Remote RN Utilization Review Specialist
NurseRemotely
WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment.
Requirements include active RN or LVN licensure, a minimum of two years in utilization review or related fields, and proficiency with Microsoft Office and healthcare software.
#J-18808-LjbffrVacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote RN Utilization Review Specialist in New York, NY vacancy
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
NurseRemotely
United States1 day ago $65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
Jacksonville, FL3 days ago- ...seeking experienced nursing professionals to review medical records and ensure appropriate... .... Candidates must have a valid California RN license and at least two years of clinical... ...degree in a related field. The position offers remote work with emphasis on critical thinking...Remote work
Santa Barbara Cottage Hospital
United States4 days ago - ProMedica is seeking a Registered Nurse (RN) to join the Care Coordination team as the coordinator of a patient's plan of care. The RN... ..., and the health care team to improve outcomes. This per diem, remote position is limited to certain US states; Ohio license, CPR, and...Remote workDaily paid
1001 ProMedica Shared Services, LLC
Defiance, OH2 days ago - ...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
Mass Digital Health
United States4 days ago $50k
...lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote workNurseRemotely
United States4 days ago- ...treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews,... ...School diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) preferred Minimum of three years'...Remote workFull time
Virtual Vocations Inc
United States3 days ago - ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL3 days ago - ...Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR...Remote workFull timeMonday to FridayFlexible hours
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA4 days ago $30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ...along with experience in Epic EHR and Utilization Review. The selected candidate will perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote workHourly payContract workPyramid Consulting
Long Beach, CA4 days ago- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
$110k
...outcomes in the expected time frame and with the most efficient utilization of resources. Carries out activities related to utilization... ...physician regarding appropriate documentation for justification. Reviews the patient’s plan of care in conjunction with the clinical...Daily paidFull timePart timeFlexible hoursShift workMontefiore Nyack
Brooklyn, NY4 days ago- ...Mass Digital Health is seeking a Utilization Review Nurse in Quincy, Massachusetts. This role involves evaluating patients for appropriate admission... ...coordination. This position requires at least two years of RN experience in care management or utilization management. The...
Mass Digital Health
Quincy, MA3 days ago $40k - $50k
...Job Type Full-time Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey...Remote workFull timePart timeWork at officeWeekend workThe Joint Commission
Fort Lauderdale, FL2 hours ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health Outreach
United States2 days ago- ...Health Business Solutions LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate level... ...criteria, and collaborate with insurers on denials. Requires RN license (US multi-state/compact), BSN preferred, 2+ years UR experience...
Health Business Solutions
Florida, NY1 day ago $60k - $75k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US 14 days ago Requisition... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The... ...license or relevant certification, such as RN, LPN/LVN, LMSW, LPC, CADC, LADAC, CCM,...Remote workFull timePart timeWork at officeBradford Health Services
Birmingham, AL14 hours ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health‑sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal areaCharlie Health, Inc.
New York, NY2 days ago- Kingman Healthcare Incorporated (KHI) seeks an experienced Utilization Review Nurse to support case management in Arizona. You will conduct medical... .... Ideal candidates hold a BSN (MSN preferred), have 3+ years RN hospital experience, and UR or CM exposure. #J-18808-Ljbffr
Kingman Healthcare
Kingman, AZ3 days ago $35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 200... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...Remote workFull timeTemporary workWork at officeMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID3 days ago- ...A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...Monday to Friday
HealthCare Support
Syracuse, NY1 day ago - ...Excellus BCBS in New York seeks a Utilization Management professional to coordinate behavioral... ...services for members. You will perform clinical reviews, ensure medical necessity, and... ...Requirements include an associates degree with NYS RN license and at least three years of UM...Work at office
Excellus BlueCross BlueShield
East Syracuse, NY4 days ago $68 per hour
...Job Title: Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation... ...(MRP) $100,500/yr Work Model: Remote – offsite Responsibilities... ...prospective, concurrent, and retrospective reviews for authorization, appropriateness...Remote workContract workTemporary workLocal areaSystem One
Baltimore, MDa month ago- ...UofL Health in Louisville, KY seeks an experienced Utilization Review RN to support the Utilization Management function. You will assess medical necessity for admissions and continued stay, coordinate with physicians and case managers, and document in Case Management Software...
UofL Health
Louisville, KY2 days ago - ...improvement huddles, employee surveys, and town hall meetings Job Description A Day In The Life The Utilization Review Specialist (RN) is responsible for ensuring appropriate utilization of healthcare services across the continuum of care. This role evaluates...Full timeWork at officeWeekend work
Munson Healthcare
Traverse City, MI13 days ago - ...Job Description Job Description Position Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management for participants enrolled in the Program for All-Inclusive Care for the Elderly. The position ensures that services are medically...Work at office
Chinatown Service Center
Alhambra, CAa month ago - ...Job Description Job Description Utilization Review Specialist Job Description Unique opportunity to join Maryhaven, Central Ohio’s largest and... ...Health Records. Must have LPCC, LSW, LCDC III or RN. Utilization Review Specialist Requirements ~ Salary...
MARYHAVEN, INC.
Columbus, OHa month ago - ...a Pre-Authorization Nurse to review prior authorization requests for... ...decision-making abilities. Remote position from LA with a choice... ...Thurs), 8-hour shifts. Active RN license in Louisiana and 2+... ...are required; health plan or utilization management background is a plus...Remote workShift work
IntelliResume
United States1 day ago - Gateway Regional Medical Center, Inc. is seeking a full-time Utilization Review Specialist RN responsible for conducting admission and concurrent reviews to avoid payment denials, while managing appeals. This role requires collaboration with interdisciplinary teams to...Full time
- ...United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...care management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
Well Sense Health Plan
United States3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Utilization Review Specialist. Be the first to apply!
