Remote RN - Clinical Utilization & Discharge Review
Centene Corporation
Centene Corporation is seeking a remotely based Registered Nurse to perform concurrent reviews, assess acuity, and validate medical necessity across care settings. The role requires CA licensure and a Nursing degree with 2–4 years of related experience, including acute care.
You will collaborate with Medical Affairs and providers to ensure timely, appropriate care for members. Responsibilities include documenting findings, assisting with discharge planning, and educating providers on utilization
#J-18808-Ljbffr$27.02 - $48.55 per hour
...Centene is seeking a Clinical Review Nurse to perform concurrent reviews to... ...necessity, and contribute to discharge planning according to care policies... ...care experience and strong utilization management knowledge. You will work remotely in North Carolina, with a full...Remote workHourly payFull timeDay shift- ...Centene Corporation is seeking a remote Utilization Review Nurse to perform concurrent reviews and validation... .... You will assess inpatient services, discharge planning, and coordination with... ...programs. Ideal candidates hold an RN or LPN license with Michigan licensure...Remote work
- ...seeking a Registered Nurse for a remote role with Arizona hours (1st shift). You will review medical records for quality, safety, and utilization issues, identify PQIs, and... .... Must hold an active RN license, have 3+ years of clinical experience in med/surg or behavioral...Remote workDay shift
- ...Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to support compliant, cost...Remote workFull time
- ...Centene Corporation is seeking a Nurse Reviewer for remote work in the United States. The role involves performing concurrent reviews to determine appropriate level of care and discharge planning, with emphasis on medical necessity and care setting. Requires active...Remote work
- ...Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves... ...medical necessity criteria to reviews, documenting findings, and interfacing... ...license active and 3+ years clinical experience preferred....Remote workFull time
- ...Position Summary: The RN Integrated Care... ...the operation of our Clinical Team and the overall experience... ...required to address utilization review cases. Roles and... ...utilization management, discharge planning, care... ...Requirements This is a remote position. Our whole company...Remote workLive inFlexible hoursWeekday work
$63.1k - $94.65k
...Utilization Review RN Join a healthcare team dedicated to improving patient outcomes... ...operations. In this part-time, remote role, you will apply your clinical expertise to evaluate medical necessity... ...in utilization review, discharge planning, medical necessity assessments...Remote workTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift- ...Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health... ...necessity, and appropriate care levels, contributing to discharge planning within care policies and guidelines. Ideal candidates...Remote work
$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the... ...will act as a vital bridge between clinical care and hospital operations, ensuring... ...in utilization review, discharge planning, or working with medical...Remote workWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week$38.66 - $58.32 per hour
...Responsibilities As our Utilization Review RN, you will meticulously review... ..., concurrent, and post-discharge reviews, ensuring compliance... ...and proficiency in applying clinical guidelines will be key to your... ...This position is open to remote/out of state candidates...Remote work- ...Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for... ...to hire. The role is remote with work location listed as... ...necessity, and contribute to discharge planning according to care policies... ...requires an Associate degree, RN license in MS or a compact...Remote workContract work
- ** OUTSTANDING OPPORTUNITY - CLINICAL NAVIGATOR - SR. UTILIZATION REVIEW NURSE II ** ** POPULATION HEALTH WORK EXPERIENCE A SIGNIFICANT PLUS! ** The... ...health care team, members, and caregivers to assist in discharge planning, cost of care options, and/or coordinating and...Work experience placementLocal area
- ...Program sites. Job Title: Utilization Review RN Job Summary The... ...concurrent, and retrospective clinical reviews to determine... ...admission, continued stay, and discharge reviews for inpatient, observation... ...Work Conditions ~ Remote role with reliable high-speed...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
$63.1k - $94.65k
...have current compact RN license, or be willing... ...populations. Candidates with clinical backgrounds in NICU,... ...Information: Our Utilization Review team provides coverage... ...preferred Utilization review/discharge planning experience... ...Required: This is a remote role which requires...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work- ...Work-life balance. ~ Remote setting ROLE... ...This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual... ...aftercare needs, implements discharge planning and/or case... ...but is not limited to RN, LMSW, LMHC. # Must...Remote workTemporary workWork at officeMonday to FridayFlexible hours
- ...a Friend Back Remote Work from Home Share... ...- 5:00 PM As a Utilization Review Registered Nurse for... ...opportunity to use your clinical, managed care,... ...involved Initiate discharge planning of members... ...Unencumbered Registered Nurse (RN) license in Maryland (...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment... ...must have a current RN license and at least 1 year of clinical experience. Competitive hourly compensation worth $30-$38...Remote workHourly payPart time$40 per hour
...Industry Registered Nurse (RN) $40/hour -... ...reside in TX Full time remote Candidates must be... ...initial, concurrent review activities; discharge care coordination for... ...divisions. Collects clinical and non-clinical data... ...information regarding utilization management requirements...Remote workFull timeContract workWork at office- ...Overview Title: Clinical Review Nurse – Prior Authorization... ...Location: Fully Remote (PST Time Zone - WA/OR... ...Authorization Review to join our Utilization Management team. In... ..., ensure timely discharges, and collaborate with... ...~ Active RN license (WA; must be...Remote workContract work
- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience... ...Nurse will perform clinical reviews, ensure... ...licensed Registered Nurse (RN) with experience in utilization... ...stays, transfers, and discharge plans for compliance...Remote workFull timeSecond jobWork at office
- ...Currently seeking a Utilization Management RN . Please see details... ...below: Position is remote - candidate must reside... ...will evaluate members’ clinical conditions through medical record review to determine medical necessity... .... Identify discharge planning needs early and...Remote workImmediate startDay shift
- ...Utilization Review Nurse This position has a remote option for those living close and will be able... ...responsible for determining the clinical appropriateness of care... ...address post-hospital discharge services, redirection to... ...or compact required RN license in state of...Remote workFull time
$38 - $41 per hour
...Utilization Clinical Reviewer - Remote | WFH job at Get It - Healthcare. Los Angeles, CA. Job Summary As a Utilization Clinical Reviewer, you will use your expertise to assess medical records and ensure the appropriate use of psychiatric inpatient care. With your critical...Remote workHourly payFull timeWork from homeFlexible hours$77.08k - $119.47k
...00 Responsible for Utilization Management, Quality Screening... ...of three years clinical experience in an assigned... ...management and/or discharge planning/home care... ...applicable to utilization review process. 8.... ...cannot be done from a remote location. Other Requirements...Remote workShift work$31.94 - $43.92 per hour
...psychosocial assessments Create and manage discharge plans Coordinate with MDs, nurses,... ...Lead care planning discussions Utilization Management Review medical necessity & admission status... ...acute care) OR Option 2: 3+ years RN in: Med/Surg Telemetry ICU /...Relocation packageShift workWeekend workAfternoon shift$35 - $40 per hour
...hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison... ...as needed. Review clinical documentation for... ...visit utilization, and discharge planning. Identify and... ...active nursing license (RN, LPN, or LVN) in good standing...Remote workContract workFlexible hoursWeekend work- ...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... ...Registered Nursing Program; RN preferred. 2. Minimum of...Remote workPermanent employmentFull timeTemporary workFlexible hours
$86.96k - $113.67k
...Utilization Review Nurse Capital Health is the region's leader in providing progressive, quality... ...reimbursement, denials, appeals and clinical audits for inpatient cases. Ensures... ...management field including utilization review, discharge planning, outcomes management,...Full timeTemporary workPart timeFlexible hours
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