Utilization Review Specialist (RN) - Work From Home
$65k - $85kConcierge Home Care
Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only) Concierge Home Care | Work From Home Opportunity – Must Reside in Florida 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 strong OASIS, coding, QA, and home health documentation review experience who thrives in a fast-paced remote environment. Quick Highlights Work From Home (Florida-Based Candidates Only) Position Salary: $65,000–$85,000 Florida RN License Required OASIS Certification Required Home Health Coding Certification Required Monday–Friday or Weekend Schedule Options Quarterly Bonuses & Incentives Full Benefits Package What You’ll Do Review home health clinical documentation for accuracy and compliance Audit OASIS documentation and care plans Ensure coding accuracy and reimbursement integrityCollaborate with Branch Directors, Clinical Managers, and field clinicians Support quality assurance and regulatory compliance initiatives Maintain productivity while reviewing high-volume documentation Qualifications Required OASIS Certification (required) Coding Certification (required) Minimum 2 years of Home Health experience Strong knowledge of Medicare guidelines and home health regulations Ability to work independently in a remote setting Excellent attention to detail and organizational skills Preferred SHP platform experience Prior QA, Utilization Review, or Clinical Auditing experience Schedule Options Weekday Position Monday–Friday Three 12-hour shifts Life Insurance 401(k) Quarterly Bonus Opportunities Employee Referral Program Free CEUs Why Concierge Home Care? At Concierge Home Care, our mission is simple: Caring for people who care for people. We are committed to supporting our clinicians with strong leadership, flexibility, and opportunities for professional growth. Employment is contingent upon successful completion of an AHCA Level 2 background screening. For more information, please visit the Florida Care Provider Background Screening Clearinghouse. #J-18808-Ljbffr Concierge Home Care
- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering... ...the continuum. This role offers work-from-home scheduling, Monday–Friday, with some... ...years inpatient nursing, and 2+ years in utilization management or discharge planning, with...Work from homeRemote workMonday to FridayWeekend work
$60k - $62k
...Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States... ...expertise. Position Overview The Utilization Review Specialist is responsible for all aspects of the... ...Utilization Review (as either CADC, LAADC, RN, LCSW, LPN, LMHC, LMFT, RN Case...Work from homeFull timePart timeRemote workFlexible hours- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay....SuggestedRemote work
- ...Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical necessity... ...the organization. The role requires Texas RN licensure and a nursing diploma, with...SuggestedRemote work
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...SuggestedRemote work
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports... ...requires a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of related...Full timeRemote work- ...Coordinator Jobs in United States Appeals & Grievance Case Resolution Specialist Appeals & Grievances Coordinator - Kelsey Seybold Clinic -... ...Case Resolution Specialist Dental Healthcare Analyst - Work From Home Senior Grievance and Appeals Coordinator Grievance and Appeals...Work from homeFull timeContract work
- ...Gateway Regional Medical Center, Inc. is seeking a full-time Utilization Review Specialist RN responsible for conducting admission and concurrent... ...preferred. The position offers a competitive salary, health benefits, and a supportive work environment. #J-18808-LjbffrFull time
- ...A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities... ...two years of experience. This position offers a stable work schedule from Monday to Friday and an opportunity to work...Monday to Friday
- ...CommonSpirit Health's St. Mary Medical Center in Long Beach, CA, seeks a Utilization Review Nurse to safeguard clinical decision-making, regulatory... ...care aligns with established criteria. The role requires CA RN licensure, AHA BLS, and strong UM/regulatory knowledge, with...
- ...UofL Health is seeking a Utilization Review RN to support the Utilization Management process. You will assess medical necessity for admissions and ongoing stays, review patient records against payer guidelines, and communicate decisions to physicians and case managers....
- ...Mass Digital Health is seeking a Utilization Review Nurse in Quincy, Massachusetts. This role involves... ...position requires at least two years of RN experience in care management or... ...management. The Utilization Review Nurse will work in a fast-paced environment focused on...
- ...UofL Health is seeking a Utilization Review RN at the Frazier Rehab Institute - UMC in Louisville, KY. The role focuses on conducting utilization management activities, ensuring medical necessity for admission and continued stay, and coordinating with physicians and payors...
- WNS HealthHelp (A Capgemini Company) is seeking a licensed registered nurse to perform concurrent inpatient utilization reviews from a remote setting. You will collaborate with attending physicians and care teams to determine medical necessity and appropriate level of care...Remote job
- HonorHealth is seeking an RN Utilization Review Specialist to review and monitor health care service utilization, ensuring appropriate levels of care... ...and other payers from admission through discharge. You will work with the Care Management team to ensure documentation...Remote jobDaily paid
- Jobgether is partnering with a U.S.-based healthcare employer to recruit a Case Manager - Utilization Review Specialist for a fully remote role in the United States. The position focuses on admission and concurrent reviews, medical necessity determinations, and coordination...Remote job
- Intermountain Health’s St. Marys Regional Hospital seeks an RN Utilization Review Care Management I to perform utilization review screenings,... ...compliant, efficient, and patient-centered services. Remote work is offered where approved, with shifts enterprise-wide and occasional...Remote jobShift work
- Intermountain Healthcare Inc. is seeking an RN Utilization Review Care Management I for a fully remote, part-time role. You will review records... ..., cost-effective care across multiple regions. Remote work and Teams-based collaboration are required. The role emphasizes...Remote jobPart timeWeekend work
- Sedgwick is seeking a remote RN Utilization Review professional in Tennessee to provide timely utilization reviews and advocate for cost-effective... ...certification. Competitive benefits and a flexible remote work setup accompany the position. #J-18808-Ljbffr Sedgwick...Remote jobFlexible hours
- Quorum Health Corporate is seeking a remote Utilization Review Specialist with a registered nurse background to manage admission decisions and concurrent reviews, ensuring compliance with payer and regulatory standards. Responsibilities include coordinating appeals, documenting...Remote job
- Jobgether is partnering with a healthcare organization to hire a Case Manager - Utilization Review Specialist for a full-time remote role based in the United States. You will oversee admission and concurrent reviews, assess medical necessity, and coordinate appeals to support...Remote jobFull time
- ...is recruiting a Michigan-licensed Registered Nurse (RN) for a contingent, fully remote Utilization Review / LTSS Review Nurse role. The position supports Michigan... ...Medicaid programs, reviews Nursing Facility LOC and Home Help assessments, and requires UR/UM and LTSS...Remote jobFlexible hoursAfternoon shift
- Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and discharge planning in collaboration...Remote jobPart timeRelief
- Jobgether, in partnership with a healthcare organization, seeks an experienced Case Manager - Utilization Review Specialist for a fully remote role in the United States. This position focuses on admission and concurrent reviews, medical necessity assessment, and coordination...Remote job
- ...Health in Columbia, MD is seeking an experienced Utilization Review professional. The role requires acute care UR experience, RN licensure, and the ability to cover four... ...shifts per month plus in-person training. You will work with physicians, social workers, and payors to...Shift workWeekend work
- UofL Health in Louisville seeks an Utilization Review RN to support the Utilization Management process, assessing medical necessity for admission and continued stay, coordinating care with physicians and case managers, and ensuring compliance with CMS, payor guidelines,...
- Sleep Management, LLC dba Viemed is offering a full-time Utilization Review Coordinator position from 8:00 a.m. to 5:00 p.m. in an office setting. The RN will review patient records to determine coverage for therapies and equipment, ensure documentation supports recommendations...Full timeWork at office
- Upstate Medical University in Syracuse, NY seeks a UR-CR Specialist I to ensure accurate recording and utilization of patient care services. Through chart review and screening criteria, you will verify appropriate level of care during the hospital stay and collaborate...
- Universal Health Services (UHS) is seeking a dedicated Utilization Review professional to oversee documentation and authorization for inpatient and outpatient services. The role emphasizes coordinating with third-party payors and internal teams to ensure appropriate care...
- Talantir Hospitals in Atlanta, GA is seeking a Registered Nurse for Utilization Review. The role focuses on clinical pathways, navigator support, and utilization review activities to optimize patient care and discharge planning. Shift options include day shifts with full...Daily paidFull timePart timeShift workDay shift
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