Remote Clinical Advisor - Utilization & Case Management
$67.6k - $127kLuminare Health Benefits Inc.
- Remote job
Luminare Health Benefits Inc. is seeking a Clinical Advisor responsible for client support and collaboration with healthcare teams. This role is vital for ensuring that client needs are met in a dynamic environment. The ideal candidate should have a Registered Nursing License and at least five years of clinical experience. The position offers remote work flexibility within the continental US, excluding specific states. A competitive compensation range of $67,600 - $127,000 will be provided based on individual qualifications. #J-18808-Ljbffr Luminare Health Benefits Inc.
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from... ...and treatment appropriateness Create case summaries for requests not meeting... ...Clinical Review Nurse- Prior Authorization Remote Registered Nurse (Remote Patient...Remote workFull timeWork at officeWork from homeNight shift$2,250 per week
...Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in... ...and payers to ensure compliance with clinical guidelines, regulatory requirements, and... ...-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT – 13...Remote workTemporary workShift workNight shiftWeekend work- ...Health Plansis hiring an Utilization Review Nurse/RN- Remote in Virginia Status: Full... ...responsible for utilization management services within the scope... ...of care coordinator with case management and facilitates... ...CMS, state, medical policy, clinical criteria). Facilitates...Remote workPermanent employmentFull timeTemporary workShift work
$2,210 per week
...independent leader in personalized managed health care, focused on what'... ...Holidays Work-life balance. Remote/hybrid setting (once trained)... ...: This individual will utilize clinical knowledge and communication skills... ...individual interfaces with case managers and disease...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are essential....Remote workContract work
- ...Guidehealth leverages remotely‑embedded Healthguides™ and a centralized Managed Service Organization to... ...Description We are seeking a Clinical Care Manager who is... ...precise and timely Utilization Review. In this role,... ...and Peer Reviewers for cases requiring medical necessity...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home
- ...Department: Utilization Management Schedule: M-F 8am-5pm Work Location: Remote Benefits for eligible positions generous paid time off paid parental leave... ...Provide health care services regarding admissions, case management, discharge planning and utilization...Remote work
- ...Hospital Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations*... ...Commission/ Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote work
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities... ...home health. This contract role offers a chance to manage healthcare quality efficiently while working...Remote workContract work
- Med-Metrix is hiring a Physician Advisor in Parsippany-Troy Hills, NJ, to perform clinical case reviews and optimize patient care. The role demands a Board... ...years of clinical experience and experience in utilization management. Responsibilities include consultation on...
- ...providing skilled nursing care, case management, and hospice care to... ...health, or hospice care. Clinical assessment, medication administration... ...: Experience in Utilization Review or case management roles... ...to work independently in remote settings. Must be able...Remote workFlexible hours
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...Utilization Management, Utilization Review, or Case Management ~• Preferred...Remote workContract workImmediate startMonday to Friday- ...Communities Together. This is a remote position in which we are... ...: ~ ~ Health plan utilization management ~ Medicare and Medicaid rules... ...preferred. ~ One (1) year clinical nursing experience plus four... ...preferred: Team leadership. Case management. Medicare and...Remote work
- ...Summary Utilization Review Nurse - Case Management Full-time, day shift (varies 7:30a-4:00p or 8:00a-4:30p) Hybrid (remote with rotating in house coverage) 72-hour position - Rotating 4/... ...required. (Combination of education and clinical experience will be accepted in lieu...Remote workFull timeWeekend workDay shift
$41 - $45.5 per hour
...with Direct Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL, TX, NM, OK, MT,... ...care and supports members through clinical assessments, health education, and utilization management. Key Responsibilities: Perform...Remote work- ...hiring an Integrated Nurse Case Manager in the Central-... ...am-5pm) *Position is remote but does require in person... ...or face-to-face clinical assessments for the identification... ...and efficient utilization of health benefits;... ...Directors, Physician Advisors and/or Inter-Disciplinary...Remote workFull timeTemporary workCurrently hiringShift work
- ...Utilization Management Nurse BHPS provides Utilization Management services to... ...benefit coverage while working remotely. Primary Responsibilities: Performs clinical utilization reviews using... ...and Coordination of Benefit Cases and notifies appropriate parties...Remote workContract workWork at office
- ...Hospital is hiring a full time RN Case Manager for our inpatient units... ...Acting as a clinical leader of the healthcare team... ...improving patient care Utilizing complex critical thinking skills... ...positions that are available as remote work, Sentara Health employs...Remote workFull timeTemporary workRelocation packageShift work
- ...Quorum Health is seeking a Case Manager - Utilization Review Specialist for a remote role. The Specialist will manage admission reviews, conduct appeals, and identify workflow improvements. This position requires a current RN license and significant experience in healthcare...Remote work
- ...Hospital is hiring an Inpatient Case Manager RN to work full-time 40... ...of care while facilitating clinical appropriateness and LOS. Directly... .... Promotes effective utilization and monitoring of health services... ...that are available as remote work, Sentara Health employs...Remote workFull timeTemporary workRelocation packageShift work
- ...Currently seeking a Utilization Management RN . Please see details and qualifications... ...below: Position is remote - candidate must reside in... ...you will evaluate members’ clinical conditions through medical record... ...when needed. Refer cases that do not meet criteria to...Remote workImmediate startDay shift
$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento... ...requests, and clinical documentation to support... ...reviewers to support case review processes. Assist... ...timelines. Support case management activities and... ...working independently in a remote or office-based setting...Remote workWeekly payContract workWork at officeMonday to Friday$3,155 per week
...Registered Nurse (RN) | Case Manager Location: San Francisco, CA Agency: Cynet Health... ...between offices but will primarily be remote. Candidates should have experience in care... ...is necessary. The ability to utilize InterQual criteria and engage in concurrent...Remote workFull timeContract workShift work$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type... ...Contract W2 Location: Remote - but MUST reside in one... ...delegated tasks within the Nurse Case Management job family... ...healthcare services Use clinical expertise to assess, coordinate...Remote workDaily paidContract workMonday to FridayShift workWeekend work- ...hiring an Integrated Nurse Case Manager for Northern Virginia,... ...or face-to-face clinical assessments for the identification... ...and efficient utilization of health benefits;... ...Directors, Physician Advisors and/or Inter-Disciplinary... ...that are available as remote work, Sentara...Remote workTemporary workCurrently hiringShift workDay shift
$63k - $65k
...PURPOSE OF THE ROLE To utilize evidence-based tools to... ...great work. Apply your RN clinical knowledge and experience to assist in the management of complex medical... ...well‑being of others in a remote work environment. Enjoy... .... Certification in case management, pharmacy, rehabilitation...Remote workWork experience placementFlexible hours- ...Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN... ...authorization processes, coordinate clinical information, support medical... ...This position is fully remote Monday-Friday 8am - 5pm with... ...and phone and ensure timely case entry into the designated tracking...Remote workLocal areaMonday to FridayShift work
$35 - $40 per hour
...Location Fully Remote Position Summary The Utilization Review Nurse serves... ...guidelines. Refer cases outside of... ...Utilization Review Physician Advisor. Maintain... ...support to payer case managers, patients, and provider... ...needed. Review clinical documentation for...Remote workContract workFlexible hoursWeekend work$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 6... ...position, you will utilize your clinical judgement to approve or... ...equipment Refer cases to Medical Directors as needed... ...Candidates with only case management experience are not a fit....Remote workHourly payMonday to Friday- ...This position has a remote option for those living... ...hospital as needed. The Utilization Review Nurse is... ...responsible for determining the clinical appropriateness of... ...and efficiently manage a diverse workload in... ...Identify and present cases of possible quality of...Remote workFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Advisor - Utilization & Case Management. Be the first to apply!
- home health nurse practitioner New York, NY
- associate director of nursing New York, NY
- nurse practitioner hospitalist New York, NY
- nurse practitioner wound care New York, NY
- family nurse practitioner New York, NY
- trainee nurse practitioner New York, NY
- research nurse practitioner New York, NY
- pediatric nurse practitioner work from home New York, NY
- nurse practitioner-internal medicine New York, NY
- clinical resource nurse New York, NY




