Remote Utilization Review RN — Care Coordination
Providence Health & Services
- Remote job
Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience and hold Registered Nurse Licenses in Oregon and Washington. This role encompasses care coordination and discharge planning, along with various compliance and policy development duties. A comprehensive benefits package is provided, including 401(k) matching and health insurance. #J-18808-Ljbffr Providence Health & Services
- ...Mississippi Medical Center. Please review the following instructions prior... ...Nursing Organization: Utilization Review Location/s: Main... ...Campus Jackson Job Title: RN - Utilization Reviewer - Coordinated Care - PT - Remote Job Summary: Accountable...Remote workPart timeWork experience placementCasual workSeasonal workShift work
$69.38k - $92.28k
MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum. This hybrid... ...are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent...Remote job$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX... ...and will include 80% travel. Remote role. Will require a driver... ...and need for services for care plan development. Monitor... ...telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX... ...and will include 80% travel. Remote role. Will require a driver... ...and need for services for care plan development. Monitor... ...telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization...Remote workWork at officeLocal areaWork from homeHome officeMonday to Friday
- ...Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned... .../appeals. Assess and coordinate discharge planning needs...Remote work
- Martin's Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong background in clinical nursing and utilization... ...in quality initiatives. Candidates must have a Compact RN License and at least 3 years of clinical nursing...Remote job
- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to... ...and cost-effective patient care. Working collaboratively... ...assesses medical necessity, and coordinates with healthcare providers... ...for facility based staff; optional for remote staff....Remote workWork at office
- ...facilitate effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced... ...delegated to Central Utilization Review LVN/LPN Case Manager and/... ...thru Saturday schedule. Remote, but you must live locally...Remote workWork at office
- ...We are seeking an experienced Utilization Review Nurse to join our team in a hybrid... ...County (Hybrid: In Office/Remote) Schedule: Monday to Friday, 8... ...Participate in case management and care coordination meetings. Qualifications Active RN license in the state of New...Remote workWork at officeMonday to FridayFlexible hours
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 6... ...combination of in person and remote considered) GENERAL SUMMARY... ...ensures safe transitions of care. GIBSON AREA HOSPITAL &... ...AND RESPONSIBILITIES Coordinate and facilitate patient progression...Remote workHourly payFull timeWork at officeRelocation packageShift work- ...position will be responsible for conducting utilization review/medical management for all services... ...appropriateness of quality of care based on contract, state, or URAC requirements... ...screening criteria to peer reviewer. Coordinates and participates in peer-to-peer review...Remote workContract workLocal area
- ...healthcare analytics firm is seeking a Registered Nurse for a remote role focused on utilization review and clinical determinations. The position requires... ...5+ years of varied healthcare experience, and an active RN license in Illinois. Responsibilities include conducting...Remote job
$45.9 - $71.4 per hour
Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior... ...retrospective review of claims and other data, care coordination and discharge planning. Location 100% remote....Remote jobHourly payLocal area$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment... ..., accurate, and compliant care decisions in accordance... ...processes. Assist with coordination of peer reviews and communication... ...working independently in a remote or office-based setting....Remote workWeekly payContract workWork at officeMonday to Friday$57.28 - $88.92 per hour
...Senior Living - Avon in Los Angeles seeks a qualified Registered Nurse to perform utilization review and coordinate care. The candidate must have a nursing school degree and a California RN license. The role requires 3 years of utilization management experience and...Hourly pay- ...Responsibilities Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is... ...regarding review outcomes. Collaborates with facility RN Care Coordinators to ensure progression of care....
- ...healthcare organization is seeking a skilled professional to provide utilization review and coordinate care for members in California. The successful candidate will have a Nursing school degree and a California RN License. Key responsibilities include ensuring quality and...
- ..., Inc. is hiring a Registered Nurse for the Utilization Review at Peace Hospital in Louisville, Kentucky. This... ...admission and stay medical necessity, and coordinating care. Qualified candidates should have a nursing degree, RN licensure in Kentucky, and experience in...Part time
$73.86k - $96.02k
...others reflect our commitment to caring for our people, so they can... ...concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal... ...their non-leadership role as an RN. However, they are required to...Local area$80 - $95 per hour
...Hospital RN Care Coordination & Utilization Review Immediate need for a talented Hospital RN Care Coordination & Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in San Jose, CA (Onsite). Please review the job description...Contract workLocal areaImmediate start- ...healthcare staffing firm is seeking a dedicated Registered Nurse to manage utilization review processes. This RN will ensure quality and cost-effective healthcare by assessing medical necessity, coordinating care, and managing appeals for denied services. Candidates must hold a...
- CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote job
$71.1k - $97.8k
...organization is seeking a Utilization Management Registered Nurse. In this remote role, you will use your... ...skills to support the coordination of medical services. You... ...based on information from care providers, and ensuring... ...need to hold a Compact RN license and have over a...Remote job$71.1k - $97.8k
...organization is seeking a Utilization Management Registered Nurse to support the coordination and determination of... ...and ensuring appropriate care for members. Candidates should hold a Compact RN license and possess... ...experience. The position is remote with a salary range of...Remote job$71.1k - $97.8k
...in the United States seeks a Utilization Management Registered Nurse to coordinate medical services and benefit determinations. This remote position requires a Compact RN license and over one year of clinical... ...in a hospital or acute care setting. The role involves using...Remote job$71.1k - $97.8k
...insurance company is seeking a Utilization Management Registered... ...nursing skills for coordinating medical services and... ...benefit determinations. This remote position requires... ...experience and a Compact RN license. Responsibilities include making care determinations,...Remote job- ...Health Partners is looking for an RN Concurrent Review nurse to guide utilization management efforts in our mission-driven... .... This role offers hybrid or fully remote arrangements, with major... ...transforming healthcare from sickness care to wellness guidance. #J-18808-Ljbffr...Remote job
- A healthcare organization is seeking a Utilization Management Registered Nurse to utilize clinical nursing skills in coordinating medical services. This remote role requires a Compact RN license and over a year of clinical experience. Responsibilities include interpreting...Remote job
- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services... ..., alongside a minimum of 3 years of direct patient care experience. The role involves applying Medicaid...Remote jobFull time
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