RN - Utilization Review
INFOJINI
RN - Utilization Review
Shift Details: Shift 3x11.5 Days
Job Order Details: Start Date 10/26/2026 End Date 12/19/2026 Duration 8 Week(s) Float Required No
Client Details: City NEW YORK State NY
INFOJINIVacancy posted 2 days ago
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New York, NY1 day ago $2,507 per month
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New York, NY1 day ago- ...role is specific to the LTSS department. RN will be responsible for providing case management... ...based on authorization and concurrent review. Provides monthly telephonic outreach to... ...appropriateness of treatment setting by utilizing the applicable medical policy and...SuggestedContract workRemote workMonday to FridayFlexible hours
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New York, NY1 day ago - ...seeking a licensed nurse to perform concurrent reviews for Ambetter members in Georgia. This... ...care decisions. The position requires RN/LPN licensure with nursing education and... ...years acute care experience; knowledge of utilization management is preferred. This role offers...SuggestedRemote jobMonday to Friday
- ...the United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...remote, full-time role requires an active RN license, nursing degree, and experience with... ...physicians and care management to ensure timely reviews, document outcomes, and maintain...Remote jobFull time
- Sedgwick is seeking an Utilization Review RN to provide timely, evidence-based utilization review services in a remote setting, maximizing quality care and cost-effective outcomes. Ideal candidates will have active RN licensure and relevant clinical experience. The role...Remote jobFlexible hours
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...certifications, and overall qualifications. Must have current compact RN license, or be willing to obtain* NICU and/or Pediatric... ...are highly encouraged to apply. Schedule Information: Our Utilization Review team provides coverage seven days a week, operating between 8:...Temporary workWork at officeLocal areaRemote workFlexible hoursShift work$63k - $65k
...Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Utilization Review RN As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional...Work experience placementRemote workFlexible hours- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role... ...patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master...Remote work
Santa Barbara Cottage Hospital
New York, NY3 days ago $122.91k - $188.02k
...Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $...Healthfirst
New York, NY5 days ago- ...better care experience for all. Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews... ...conferences. Qualifications: Education: Registered Nurse (RN) with an active, unrestricted California nursing license...
- ...1099 Contractor) who is licensed in the United States to lead utilization management discussions with treating providers. The role applies... ...of care and medical necessity. The Physician Advisor will review documentation, participate in peer-to-peer discussions, and escalate...Remote jobFor contractors
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- Position Title: Case Manager, RN - Utilization Review - PRN Department: OUMC Utilization Review Job Description: Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. Please do not apply if you reside...Full timeReliefLocal areaRemote workWork from homeRelocationShift work
- Healthfirst in New Jersey is seeking a Medical Peer Reviewer to support the CMO Administration by assessing requests for authorization... ...per week and paid time off; the team collaborates across Utilization Management, Care Management, and medical departments. #J-1880...
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...Job Description Job Description RN – Utilization Review Location: East Elmhurst, NY Employment Type: Contract – 13 Weeks Pay Rate Travel: $2,550–$2,630 per week Local: $69–$73 per hour Position Summary We are seeking a Registered Nurse (RN) –...Hourly payContract workLocal area- ...Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in... ...evaluate members’ clinical conditions through medical record review to determine medical necessity for services. Using advanced...Immediate startRemote workDay shift
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Virtual Vocations Inc
New York, NY2 days ago $20 - $30 per hour
...A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...Guidelight Health
New York, NY5 days ago$62k - $70k
...the Role The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the... ...virtual IOP clients in a timely manner Completes peer to peer reviews with insurance MDs to advocate for treatment post first line...Full timeLocal areaRemote workCharlie Health, Inc.
New York, NY1 day ago- ...treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent... ...High School diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) preferred Minimum of three years'...Full timeRemote work
Virtual Vocations Inc
New York, NY2 days ago - ...partnering with a leading organization to recruit a Clinical Quality Reviewer (RN or LCSW) for USA-remote work in approved states. The role... ...reviewing clinical cases, identifying quality, safety, and utilization concerns, and supporting improvement across a complex...Remote job
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...Job Description RN - Utilization Review \n Location: New York, NY 10004 \n Contract: 13 weeks \n Schedule: 3 Days/Week | 11.5 Hours/Day \n Shift Time: 9:00 AM-5:00 PM \n Guaranteed Hours per Week: 34.5 \n Pay: Local: $60 to $63/hourly on W2 \n...Hourly payContract workLocal areaWork from homeShift work3 days per weekPride Health
New York, NY14 days ago$50 - $55 per hour
...Job Description RN – Utilization Management \n \n New York, NY – Midtown \n $50–$55/hour \n Monday–Friday, 9:00 AM–5:00 PM... ...Strong payer-side UM experience, including medical necessity reviews, prior authorizations, appeals, and benefit determinations \n...Permanent employmentTemporary workMonday to FridayGreen Key Resources
New York, NY4 days ago- Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We are leaders in assisting front-line...Full timeContract workRemote work
- Summary Performs medical reviews using clinical/medical information provided by physicians... ...support and review of medical claims and utilization practices. Description Logistic: Palmetto... ...Licenses and Certificates : Active RN licensure in state hired, OR, active compact...Full timeFor contractorsWork experience placementWork at officeLocal areaRemote workMonday to Friday
$65 per hour
Job Title: Registered Nurse (RN) - Case Management Location: New York, NY 10037 Start... ...manage resources, and ensure appropriate utilization of healthcare services while maintaining... ...discharge planning. Conduct utilization review to ensure appropriate level of care and...Hourly payWeekly payLocal areaShift work- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract... ...Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This...Full timeContract workRemote work
$48 - $65 per hour
...Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:... ...The work can touch prior authorization, utilization review, care coordination, patient access... ...work What we’re looking for ~ Active RN license ~ BSN preferred ~3+ years of...Long term contractRemote workMonday to FridayMedix™
New York, NY1 day ago
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