Remote Utilization Review RN - Insurance Care Quality
IntePros
A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence-based criteria for patient treatment, and collaborating with healthcare providers. Strong clinical judgment and familiarity with review tools are essential for this role. The ideal candidate will have 2-5+ years of experience in the field. #J-18808-Ljbffr
$40.12 - $62.94 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty... ...by the patient's insurance. The team focuses on... ...or improving quality of care.Summary:Conducts initial... ....This is a Full-time remote position.Responsibilities... ...Utilization Review RN reviews the medical record...Remote workQualityFull time$40 per hour
...Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for 6 months... ...in TX Full time remote Candidates must be... ...initial, concurrent review activities;... ...effectiveness and quality of medical/surgical... ...information regarding utilization management requirements...Remote workQualityFull timeContract workWork at office$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities... ...looking for an experienced Utilization Review Specialist (RN) to join our remote home... ...field clinicians Support quality assurance and regulatory... ...Position Monday–Friday Life Insurance 401(k) Quarterly Bonus...Remote workQualityMonday to FridayWeekend workWeekday work- ...integrated health care plans and... ...and disability insurance benefits, dental... ...LTSS department. RN will be responsible... ...to promote quality member outcomes... ...and concurrent review. Provides monthly... ...setting by utilizing the applicable... ...*possible remote opportunity after...Remote workQualityContract workMonday to FridayFlexible hours
$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside... ...a massive impact on patient care? We are seeking a dedicated Utilization... ...denial rates. Revenue Integrity & Quality: Accurately manage ConnectCare and...Remote workQualityWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week- Ensemble Health Partners is seeking a Lead Utilization Review RN to drive medical necessity reviews, discharge planning, and appeals... ...The role supports revenue cycle integrity and patient care quality in a remote US-based environment. You will evaluate admissions, coordinate...Remote jobQuality
$113.73k - $170.46k
...ensuring that patients receive high-quality care while efficiently utilizing medical resources. Reviews patient medical records,... ...with healthcare providers and insurance companies to ensure a seamless... ...Certifications: ~ Registered Nurse (RN) licensure in the state of...Remote workQualityFull timeWork experience placement- ...Non-profit Managed Care Organization (MCO)... ...Department Of Insurance. Through Its Network... ...access to the high-quality health care they need... ...Behavioral Health Utilization Manager will... ...concurrent and discharge reviews on assigned... ...Work Schedule: Remote Other Requirements...Remote workQualityContract workWork experience placement
$75k - $100k
...Utilization Management RN (Registered Nurse) evaluates efficiency... ...judgment to review medical services... ...We are open to remote work in the following... ...appropriate and quality services in a cost... ...of quality care and reasonable cost... ...relationships, and insurance benefits. ~ Strong...Remote workQualityFor contractorsWork at officeLocal areaImmediate start$63k - $73k
...us, experience our caring culture, and enjoy work... ...you can achieve. Utilization Review Nurse (RN) As a nurse at Sedgwick... ...of others in a remote work environment. Enjoy... ...services to maximize quality care andcost-... ...disability and life insurance, employee assistance...Remote workQualityWork experience placementLocal areaFlexible hours- ...Job Description The utilization review and management (UM) component... ...appropriate level of care, while supporting... ...recognizing our commitment to quality, safety, and... ...healthcare regulations, insurance policies, and quality... ...This is an in-office, no remote work capability...Remote workQualityFull timeWork at office
- ...Join our team as a remote (Oklahoma City) full... ...every other weekend RN Case Manager -Utilization Review at INTEGRIS Health,... ...appropriate levels of care as indicated by clinical... ...without impacting quality or outcomes.... ...is acceptable to our insurance carrier. PREFERRED QUALIFICATIONS...Remote workQualityFull timeWork at officeWeekend work
$81.95k - $110.24k
...possible in healthcare. The Lead Utilization Review RN is a key contributor to the overall financial, quality, and clinical performance of... ...an outcomes-oriented, patient care delivery system, which places... ...required #LI-LS1 #LI-REMOTE Join an award-winning company...Remote workQualityFull timeWork at officeLocal area$63.1k - $94.65k
...have current compact RN license, or be willing... ...Information: Our Utilization Review team provides coverage... ...utilization of health care resources and assists... ...Monitor for readmissions Quality/Revenue Integrity... ...Required: This is a remote role which requires...Remote workQualityTemporary workWork at officeLocal areaFlexible hoursShift work$62.4k - $117.62k
...monitoring the utilization of physical health... ...Director for review. Refer to and... ...and efficient care delivery processes... ...potential quality of care and utilization... ...and active NYS RN license... ...and/or dental insurance, retirement plan... ...opportunity for remote work within all...Remote workQualityFull timeContract workWork at office$85.7k - $129.31k
...Job Description: The RN Utilization Review Care Management I leverages clinical... ...promote cost-effective, high-quality care. Collaboration with... ...others, healthcare providers, insurers, and other involved parties... ...successfully working in a remote environment or using Advanced...Remote workQualityHourly payReliefWork at officeFlexible hoursShift workWeekend work2 days per week$2,784 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Bethel... ...in design, execution, quality assurance, and assessment... ...including IV/central line care, fall precautions, age-specific... ...housing provided in a remote area with shared common spaces...Remote workQualityWeekly payWork experience placementShift workDay shift- ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will assist patients through the continuum of care in collaboration with the patient’s... ...to meet medical needs while maintaining safety and quality. #J-18808-Ljbffr...Remote workQuality
- ...HealthStaff is searching for a Utilization Review RN for a hybrid position for a... ...other members of the health care team to meet individualized... ...criteria, knowledge of insurance coverage, and communication... ...department policies, procedures, quality standards, and safety standards...Quality2 days per week1 day per week
$47.03 - $63.48 per hour
...redefining the possible in healthcare. The RN, Senior Utilization Review Quality will play an essential role in... ...nursing experience in an acute care environment required Utilization review... ...patient and client experiences This is a remote position; however, candidates must...Remote workQualityTemporary workWork at officeLocal area- ...To enhance the quality of care in workers' compensation, the full-time Utilization Review Nurse will assess medical... ...parties involved, working remotely during standard... ...discuss care plans with insurance representatives and other... ...medical program (RN, DC, PT, DPT, LVN, OT...Remote workQualityFull time
- ...Location: Fully remote (PA RN License or Compact including... ...and detail-oriented Utilization Review RN with a valid PA... ...with prior work in insurance utilization review.... ...appropriateness of care Apply evidence-based... ...to ensure efficient, quality patient care...Remote workQualityFull timeContract work
- ...Title: Clinical Review Nurse – Prior... ...Location: Fully Remote (PST Time Zone... ...to join our Utilization Management team... ...providers, and care management teams... ...to support high-quality, cost-effective... ...~ Active RN license (WA; must... ...Health Care and Insurance Note: This description...Remote workQualityContract work
$63.1k - $90k
...Utilization Review Registered Nurse (RN) – Remote Salary: $63,100–$90,000 annually + Bonus + Shift Differentials Medix... ...Department, Operating Room, or inpatient care management. Prior utilization... ...while meeting established quality and productivity expectations. Support...Remote workQualityCasual workWork from homeMonday to Friday10 hours per weekShift workRotating shiftAfternoon shift- ...Are you an RN looking to transition into... ...your career in Utilization Review? We're seeking a clinically... ...nurses with acute care experience who... ...to support quality patient care and appropriate... ...managers, and insurance payors to obtain... ...in a fast-paced, remote environment. Reliable...Remote workQualityTemporary work10 hours per weekShift workWeekend workAfternoon shift
- ...Utilization Review Registered NurseExcel. Empower. Advance... ...) is the managed care and health... ...balance - This is a remote role! Candidates in... ...Dental, and Vision Insurance.403B Savings Plan... ...Registered Nurse (RN) license in Maryland... ...to drive improved quality and better health...Remote workQualityLocal areaMonday to Friday
- ...DescriptionJob Description Utilization Review Nurse Location: [City, State / Remote] Employment Type:... ..., and support high-quality, cost-effective patient care.The ideal candidate... ...Registered Nurse (RN) with experience in... ...care.Communicate with insurance companies, managed...Remote workQualityFull timeSecond jobWork at office
$35 - $40 per hour
.../hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison... ...delivery of home health care. This role monitors... ...Identify and escalate quality‑of‑care concerns to the Quality... ...active nursing license (RN, LPN, or LVN) in good standing...Remote workQualityContract workFlexible hoursWeekend work- ...managed health care, focused on what... ...while ensuring quality care through... ...voluntary life insurance. Critical Illness... ...life balance. ~ Remote setting... ...individual will utilize clinical knowledge... ...a second level reviewer. This individual... ...not limited to RN, LMSW, LMIC....Remote workQualityTemporary workWork at officeMonday to FridayFlexible hours
$82k - $88k
...Utilization Review Nurse Fully Remote • Involuntary Remote - ALL STATES - Remote... ...'s Degree Category Insurance Responsible for... ...for requested medical care using evidence-based... ...management, and Quality Assurance standards... ...unrestricted Registered Nurse (RN) or Licensed...Remote workQualityFull timeShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review RN - Insurance Care Quality. Be the first to apply!
- kaiser rn United States
- outpatient rn United States
- sedation rn United States
- 1099 rn United States
- ed rn United States
- registered nurse office United States
- rn visa sponsorship United States
- labor & delivery rn United States
- registered nurse remote United States
- mother baby postpartum rn registered nurse United States


