RN Utilization Review Specialist — Remote After Training
HonorHealth
- Remote job
HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role ensures medical necessity across Medicare, AHCCCS, and other payers, both on admission and concurrently. The position requires an RN license (compact allowed), 1 year UR/UM or Case Management experience, and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr HonorHealth
- ...Healthcare Utilization Review Specialist Join our team at Company and build a meaningful career in employee... .... Requirements ~(Prior training in coding, insurance, basic medical... ...employer-match** WOW! (100% fully vested after 3 years) ~10+ paid holidays ~...Remote workTrainingTemporary workSummer workFlexible hours
- Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases,... ...and data analysis to improve patient outcomes. After a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide...Remote jobTrainingWork at officeWork from home
- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing... ...Office and healthcare systems. Starting training is 08/03/2026 with a 6-week schedule; regular hours after training run CST. #J-18808-Ljbffr...Remote workTrainingWork at office
- ...Description A Day In The Life The Utilization Review Specialist (RN) is responsible for ensuring... ...of care and remains unresolved after discussing with referring/attending... ...position will be 50/50 hybrid & onsite. Training Schedule: Onsite M-F 8AM -4:30PM...TrainingWork at officeWeekend work
- ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs. You will review cases, coordinate with providers, and ensure timely decisions in line with policy and regulatory requirements. Ideal...Remote workWork at office
- Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote job
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- ...Description Job Description Position Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management for... ...care planning sessions. Support staff education and training on utilization management policies and standards. Minimum...TrainingWork at office
- ...Job Description Job Description Utilization Review Specialist Job Description Unique opportunity to... ...treatment or equivalent experience and training in behavioral health field.... ...Must have LPCC, LSW, LCDC III or RN. Utilization Review Specialist...Training
$38.5 - $61.6 per hour
...Grow your career with comprehensive training and development opportunities, mentorship... ...Holiday pay Description The RN Utilization Specialist reflects the mission, vision, and... ...utilization. The RNUS through regular reviews and audits and collaboration with the...TrainingHourly payFull timePart timeFor contractorsWork experience placementWork at officeLocal areaRelocation packageFlexible hours$110k
...time frame and with the most efficient utilization of resources. Carries out activities related... ...documentation for justification. Reviews the patient’s plan of care in conjunction... ...Montefiore Nyack Hospital will recruit, hire, train, transfer, promote, layoff and discharge...TrainingDaily paidFull timePart timeFlexible hoursShift work- HealthHelp - A WNS Company is seeking a nurse (RN/LPN) to perform utilization reviews, collaborate with clients, and ensure timely, compliant case evaluations. The role is remote with training and standard hours. The successful candidate will hold an active RN or LPN/LVN...Remote jobTraining
- University of Maryland Medical System seeks a Utilization Review Nurse for weekend shifts in Towson, MD. The role bridges care teams... ..., Excel and Word proficiency, and nursing credentials. Training is partly remote with onsite start as needed. #J-18808-Ljbffr University...Remote jobTrainingShift workWeekend work
- ...Carolina subsidiary, seeks a Medical Reviewer II (RN) to perform medical claim... ...documents decisions and supports utilization review across multiple services. The position is remote, full-time, with standard hours 8:00 AM-5:00 PM ET, training, and potential overtime. RN...Remote jobTrainingFull time
- ...Children’s Hospital is seeking a Behavioral Health Utilization Review Specialist to review cases, determine medical necessity, and ensure... ..., collaborating with clinical staff and payers. After a 90-day in-office training period, the position offers work-from-home options....Remote jobTrainingWork at officeWork from home
- ...integrating, and monitoring the utilization of behavioral health (... ...Medical Director for review. Refer to and work... .... Assists with training and special projects, as... ...degree and active NYS RN license required. Bachelors... ...may be opportunity for remote work within all jobs posted...Remote workTrainingContract workWork at office
$62k - $70k
...position is to ensure that the utilization process is thorough,... ...manner Completes peer to peer reviews with insurance MDs to advocate... ...company systems Delivers training to clinical teams for high quality... ...-sponsored benefits. #LI-REMOTE Please note that this role...Remote workTrainingFull timeLocal area- ...Friday (8:00am-4:30pm) Position is work from home after a 90 day in-office training period. Job Description Summary Reviews behavioral health cases to determine medical... ...authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial...TrainingWork at officeWork from homeMonday to FridayFlexible hours
$35 - $43 per hour
...0/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must... ...CA or hold an active CA RN license) Duration: 12 months... ...or convert) Schedule: Training 8 AM – 5 PM PST (approx.... ...Review will perform utilization management functions to...Remote workTraining- ...to others. How you’ll contribute A Utilization Review Specialist who excels in this role: Facilitates... ...certification and Crisis Prevention Training (CPI) preferred. May be required to work... ..., and comprehensive discharge and after‑care planning. Accredited by The Joint...TrainingFull timeTemporary workPart timeReliefFlexible hours
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
$35 - $37 per hour
...Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay... ...of physician case reviews, supporting the... ...either prior to or after their travel assignments... ...practicing or not. Utilization Review experience is... ...first three months of training (approximately 2 months...Remote jobTrainingPermanent employmentFull timeTemporary workMonday to Friday- ...Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American... ...Successful completion of required training Handle multiple priorities effectively... ...active and unrestricted Registered Nurse (RN) license Equal Opportunity...Remote workTrainingFull timeTemporary workLocal area
$42 per hour
...Registered Nurse (RN) - Telehealth Medicare... ...Wellness Visit Specialist - PRN Full-time... ...Guidehealthleverages remotely-embedded... ...completed. Virtually reviewing and updating patient... ...chronic diseases, utilizing remote monitoring... ...virtual team meetings, training sessions, and continuing...Remote workTrainingBi-weekly payFull timeTemporary workFor contractorsReliefLocal areaWork from homeMonday to Friday$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 -... ...leadership, and other management Experience educating and training staff Environmental Job Requirements and Working...Remote jobTrainingHourly payMonday to Friday- ...To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective... ...clinical teams in a fully remote capacity. Key Responsibilities... ...Qualifications Current, unrestricted RN license Five or more years of...Remote workPart time
- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
- A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...Remote workFlexible hours
- ...The primary responsibilities of the RN UR Specialist include performing activities related... ...certifications and authorizations related to Utilization review duties in Care Management. Timely... ...For non-clinical areas, has attended training and demonstrates usage of age-...Remote workTrainingFull timeContract workWork at office
- ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle... ...to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities...Remote workWork at officeFlexible hours
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