Remote Utilization Review RN (InterQual) - PA Licensed
The Judge Group, LLC
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 years of Medical/Surgical experience and proficiency with InterQual criteria. This position offers a day shift workload with flexible weekends and requires an active PA RN license. #J-18808-Ljbffr
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review RN (InterQual) - PA Licensed in New York, NY vacancy
$30 - $34 per hour
...A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...Remote workHourly payAstrana Health
California, MO5 days ago- ...staffing agency seeks a Utilization Management RN to evaluate... ...through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key... ...have an active PA RN license and a minimum of three... ...s applications and InterQual criteria. #J-18808-...Remote work
The Judge Group, LLC
New York, NY5 days ago - ...Provides support for clinical member services review assessment processes. Verifies that... ...the Molina care model. Adheres to utilization management (UM) policies and procedures... ...and experience. Registered Nurse (RN). License must be active and unrestricted in...Remote workWork at office
Molina Healthcare
United States12 hours ago $25.08 - $51.49 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures... ...and experience. • Registered Nurse (RN). License must be active and unrestricted in...Remote jobHourly payWork experience placementWork at office- ...Currently seeking a Utilization Management RN . Please see... ...below: Position is remote - candidate must... ...tri-state area (PA, DE, NJ) M-F, day... ...have an active PA license or a Nurse Licensure... ...Management and InterQual experience About... ...through medical record review to determine...Remote workImmediate startDay shift
The Judge Group, LLC
New York, NY5 days ago - ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to... ...evidence-based criteria (e.g., InterQual) to evaluate the... ...unrestricted Registered Nurse (RN) license in the State of Texas or... ...for facility based staff; optional for remote staff.Remote workWork at office
Nexus Health Systems
Houston, TX3 days ago - ...Utilization Review Registered Nurse Johns Hopkins Health... ...balance - This is a remote role! Candidates in the... ...priority: MD, DC, VA, PA, DE, FL ~ Medical,... ...criteria sets (i.e. InterQual) ~ Ability to negotiate... ...Registered Nurse (RN) license in Maryland (or Compact...Remote workMonday to Friday
Johns Hopkins Medicine
United States2 days ago - ...A recruitment agency is seeking a Pre-Certification RN to evaluate clinical conditions and determine medical necessity for services. This remote position requires an active RN license in PA or a Compact license, along with a minimum of 3 years of acute care clinical experience...Remote work
The Judge Group, LLC
New York, NY2 days ago - ...solutions provider is seeking an experienced Inpatient RN Utilization Reviewer to manage a complex inpatient caseload remotely. The ideal candidate will possess strong... ...teams. The position requires a current MA RN license and offers a 4-month contract with potential for...Remote jobContract work
- ...care and appropriate utilization of resources, balanced... ...to Central Utilization Review LVN/LPN Case Manager and... ...working knowledge of InterQual or Milliman guidelines... ...Registered Nurse license Preferred Requirements... ...thru Saturday schedule. Remote, but you must live locally...Remote workWork at office
Santa Barbara Cottage Hospital
New York, NY2 days ago $75k
...Nurse to perform inpatient utilization reviews, ensure compliance with medical... ...role requires a current RN license, two years of acute care... ...experience, and familiarity with InterQual criteria. The position... ...schedule and the possibility of remote work, with a base salary...Remote workFlexible hoursHealthHelp
New York, NY2 days ago$38 - $40 per hour
...REMOTE - Candidates must be based in Texas... ...Collin Counties RN working in the insurance... ..., concurrent review activities;... ...information regarding utilization management requirements... ..., unrestricted license in the state of operations... ...) MCG or InterQual experience...Remote workHourly payContract workWork at officeMadea Home Care Services
Plano, TX1 day ago$65k - $78k
...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization,... ...updated on clinical guidelines. Maintain RN license and meet continuing education... ...in prior authorization reviews using InterQual or MCG. ~ Strong written communication...Remote workFull timeContract workWork at officeWork from homeFlexible hoursGainwell Technologies
Juneau, AK4 days ago- ...position, please review this tip sheet.... ...opportunity for a Nurse Utilization Review Supervisor... ...the contracted licensed medical necessity... ...midnight rule and/or Interqual® criteria. Assures... ...Physician Advisor (PA) after the Case... ...State of Florida RN license required...Remote workFull timeTemporary workWorldwideNight shiftWeekend work
The University of Miami
United States5 days ago - ...Utilization Management RN - Pediatrics (Remote) | New York RN License Required | 110K+ • Fully remote opportunity • Pediatric... ...compliance. Through clinical review and coordination, this role... ...guidelines including MCG or InterQual criteria • Collaborate...Remote workFull timeContract workWork at office
Morgan Stephens
United States4 days ago $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... ...with hospital staff. Candidates must have a current RN license and at least 1 year of clinical experience. Competitive hourly...Remote workHourly payPart timeSanta Barbara Cottage Hospital
New York, NY2 days ago- ...Utilization Review Nurse (RN) Neuropsychiatric Hospitals is looking for a Utilization... ...multiple hospitals both remotely and traveling onsite to... ...care guideline standards (InterQual and Milliman). Conduct... ...Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the...Remote workWork at office
NeuroPsychiatric Hospitals
United States1 day ago $85.7k - $128.54k
The Supervisor, Utilization Management (UM), reports to the Manager... ...pre‑service and claims reviews. Supervise licensed and coordinator staff, ensuring... ..., valid, and unrestricted RN or LVN license in California... ...clinical criteria (MCG, InterQual, Apollo, CMS National & Local...Remote jobLocal area$47.06k - $70.24k
...A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness,... ...claims examiners. Candidates must have a current RN license and at least four years of clinical experience, particularly...Remote workCare Options For Kids
Fort Worth, TX4 days ago$57.28 - $88.92 per hour
...Description RN Utilization Review - Remote position. This position will work Full-time, 8-hour day... ...Upon hire: California Registered Nurse License ~2 years experience working in a... ...Nursing Experience working with Interqual guidelines. Experience in a multi...Remote workMinimum wageFull timeLocal areaShift workDay shiftProvidence Health & Service
United States2 days ago- ...Providence Health Plan Group is seeking an RN for Utilization Review. This remote position requires strong clinical skills and knowledge in Utilization... ...an Associate's Degree in Nursing and a California RN License. Providence offers extensive benefits, including a 401(...Remote workDaily paidPart timeShift work
Providence Health Plan Group
Irvine, CA1 day ago $57.28 - $88.92 per hour
...Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts... .... ~ California Registered Nurse License upon hire. ~2 years - Experience working... ...Nursing. Experience working with Interqual guidelines. Experience in a multi...Remote workDaily paidMinimum wageLocal areaShift workDay shiftProvidence Service
Mission Hills, CA8 days ago- ...opportunity for a local remote position. There is no... ...2 years of RN experience performing... ...hospitalized patients 2 years of Utilization Review (UR) experience reviewing... ...active MO or IL RN license If candidate only has... ...s level of care. Uses Interqual Criteria to determine...Remote workFull timeReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO4 days ago - ...Overview Title: Clinical Review Nurse – Prior... ...Review Location: Fully Remote (PST Time Zone - WA/... ...Review to join our Utilization Management team. In this... ...~ Active RN license (WA; must be in good... ...Authorization review and InterQual experience required...Remote workContract work
SPECTRAFORCE
Washington DC1 day ago $35 - $43 per hour
.../hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must... ...CA or hold an active CA RN license) Duration: 12 months (... ...Concurrent Review will perform utilization management functions to... ...in alignment with InterQual and organizational...Remote workIMCS Group
New York, NY2 days ago$41 - $45.5 per hour
...Senior Analyst Location: Remote (within plan states:... ...NM, OK, MT, and TN. License Required: Active, unrestricted RN License Must have MCG/InterQual experience. Job... ...health education, and utilization management. Key Responsibilities... ..., and retrospective reviews for inpatient, rehab,...Remote job- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in... ...providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive...Remote work
Guidehealth
Chicago, IL4 days ago $35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential... ...Required Qualifications Active Licensed Vocational Nurse (LVN) license.... ...Comfortable working independently in a remote or office-based setting. Working...Remote workWeekly payContract workWork at officeMonday to FridayCanon Recruiting Group
Sacramento, CA1 day ago- TurningPoint Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be a Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking skills and attention to detail. The...Remote job
$30 - $38 per hour
...Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis... ...as needed. Work to the top of the RN license and ensure proper referral to medical... ...skills to successfully perform in a remote healthcare environment. Ability to...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend workSanta Barbara Cottage Hospital
New York, NY2 days ago
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