Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Clinical Review Nurse - Utilization & Discharge

Pyramid Consulting, Inc.

New York, NY
  • 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

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical Review Nurse - Utilization & Discharge in New York, NY vacancy
  • 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

    Centene Corporation

    Kansas City, MO
    2 days ago
  •  ...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 work
    Permanent employment
    Full time
    Temporary work
    Flexible hours

    Vivo HealthStaff

    Burbank, CA
    4 days ago
  •  ...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 work
    Hourly pay
    Flexible hours
    Shift work
    Weekend work

    Axelon

    United States
    3 days ago
  •  ...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 work
    Weekend work

    Spectraforce Technologies

    Charleston, SC
    3 days ago
  • $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 work
    Full time
    Work at office
    Work from home
    Night shift

    Broadpath Inc

    United States
    3 days ago
  • $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 work
    Hourly pay
    Full time
    Part time
    Work at office
    Work from home
    Monday to Friday
    Flexible hours

    Centene Corporation

    Kansas City, MO
    1 day ago
  •  ...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 work
    Full time
    Work at office
    Monday to Friday
    Flexible hours
    Weekend work

    IntelliResume

    Brooklyn, NY
    3 days ago
  • $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 work
    Hourly pay
    Full time
    Part time
    Work at office
    Monday to Friday
    Flexible hours

    Centene Corporation

    United States
    4 days ago
  •  ...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

    Mindlance

    United States
    1 day ago
  •  ...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 work
    Contract work
    Flexible hours
    Weekend work

    Spectraforce Technologies, Inc.

    Jackson, MS
    5 hours ago
  •  ...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 work
    Hourly pay
    Shift work

    Pacer Group

    Remote
    2 days ago
  •  ...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 work
    Contract work
    Work at office
    Local area

    nTech Workforce

    Mundelein, IL
    11 days ago
  • $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 work
    Temporary work
    Part time
    Work at office
    Work from home
    Flexible hours
    Shift work
    Afternoon shift

    Jobgether

    Oregon State
    1 day ago
  •  ...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

    Medix

    United States
    18 hours ago
  •  ...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

    United States
    5 days ago
  •  ...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 work
    Monday to Friday

    Centene Corporation

    United States
    1 day ago
  • 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 work
    Contract work

    Rangam

    United States
    2 days ago
  •  ...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 work
    Contract work

    SPECTRAFORCE

    Washington DC
    3 days ago
  •  ...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

    Humana

    Columbus, OH
    5 days ago
  •  ...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 work
    Immediate start
    Day shift

    The Judge Group, LLC

    New York, NY
    1 day ago
  • HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The ideal candidate has an RN license... 
    Remote job

    NurseRemotely

    New York, NY
    4 days ago
  •  ...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

    Northpoint-Recovery-Holdings,-LL

    United States
    3 days ago
  •  ...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 work
    Contract work
    Work at office
    Local area
    Immediate start

    nTech Workforce

    Columbia, MD
    7 days ago
  •  ...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 work
    Work at office
    Monday to Friday
    Shift work

    Axelon

    United States
    1 day ago
  • 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

    Freeman Health System

    Street, MD
    6 days ago
  •  ...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 work
    Permanent employment
    Work at office
    Local area

    American Recruiting & Consulting Group

    Jacksonville, FL
    4 days ago
  •  ...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 job
    Full time

    WellSense Health Plan

    New York, NY
    5 days ago
  • $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 work
    Work at office
    10 hours per week
    Flexible hours
    Shift work
    Weekend work
    Afternoon shift
    3 days per week

    Medix

    New York, NY
    3 days ago
  • 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 job
    Relief
    Flexible hours

    Ferry County Public Hospital District

    Republic, WA
    4 days ago
  • $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 employment
    Work at office
    Relocation package

    i4 Search Group

    Farmington, NM
    12 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Clinical Review Nurse - Utilization & Discharge. Be the first to apply!