Remote Clinical Review Nurse - Utilization & Discharge
Pyramid Consulting, Inc.
- Remote job
Pyramid Consulting is seeking a Clinical Review Nurse for a 06+ month remote contract in the United States. The role focuses on concurrent reviews to assess health status and appropriate levels of care, with collaboration across Medical Affairs and discharge planning. Requirements include an accredited nursing program, RN licensure, and 2–4 years in acute care with utilization management experience preferred. Benefits include comprehensive health coverage and time-off per location. #J-18808-Ljbffr Pyramid Consulting
- Centene Corporation is seeking a Nursing professional to perform concurrent reviews, ensuring appropriate care settings... ..., and educating providers on utilization processes. Requires MO RN licensure... ...care. Pay range listed; outpatient, remote or hybrid work options may be...Remote job
- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... ...from an accredited Registered Nursing Program; RN preferred. 2....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...Work Mode: 100% Remote - MS (candidates can... ...medical necessity reviews of inpatient admissions... ...stays. Apply clinical criteria and guidelines... ...within nursing scope. Identify discharge planning needs and... ...ensure appropriate utilization, regulatory compliance...Remote workHourly payFlexible hoursShift workWeekend work
- ...Position Title Clinical Review Nurse - Concurrent Review Work Location Remote (EST preferred but will consider CST)... ...necessity, and contributing to discharge planning according to care policies... ...systems according to utilization management policies and guidelines...Remote workWeekend work
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical... ...and concurrent review of hospitalizations and extended... ...manual changes Evaluate discharge planning risks and facilitate... ...- Prior Authorization Remote Registered Nurse (Remote...Remote workFull timeWork at officeWork from homeNight shift$27.02 - $48.55 per hour
...flexibility to work remotely from their home anywhere... .... This team performs clinical reviews for medical and... ...member’s transfer or discharge plans to ensure a timely... ...interdepartmental teams on utilization processes to promote... ...Accredited School of Nursing or Bachelor's degree...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- ...About This Role The Clinical Review Nurse-Concurrent Review performs concurrent... ...and a strong understanding of utilization management processes. Highlights Location: Remote, OK Schedule: Full Time, Monday... ...review findings and discharge plans in health management systems...Remote workFull timeWork at officeMonday to FridayFlexible hoursWeekend work
$27.02 - $48.55 per hour
...Concurrent Review Nurse Position Purpose: Performs... ...and contributing to discharge planning according to... ...This position is fully remote/work from home, and will... ...systems according to utilization management policies... ...medically necessity based on clinical policies and...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...Accredited School of Nursing or Bachelor's... ...experience. Clinical knowledge and... .... Knowledge of utilization management processes... ...necessity and clinical reviews of authorization... ...'s transfer or discharge plans to ensure a... ...supportive; Team is REMOTE but team relies heavily...Remote work
- ...Position Title Clinical Review Nurse - Concurrent Review Work Location Remote-MS CST Assignment Duration 3 Months... ...necessity, and contributing to discharge planning according to care... ...Background & Context The Utilization Management team review members...Remote workContract workFlexible hoursWeekend work
- ...Job Title: Clinical Review Nurse - Concurrent Review Location: Remote Duration: 12 months XXXX: XXXXXXXXXXX/... ...necessity, and contributing to discharge planning according to care policies... ...systems according to utilization management policies and guidelines...Remote workHourly payShift work
- ...Virginia, (or) DC states \n \n Role: HEDIS Clinical Review Nurse \n W2 Contract: 5 Months \n Location: Primarily remote \n \n ~ Requires mandatory on-site... ...during the first two weeks of assignment. \n • Utilize EMR systems (such as Epic, Athena) and...Remote workContract workWork at officeLocal area
$63.1k - $94.65k
...partner is looking for a Utilization Review RN based in the United... ...operations. In this part-time, remote role, you will apply your clinical expertise to evaluate... ...for a registered nurse who combines strong clinical... ...in utilization review, discharge planning, medical necessity...Remote workTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift- ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and... ...Experienced RNs with ICU/ED/OR background, strong clinical judgment, and a mindset that embraces AI tools to streamline...Remote work
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning. Requires an Iowa license (or compact... ...and educating providers on utilization processes. Schedule is Mon-Fri, 8...Remote work
- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members.... ...findings, coordinating with Medical Affairs, and guiding discharge planning. The position offers competitive pay and comprehensive...Remote workMonday to Friday
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing... ...management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license in New...Remote workContract work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident)... ...Authorization Review to join our Utilization Management team. In this... ...authorization reviews, ensure timely discharges, and collaborate with...Remote workContract work
- ...seeking a Pre-Authorization Nurse to review and approve prior... ...authorization requests, applying clinical judgment across care... ...adherence to guidelines in a remote environment. Candidates... ...experience and familiarity with utilization management and discharge planning. #J-18808-...Remote job
- ...Currently seeking a Utilization Management RN .... ...: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact... ...evaluate members’ clinical conditions through medical record review to determine... ...evaluation. Identify discharge planning needs...Remote workImmediate startDay shift
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- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...Remote work
- ...5 months Work Location: Primarily Remote (Hybrid focus for candidates residing... ...leading healthcare organization as a Clinical Medical Review Nurse supporting the annual HEDIS retrospective... ...first two weeks of assignment. Utilize EMR systems (such as Epic, Athena)...Remote workContract workWork at officeLocal areaImmediate start
- ...Nurse Reviewer Location: 100% Remote; nationally sourced within approved U.S. states. Must be available... ...Summary: The Nurse Reviewer performs clinical review of authorization requests... ...years of clinical nursing experience; utilization management, managed care, or prior...Remote workWork at officeMonday to FridayShift work
- Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on... ...Department patients with their social and discharge needs. Candidates must be licensed RNs with strong nursing experience. The organization offers...Remote job
- ...Clinical Review Nurse - RemoteARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc... ...the coverage, medical necessity, utilization and appropriateness of care per...Remote workPermanent employmentWork at officeLocal area
- ...is seeking an Inpatient Utilization Management Clinician to... ...treatment, and support discharge planning across care teams. This fully remote, full-time role... ...an active RN license, nursing degree, and experience... ...management to ensure timely reviews, document outcomes, and...Remote jobFull time
$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from... ...will act as a vital bridge between clinical care and hospital operations, ensuring... ...experience in utilization review, discharge planning, or working with medical...Remote workWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week- Ferry County Health is seeking a Utilization Review Nurse (PRN) to review medical records and treatment... .... This role includes coordinating discharges, reviewing authorizations, and... ...care coordinator. A flexible onsite/remote arrangement is available. The ideal candidate...Remote jobReliefFlexible hours
$25k
...Click Here Position: UTILIZATION REVIEW RN- Case Management (IN... ...review using evidence-based clinical guidelines. Identifies and... ...outreach to coordinate post-discharge care, encourage use of in-network... ...follow-up. Applies the nursing process and critical thinking...Permanent employmentWork at officeRelocation package
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