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- ...assistance, 403(b), remote work United States... ...AM - 5:00 PM As a Utilization Review Registered Nurse for... ...priority: MD, DC, VA, PA, DE, FL ~ Medical,... ...criteria sets (i.e. InterQual) ~ Ability to negotiate... ...Unencumbered Registered Nurse (RN) license in Maryland (or...Remote workFull timeMonday to FridayDay shift
Johns Hopkins Medicine
Hanover, MD5 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 - Currently seeking a Utilization Management RN . Please see... ...below: Position is remote - candidate must reside in PA, DE, or NJ M-F, day... ...have an active PA license or a Nurse Licensure... ...experience. **Must have InterQual exp. About the... ...judgment to review medical records, validate...Remote workImmediate startWeekend workDay shift
- ...Utilization Review Nurse- Remote American Health Plans, a division of Franklin, Tennessee... ...UM department with use of Interqual or MCG Prefer clinical... ...solid decisions License/Certification: Current... ...unrestricted Registered Nurse (RN) license Equal...Remote workFull timeTemporary workLocal area
American Health Partners
Franklin, TN1 day ago - ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
TurningPoint Healthcare Solutions
Florida, NY1 day 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- ...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 DC2 days ago - ...great opportunity for a local remote position. Schedule... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing... ...both Missouri and Illinois RN licenses. ~ If candidate only... ...'s level of care. Uses Interqual Criteria to determine level...Remote workReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO4 days 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- ...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 $70.7k - $133.08k
...Saint Thoma Facility: Remote Department: Utilization Management Schedule: Full... ...& Medical Necessity Review: Evaluating service requests... ...evidence-based tools (like InterQual) to ensure they comply with... ...Credential(s): ~ Licensed Registered Nurse credentialed...Remote workFull timeLocal areaAscension
Murfreesboro, TN2 days ago- ...Program sites. Job Title: Utilization Review Nurse Job Summary... ...-based criteria (e.g., InterQual/MCG) and health plan... ...or delegated UM). Licenses/Certifications Current RN or LPN license by the Florida... ...Work Conditions ~ Remote role with reliable high-...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
Miami Jewish Health
Miami, FL3 days ago $40 per hour
...in TX Full time remote Candidates must be based in TX. RN working in the insurance... ..., concurrent review activities; discharge... ...regarding utilization management requirements... ...current, unrestricted license in the state of operations... ...* MCG or InterQual experience HireOps...Remote jobFull timeContract workWork at office$30 - $38 per hour
...Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis... ...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 work$43 - $63 per hour
...Description Job Description The Utilization Review Nurse plays a key role in evaluating... ...and discharge planning teams Utilize InterQual and Milliman criteria during utilization... ...Improvement Active Nevada RN license required Minimum 3 years of Utilization...Relocation packageLancesoft INC
Las Vegas, NVmore than 2 months ago$42 - $65 per hour
...Job Description Job Description Utilization Review Nurse Location: Las Vegas, NV Job... ...stays for medical necessity. Apply InterQual and/or Milliman (MCG) criteria. Collaborate... ...School of Nursing. ~ Current RN license in the applicable state. ~5+ years...Full timeRelocation packageLancesoft INC
Las Vegas, NV28 days ago- ...providing telephonic and e-referral case review and authorization of services utilizing established mental health and... ...This position is full-time, fully remote (work from home) and requires some... ...State of Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required....Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States2 days ago $65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule... ...: No Certs Required: BLS, WA RN License Will this traveler need to float between... .... Pending License accepted: No Fully Remote Position RTO Restrictions: Please include...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend workPacer Group
United States1 day ago$1,949.74 per month
...Nurse Specialty Utilization Review Job ID 17979666... ...Title Utilization Review RN Weekly Pay $1949.... ...Job Description Remote Utilization Review RN responsible... ...utilization management using InterQual criteria while ensuring compliance...Remote workWeekly payShift workCynet Health
Eureka, CA5 days ago$23.76 - $51.49 per hour
...Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This... ...should possess an active RN license in Nevada and at least 2 years of... ...$51.49 and requires adherence to utilization management policies. #J-18808-...Remote workHourly payMolina Healthcare
Nevada, IA1 day ago$65 per hour
...Registered Nurse-Utilization Review Job ID #20389... ...Review Registered Nurse (RN) supporting a health... ...65.00 / hour Remote, California Profession... ...criteria (e.g., InterQual, MCG) and plan policies... ...Qualifications Current RN license BLS (other...Remote workTotalMed Staffing
United States2 days ago$45k - $70k
A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities... ...with healthcare providers. A valid nursing license and a minimum of two years of clinical experience are required...Remote job- ...MISSION: Responsible for utilization of clinical and financial... ...to the Utilization Review Nurse I (LPN), and ensures... ...medical necessity utilizing InterQual criteria. Refers appropriate... ...Current Louisiana RN licensure SPECIAL SKILLS, LICENSE AND KNOWLEDGE REQUREMENTS...Work experience placementLocal areaShift work
Baton Rouge General
Baton Rouge, LA5 days ago $65k - $85k
...Santa Barbara Cottage Hospital is seeking a Utilization Review Specialist (RN) for a remote position, specifically for candidates based in Florida. The ideal candidate will possess a valid Florida RN License and certifications in OASIS and coding. The role involves thorough...Remote workSanta Barbara Cottage Hospital
New York, NY5 days ago- ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC4 days ago $84.56k - $126.84k
...Email this Job Job Overview The Utilization Review RN participates as a member of a... ...00 This position will be primarily remote but there may be occasions when you are... ...hire. Licensure(s): Registered Nurse License Salary Information Pay is dependent...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shiftChildren's Hospital Colorado
Aurora, CO2 days ago$51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state... ...to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical... ...~ Washington Registered Nurse License upon hire. ~3 years of...Remote workDaily paidLive inShift workDay shiftProvidence Swedish Medical Center
Seattle, WA4 days ago$84.06k - $118.67k
...role at a glance Location: Remote Facility: Ascension... ...Heart Hospital Department: Utilization Review Schedule: Days | Full -... ...evidence-based criteria (e.g., InterQual, MCG) to ensure medical... ...Certification / Registration: ~ Licensed Registered Nurse...Remote workFull timeLocal areaAscension
Pensacola, FL5 days ago$63k - $65k
...in Financial Services & Insurance RN Utilization Review As a nurse at Sedgwick, you can build... ...health and well-being of others in a remote work environment. Enjoy flexibility... ...regulatory standards. EDUCATION AND LICENSING: ~ Active unrestricted RN license in...Remote workWork experience placementLocal areaFlexible hoursSedgwick
Memphis, TN3 days ago
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