Remote Utilization Management Specialist - MT RN/SW
Logan Health
Logan Health is seeking a Utilization Management Specialist to review admissions across our system and determine appropriate status. The role demands strong acute care experience, effective collaboration with physicians, case management, and insurance partners, and clear communication.
This full-time, remote-enabled position requires Montana residence, with four 10-hour shifts, weekend rotations, and holiday coverage.
#J-18808-Ljbffr- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation... ...communication and EMR proficiency, with a four-day work week and remote options for Montana residents. #J-18808-LjbffrRemote work
- McLaren Health Care is seeking a Registered Nurse to join the Utilization Management team. The role focuses on determining appropriate patient status, ensuring medical necessity, and documenting care for insurance and government payers within an acute care hospital context...Remote job
- ...is seeking an experienced Registered Nurse to join our Utilization Management team in a remote capacity. The role focuses on ensuring members receive appropriate... ...of care. The ideal candidate will have an unrestricted RN license, 2+ years in adult acute or critical care, and...Remote job
- ...seeking a Registered Nurse to support utilization management and care coordination. You will assess... ...and care teams. Ideal candidates hold an RN license with 2+ years in acute/critical... ...quiet home office setup will be expected for remote work. #J-18808-Ljbffr CVS HealthRemote workHome officeWeekend workAfternoon shift
- ..., compassionate people are united in bringing the most advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through accurate certification and complete chart documentation ensuring that...Remote jobTemporary workWork experience placementLive outFlexible hours
$28.5 - $38.5 per hour
...Training on-site with consideration of remote work after 6 months to 1 year Summary... ...patient’s medical records. Performs utilization management (UM) activities in accordance with UM plan... ...an unencumbered registered nurse (RN) license with the State Board of Nursing...Remote workFull timeLocal areaMonday to FridayShift workWeekend workDay shift- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Remote workWork at office
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...strong team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization review...Remote workWork at office
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care. The role collaborates with Admitting, Financial...Remote work
- ...Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization... ...information is current and complete. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia,...Remote work
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and... ...s degree in a related field, an active RN/Social Work/Clinical Counselor license,...Remote workFull time$37.5 - $54.25 per hour
...Expertise to Logan Health’s Utilization Management Team! Our Mission : Quality... ...a Utilization Management Specialist to join our dedicated team!... ...This position is ideal for an RN or Social Worker with strong... ...person-centered care! Fully remote opportunity - Must currently...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift$90.9k - $129.9k
...for this role, rather you will provide utilization review and quality assurance. Your role... ...outcomes into the Medicaid Management Information System (MMIS) for processing... ...should expect in this role ~100% Remote home office. ~ Full-time position....Remote workFull timeWork experience placementHome officeFlexible hours$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team... ...Collaborate with Branch Directors, Clinical Managers, and field clinicians Support...Remote workMonday to FridayWeekend workWeekday work$63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt... ...Department/Location : Utilization Management Compensation: $63,102.7... .... While the position is remote, the individual in this... ...); or Registered Nurse (RN) in Michigan with at least...Remote workFull timeTemporary workMonday to Friday- HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate... ...candidate has an RN license with 1 year UR/UM or Case Management experience and 3 years RN in acute care, with strong...Remote job
- ...Mesa, AZ, in partnership with Select Medical, seeks a Case Manager (RN/SW) for Per Diem 8 hours/day onsite coverage. Compensation is $... ...effective care across the continuum, ensuring payments meet utilization criteria and safety. CCM preferred. #J-18808-Ljbffr Select...Hourly payDaily paid
- ...Brigham Health Plan is seeking a skilled RN to support vendor-related... ...ensure effective collaboration between the Utilization Management (UM) department and vendors. The position... ...requires on-call availability monthly and a remote work setup with occasional onsite meetings...Remote jobMonday to Friday
- ...Cedars-Sinai is seeking an Utilization Management Specialist to provide advanced operational support for UR activities, ensuring timely and compliant authorization processes. You will work with UR Nurses, Case Management, Revenue Cycle, and external payers to manage documentation...Remote work
- ...Case Manager - Utilization Review Specialist - Remote Full-Time Position You must reside in one of these states to be eligible for position: Arkansas... .../TRAINING & EXPERIENCE: Current state-issued RN license. Knowledge in areas such as InterQual Level of...Remote workFull time
$45.76k - $73.22k
...Job Description We're hiring a Utilization Management Specialist to join the Commercial Pharmacy Phone & UMS Team! The Utilization Management... ...presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a...Remote workWork at officeLocal areaFlexible hours2 days per week- ...A leading healthcare staffing agency is seeking an experienced Registered Nurse (RN) – Utilization Management to support clinical decision-making and ensure appropriate use of healthcare services. This role requires strong assessment skills and experience in utilization...Contract work
$35 - $37 per hour
...poster from The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $36-37/hr... .... No NPs, whether practicing or not. Utilization Review experience is helpful but not... ...: Monday - Friday, 8:00 AM - 4:30 PM MT, with rotating weekends (approximately...Remote jobPermanent employmentFull timeTemporary workMonday to Friday- ...Adventist Health in Roseville, CA, is seeking a registered nurse in Utilization Management to ensure high-quality patient care while optimizing resources. You will review medical records for appropriateness of treatments, collaborate with healthcare providers and insurers...
- Cedars-Sinai is seeking a skilled Utilization Management Specialist to support UR Nurses in timely, compliant utilization review processes. You will manage case portfolios, assemble documentation for payer submissions, and monitor payer timelines to prevent delays. In collaboration...Remote job
- Randstad USA is seeking an experienced Prior Authorization Specialist to join our national Utilization Management team. 100% remote role with a Monday-Friday schedule, 8:00 AM - 5:00 PM CST. You will manage authorization queues, verify eligibility, gather medical documentation...Remote jobMonday to Friday
- Providence California Regional Services is seeking a Senior Utilization Management Assistant for a remote, per diem role. You will support the Care Management team in coordinating patient care, performing clerical duties, and contributing to efficient care workflows from...Remote jobDaily paid
- Avsis is seeking a detail-oriented Utilization Management Administrative Support professional for a remote US-based role. You will handle email requests from provider offices, gather missing information for claims processing, and prepare correspondence for enrollees and...Remote job
$39 - $40 per hour
...Judge Group Lead Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the following states: IL, TX, NM, OK, MT, TN Schedule: Monday-Friday, 8:00 AM-5:00 PM EST or...Remote workDaily paidContract workMonday to FridayShift workWeekend work- Centene Corporation is seeking a dedicated professional to support the prior authorization request process and assist the utilization management team in Florida. The role ensures timely authorization determinations, documents medical information, and verifies insurance...Remote jobHourly payFull time
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