourcommission
Bellaire, TX3 days ago - Description: Nurses – are you looking for a change? Want to work no... ...! *Must have Mental Health and/or Substance Abuse experience... ...Holidays ~ Work-life balance. ~ Remote/hybrid setting (once trained)... ...: This individual will utilize clinical knowledge and communication...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
Hines and Associates
Rockford, IL2 days ago - ...The Role BHPS provides Utilization Management services... ...Utilization Management Nurse performs medical... ...coverage while working remotely. Primary Responsibilities... ...Disease Management, Appeals & Grievances, and... ...outpatient reviews including Behavioral Health, DME, Genetic Testing...Remote workContract workWork at office
Santa Barbara Cottage Hospital
New York, NY2 days ago - Humana is looking for a Behavioral Health Registered Nurse (RN) Intern to join the National Medicaid team. This internship serves transitioning military... ...years of behavioral health experience. The position is remote, ideally for candidates in Kentucky. #J-18808-Ljbffr...Remote jobInternship
- Humana is offering an internship for a Registered Nurse (RN) in Kentucky, aimed at transitioning military service... ...in Kentucky and have at least two years of clinical behavioral health experience. The role is remote, focusing on healthcare quality assurance and compliance...Remote jobInternship
- ...based in the United States is seeking a Registered Nurse Intern through the DOW SkillBridge internship program... ...an active RN license and have at least two years of behavioral health experience. The position is remote with a weekday schedule. #J-18808-Ljbffr Humana IncRemote jobInternshipWeekday work
$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States NeueHealth is a... ...company grounded in the belief that all health consumers are entitled to high-... ...including readability standards and appeal information. Documentation and...Remote workHourly payFull timeContract workWork at officeWork from homeNeueHealth
United States4 days ago$36 - $40 per hour
...forging our own path. We’re a remote-first staffing and... ...nation. Our mission? Bringing health to hospitals’ bottom lines.... ...coding career. If you are an Appeals and Denials Nurse looking for a new opportunity... ...care facilities. (mostly behavioral health patients with medical...Remote workPermanent employmentFull timeWork visaNorwood
New York, NY2 days ago$74.16 - $107.75 per hour
...Angeles, CA, USA Onsite or Remote Fully On-Site... ...section visibility The Utilization Management (UM) Nurse supports appropriate level... ...on denials, and supports appeal processes as needed.... ...timely in the electronic health record. Participates in...Remote workHourly payWork at officeMonday to FridayUCLA Health
Los Angeles, CA2 days ago- Humana in Maryland seeks a Registered Nurse (RN) Intern to join their National Medicaid team. This remote role involves conducting clinical reviews for behavioral health services, communicating with healthcare providers, and documenting findings. Candidates must be transitioning...Remote jobInternshipFlexible hours
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