Remote RN Reviewer Utilization Review
Gainwell Technologies
A leading healthcare solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate will have over 5 years of clinical experience and must hold an active RN license. Responsibilities include reviewing medical records, performing prior authorizations, and documenting findings. This full-time position offers comprehensive benefits starting on the first day of employment, including health coverage and a supportive work environment focused on career growth. #J-18808-Ljbffr
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote RN Reviewer Utilization Review in El Paso, TX vacancy
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...Ability to obtain additional RN licensure across the enterprise including... ...Package Flexible work solutions include remote options, hybrid work schedules,...Remote workMonday to FridayFlexible hoursWeekend work
AmeriHealth Caritas
Newtown Square, PA22 hours ago $86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access to a reliable high-... ...Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for... ...active and unencumbered Registered Nurse (RN) license in the District of Columbia required...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend workAmeriHealth Caritas
Washington DC3 days ago$35 - $37 per hour
...Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our... ...active RN license (BSN preferred) ~ Utilization Management experience required ~ Comfort... ...flexible leadership style suited for a remote, fast-paced environment Pay &...Remote workHourly payFlexible hoursCohere Health
United States11 hours ago- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
Solving IT
New York, NY1 day ago - ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
IntePros
New York, NY1 day ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
Hispanic Alliance for Career Enhancement
Springfield, IL2 days ago $130 - $145 per hour
...Hi, we’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ..., Utilization Management. Work Location This is a remote position, open to candidates who reside in the United States...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY3 days ago- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote workFor contractorsMonday to FridayFlexible hours
Dane Street
Washington DC3 days ago $174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient... ...at a time. Company: Oak Street Health Location: Remote/ Treehouse Role Description: This full-time role...Remote workHourly payFull timeAvery Healthcare Group Ltd.
United States1 day ago- ...A nationwide healthcare staffing agency is looking for an experienced Long Term Care Registered Nurse to conduct remote case reviews for the Department of Veterans Affairs. This role offers a competitive compensation structure based on case type and hours worked, combined...Remote work
GreenLife Healthcare Staffing
New York, NY1 day ago $32 - $40 per hour
A healthcare services organization is seeking a part-time remote Nurse Reviewer based in Idaho. This role involves applying nursing expertise to... ...determination letters. Qualifications include being licensed as an RN in Idaho and having two years of nursing experience. Flexible...Remote workHourly payPart timeFlexible hoursLiberty Healthcare
Coeur D Alene, ID3 days ago$23.76 - $51.49 per hour
...Molina Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly payMolina Healthcare
Nevada, IA22 hours 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, NY4 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 States1 day ago $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 workPacer Group
Everett, WA2 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 requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart timeSanta Barbara Cottage Hospital
New York, NY1 day ago- ...Fully Remote Utilization Review Position Setting: Fully Remote – Utilization Review Schedule: Full-Time, Monday–Friday Hours: Standard business... ...Patient Volume: N/A Job Requirements: Active RN license with Multi-State/Compact license required Minimum...Remote workFull timeMonday to Friday
HealthPlus Staffing
United States1 day ago - ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
Guidehealth
Chicago, IL3 days 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, NY22 hours ago - ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
HealthHelp
Houston, TX22 hours ago $44.57 - $60.44 per hour
...Location: Lippincott - 301 Lippincott Drive Remote Type: On‑Site Employment Type: Employee... ...delivery of quality care and efficient utilization of agency resources. Position... ...Position Qualifications Must have a valid NJ RN License. Approved licenses must be presented...Remote workHourly payFull timeTemporary workPart timeWork experience placementLocal areaFlexible hoursShift workWeekend workDay shift$7.5k
...LPN Licensed Practical Nurse - Utilization Mgmt Reviewer - Case Management - Full Time Cortland, NY, United States Job Description This position is eligible for up to $15,000.00 Sign on Bonus for those that are eligible. ($7,500.00 for those with less than one year of...Full timeWork at officeRelocation packageShift workGuthrie Enterprise
Potsdam, NY2 days ago- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
Gibson Area Hospital
Gibson City, IL1 day ago $63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review 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 workWork experience placementLocal areaFlexible hoursSedgwick
Nashville, TN22 hours ago$65 per hour
...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... ...No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- ...Utilization Review Nurse Participates as a member of a multidisciplinary team in completing pre-screening assessments of prospective patients... ...week. Some holidays are required as well. This role will be remote but regular meetings/trainings will require being onsite at...Remote workReliefWeekend work3 days per week
Children's Healthcare of Atlanta
Atlanta, GA3 days ago $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 medical...Remote workHourly payAstrana Health
California, MO4 days ago$1,840 per week
" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal and/or state statutes, regulations...Remote workWeekly payFull timeContract workWork at officeLocal areaAmergis
United States3 days ago- ...Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full‑time position involves managing utilization reviews and ensuring compliance with clinical policies for quality...Remote workFull time
COMAGINE HEALTH
Sacramento, CA4 days ago - ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...– 5 pm with one hour for lunch · This is an in-office, no remote work capability position Travel · Some travel may be...Remote workFull timeWork at office
MedTrust LLC
Oklahoma City, OK9 days ago
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