Remote RN Utilization & Care Management Specialist
Intermountain Healthcare Inc.
- Remote job
Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote role. The position involves screening, assessing, and evaluating utilization review activities with emphasis on cost-effective, high-quality care. You will collaborate with patients, families, providers, and insurers to ensure compliant and efficient reviews. Required RN licensure with compact licensure, BSN within four years of hire, and experience in care management or utilization. #J-18808-Ljbffr Intermountain Healthcare Inc.
- Intermountain Health’s St. Marys Regional Hospital in Colorado seeks an RN Utilization Review Care Management I for remote, part-time work. You will review medical records, apply evidence-based guidelines, and collaborate with providers, members, and payers to ensure appropriate...Remote jobPart time
- Intermountain Health in Grand Junction, Colorado, seeks an RN Utilization Review Care Management I for a part-time, fully remote role. You will evaluate medical necessity, authorize services, and guide care using evidence-based guidelines. Video interview via Teams is required...Remote jobPart time
- ...Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the... ...administrative compliance. Unlike remote roles, this position relies... ...Nurse is a Registered Nurse (RN) responsible for performing... ...necessity or the current level of care.o Medical Provider Liaison:...Remote workFull timeImmediate startShift work
- ...Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of... .... The role requires an active RN license and a Bachelor's degree is preferred... ...and emphasizes evidence-based patient care, cost containment, and compliance with...Remote workWork from home
- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and determinations for medical... ...Utilization Management team, focusing on post-acute care services including SNF, Home Health and DME. Responsibilities...Remote work
- ...Cambia seeks an Utilization Management Nurse to work remotely from OR, WA, ID or UT with preference to current employees and residents of Idaho and Utah.... ...retrospective reviews to promote quality and cost-effective care while ensuring proper payment for services. The...Remote work
- ...Health is seeking an experienced Registered Nurse (RN) to join the Utilization Management team in a remote capacity. You will review clinical information to support... ...evidence-based criteria across the continuum of care. The role requires collaboration with providers and...Remote work
- ...Cross and Blue Shield is seeking an experienced Utilization Management Nurse (RN) to perform clinical reviews of prior approvals,... ...role focuses on medical necessity, evidence-based care, and cost containment with a remote work option across multiple states. The ideal...Remote work
- ...recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an... ...include evaluating healthcare services and coordinating care for members. Join a dynamic team and make a meaningful impact...Remote workContract work
- ...Cambia Health is seeking an Utilization Management Nurse who can conduct prospective, concurrent, and retrospective reviews to ensure medical necessity and proper care pathways. You will apply evidence-based criteria and consult with physicians as needed. In this role...Remote work
- ...Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating and documenting medical... ...Associate Degree in nursing, an active compact RN license, and at least three years of geriatric care experience, with strong telephonic and virtual...Remote work
- ...Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills to coordinate, document and communicate... ...–5:00pm EST schedule. The position supports remote work with occasional travel, and requires an RN with a compact license and 3+ years of geriatric...Remote workMonday to Friday
- ...Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication... ...stakeholders. The position is remote with occasional travel to Humana offices for training or meetings. A compact RN license is required, along with at least...Remote work
- Cambia Health is seeking an Utilization Management Nurse to support care decisions from a home-based setup across several states, including Washington, Oregon, Idaho and Utah. The role emphasizes clinical judgment, cost-effective care, and policy-based reviews. The nurse...Remote jobWork from home
$26.01 - $68.55 per hour
...Health is seeking a Registered Nurse (RN) for Utilization Management. You will review clinical information to... ...determinations, apply guidelines, and coordinate care with providers to ensure appropriate care. This full-time role offers remote work from home in the United States,...Remote jobHourly payFull timeWork from home- ...seeking a Registered Nurse to join our Utilization Management team in a work-from-home weekend position... ...You will assess, plan, and coordinate care, applying clinical criteria to... ...for members. The role requires 3+ years RN experience, 1+ year in UM/Care Management...Remote jobWork from homeWeekend work
- Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication of medical services and benefit determinations... ...The position operates Monday-Friday, 8:00am-5:00pm ET, with remote/work-from-home options and occasional travel to Humana...Remote jobWork from homeMonday to Friday
- HealthCare Strategies, Inc. is seeking a Utilization Management RN to work from a home office. This full-time role runs Monday to Friday, 9am-6pm ET, offering 40 hours per week and a home-based schedule. The RN will perform telephonic clinical assessments, collect information...Remote jobFull timeWork from homeHome officeMonday to Friday
- SCAN is seeking a Medical Management Specialist-RN in California to promote quality and cost-effectiveness of care under regulatory guidelines. You will support utilization management, conduct reviews, and... ...documentation and privacy standards. Remote work mode is available. #J-1...Remote jobTemporary work
- HealthCare Strategies is seeking a Utilization Management RN to work from a HOME OFFICE. This full-time position runs Monday-Friday, 9am-6pm ET, offering a 40-hour workweek and remote work from anywhere in the United States. The role requires an active RN license, at least...Remote jobFull timeWork from homeHome officeMonday to Friday
- Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote jobWork from home
$70k - $75k
Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated... ...of inpatient or outpatient services Quality of care concerns Interfacing routinely with ordering...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses... ...for medical necessity, coordinating care, and ensuring compliance with... ...organization. The role requires Texas RN licensure and a nursing diploma, with...Remote work
- CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a home...Remote jobWork from homeWeekend workAfternoon shift
- ...Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote, part-time role. The position covers enterprise-wide shifts with on-call and weekend rotations, requiring RN licensure with a compact license within the service area. Responsibilities...Remote workPart timeShift workWeekend work
- ...progress toward quality and cost outcomes. You will mobilize resources and manage the system to meet established standards in a dynamic healthcare setting. Responsibilities include utilization management, collaboration with physicians and multidisciplinary teams, and implementing...
- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM... ...operations, Medicare, and Managed Long-Term Care (MLTC). This is a 100% remote position , but...Remote workFull timeMonday to Friday
$70.2k - $120.4k
...deliver personalized health care experiences and partner closely... ...member feels valued.The Utilization Review RN will review and document member... ...policies and utilization management and/or clinical appeals policies... ...requiredThis position is a Remote role. To be eligible for...Remote workWork experience placement$68.81k - $120.72k
...and regulatory requirements and manages concurrent and pre-bill... ...communicate with the multidisciplinary care team regarding patient status... ...for in-house patients, utilizing daily commercial authorization... ...CertificationsRegistered Nurse (RN) [Required]Accredited Case Manager...Remote workLocal areaShift workWeekend work
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