Remote Utilization Review RN
Sedgwick
- Remote job
Sedgwick is seeking an Utilization Review RN to provide timely, evidence-based utilization review services in a remote setting, maximizing quality care and cost-effective outcomes. Ideal candidates will have active RN licensure and relevant clinical experience. The role emphasizes collaboration with physicians, claims examiners, and clients, along with adherence to regulatory standards and patient confidentiality. Flexible benefits and remote access are highlighted in the posting. #J-18808-Ljbffr Sedgwick
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time- ...Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care... ...weekend hours are required to address utilization review cases. Roles and Responsibilities Prepares... ...Telecommuting Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
$45 - $50 per hour
...for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...of accredited nursing programs with an active New York RN license. #J-18808-LjbffrRemote workHourly pay- ...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
- ...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
- ...Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to support compliant, cost...Remote workFull time
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning, and recovery for injured employees while advocating for effective medical treatment. Key responsibilities...Remote workFull timeWork experience placement
- ...Job Title In this remote role, you will perform utilization reviews, ensuring compliance with clinical guidelines and patient care standards. Collaborate with interdisciplinary teams to assess patient needs and facilitate care coordination. Your expertise in medical...Remote workWeekly pay
$1,949.74 per month
...Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review RN Weekly Pay $1949.74 Shift... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift work$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work- ...Overview This remote position in Utilization Management requires a Registered Nurse with 2 years of experience. Responsibilities include working with providers, managing reviews, and utilizing EMR systems. The role follows a Monday through Friday schedule with...Remote workWeekly payMonday to FridayWeekend work
- ...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
- OU Health is seeking a Case Manager, RN for Utilization Review on a PRN basis. The role focuses on evaluating medical necessity, coordinating with... ...care while maintaining HIPAA compliance, even in a remote setup. The candidate will work with the Utilization Review...Remote jobRelief
- ...Job Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient medical records to assess the appropriateness... ...experience (hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT - 13 weeks...Remote workTemporary workShift workWeekend work
- ...specific to the LTSS department. RN will be responsible for... ...authorization and concurrent review. Provides monthly telephonic outreach... ...of treatment setting by utilizing the applicable medical policy... ...standards. Additional Info: *possible remote opportunity after training if...Remote workContract workMonday to FridayFlexible hours
- Position Title: Case Manager, RN - Utilization Review - PRN Department: OUMC Utilization Review Job Description: Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. Please do not apply if you reside...Remote workFull timeReliefLocal areaWork from homeRelocationShift work
$63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance Utilization Review RN As a nurse at Sedgwick, you can build a meaningful and... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your...Remote workFull timeWork experience placementLocal areaFlexible hours- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...Your future role at a glance Location: Remote Department: Ascension Care Management Insurance - Utilization Review Schedule: Day Shift | PRN until 12/31/26 #LI-Remote How you’ll make an impact in this role Comprehensive Clinical Review: Conduct prospective...Remote workReliefLocal areaDay shift
$63k - $65k
...Financial Services & InsuranceUtilization Review RN**As a nurse at Sedgwick, you can build a... ...health and well-being of others in a remote work environment.* Enjoy flexibility and... ...PURPOSE**: To provide timely, evidence-based utilization review services to maximize quality care...Remote workWork experience placementLocal areaFlexible hours- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation...Remote workMonday to Friday
$1,851.96 per month
...Nursing Profession Registered Nurse (RN) Specialty Utilization Review Job ID 38245223 Job Title Registered... ...Must be computer literate and have some experience with remote work. Responsibilities Utilize clinical...Remote workWeekly payContract workLocal areaMonday to FridayShift workWeekend work$48 - $55 per hour
...Description Job Description Job Title: Registered Nurse – Utilization Review (Remote) Location: Fort Myers, FL (Remote) Job Type: Contract... ...55/hr Position Overview We are seeking an experienced RN to perform utilization review, assess medical necessity and...Remote workContract workLocal areaMonday to FridayShift workWeekend workDay shift- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a 100% remote, full-time role supporting Alaska contracts. The nurse will assess medical necessity and care quality through prospective, concurrent, and retrospective reviews, applying InterQual criteria...Remote jobFull time
- ...will also apply at Broward Pace Program sites. Job Title: Utilization Review RN Job Summary The Utilization RN is responsible for... ...Functional Demands Environment Work Conditions ~ Remote role with reliable high-speed internet. Infectious Material...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
$2,220 per week
...Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements... ...Shift: 8 hours, days ~ Employment Type: Travel REMOTE POSITION Facility: Lee Health Corporate Center –...Remote workWeekly payContract workWork experience placementMonday to FridayShift workWeekend work- ...licensed nurse to perform concurrent reviews for Ambetter members in Georgia. This fully remote role follows a Monday-Friday... .... The position requires RN/LPN licensure with nursing education... ...acute care experience; knowledge of utilization management is preferred. This...Remote jobMonday to Friday
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
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