Remote RN Care Review Clinician - UM/Discharge Planning
Molina Talent Acquisition
- Remote job
Molina Healthcare seeks a Remote RN Care Review Clinician for UM/Discharge Planning in California. You will verify medical necessity, review services against guidelines, and coordinate care across the delivery continuum to achieve quality outcomes. The role requires an active RN license in CA, at least 2 years in hospital acute care or managed care, strong written and verbal communication, and Microsoft Office proficiency. #J-18808-Ljbffr Molina Talent Acquisition
$30.37 - $59.21 per hour
...support for clinical member services review assessment processes.... ...through integrated delivery of care across the continuum. Contributes... ...Adheres to utilization management (UM) policies and procedures.... ...experience. • Registered Nurse (RN). License must be active and unrestricted...Remote workHourly payWork experience placementWork at office- ...and therapists in home care, hospice, and case... ...assist a top health plan partner of ours with... ...need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an... ...experience, managed care, and discharge planning experience...Remote workContract workMonday to FridayFlexible hours
- ...Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care... ...to address utilization review cases. Roles and... ...utilization management, discharge planning, care coordination, clinical... ...Requirements This is a remote position. Our whole company...Remote workLive inFlexible hoursWeekday work
$1,759.5 per week
...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas, United... ...Traveler is hiring a remote Utilization Management... ...requiring 2 years of acute care UM experience and a TX or... ...Assesses and coordinates discharge planning needs with the...Remote workWeekly payWork experience placementLocal areaShift work$35 - $40 per hour
...analytics. Job Title RN Utilization Management Reviewer Responsibilities... ...to primary care team, specialty providers... ...teams on service planning as needed. Work closely with clinicians, medical staff,... ...and work with UM Manager to ensure... ...Location: Fully remote work at home role...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend work- ...Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical... ...to ensure medically necessary care across the continuum. This role offers... ...in utilization management or discharge planning, with an Associate degree (BSN preferred...Remote workWork from homeMonday to FridayWeekend work
$27.02 - $48.55 per hour
## Utilization Review Clinician - Behavioral HealthApply: Remote-OR: Full time: Posted Today: 1666... ...clinical review and assesses care related to mental health... ..., treatment needs, and discharge planning* Analyzes BH member data... ...(LMHP) required or* RN - Registered Nurse - State...Remote workHourly payFull timeMonday to Friday- ...UM Nurse Reviewer Under the guidance of the Utilization Management, the... ...that members receive suitable care at the right time and... ...facilitating secure and efficient discharge planning, and collaborating closely... ...Unrestricted Current California RN or LVN license At least...Immediate start
$63.1k - $94.65k
...is looking for a Utilization Review RN based in the United States.... ...operations. In this part-time, remote role, you will apply your... ...patient admissions, and ensure care aligns with established... ...experience in utilization review, discharge planning, medical necessity...Remote workTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the... ...making a massive impact on patient care? We are seeking a dedicated... ...experience in utilization review, discharge planning, or working with medical necessity...Remote workWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week$63.1k - $94.65k
...have current compact RN license, or be... ...Our Utilization Review team provides coverage... ...utilization of health care resources and assists... ...improvement team; planning, implementation,... ...Utilization review/discharge planning experience... ...Required: This is a remote role which requires...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work- ...Title Clinical Review Nurse - Concurrent... ...Work Location Remote (EST preferred but... ...reviewing the type of care being delivered,... ...contributing to discharge planning according to care... ...Required: LPN/RN Preferred: Years... ...experience required/UM or managed care exp...Remote workWeekend work
$35 - $45 per hour
...IntePros is seeking a Remote Utilization Review Nurse serves as a... ...to optimize care, drive cost‑effective... ...and payer plans. Collaborate with... ...Provide feedback to clinicians on accurate assessments... ...utilization, and discharge planning.... ...nursing program (RN, LPN, or LVN). Minimum...Remote workContract workWeekend work$95k - $107.5k
...Title: Nurse Reviewer, Utilization Management... ...office; 1 day remote FLSA Status:... ..., high-quality care in the most suitable... .... Apply plan clinical policy... ...Concurrent Review & Discharge Coordination... ...documentation within the UM platform.... ...in Nursing (ADN/RN) required; Bachelor...Remote workFull timeLocal area- ...Utilization Management (UM) Nurse, you are... .... Unlike remote roles, this position... ...Nurse (RN) responsible for... ...medical record reviews to ensure patients... ...current level of care.o Medical Provider... ...clients ongoing plan of care and conducts... ...and Post Discharge* Completes chart...Remote workFull timeImmediate startShift work
- ...: This is a remote position but will... ...our mission: caring for every person... ...savings plan with employer match... ...Conduct clinical reviews of patient records... ...timely discharges, transfers, and... ...Registered Nurse (RN) program; Bachelor... ...physicians and clinicians across 25...Remote workFull timePart timeWork at officeLocal areaShift workRotating shiftDay shift
$55 per hour
...hiring a Concurrent Review Nurse to support... .... Location: Remote (must be based in... ...that member care is provided at the... ...Functions: Confirm care plans with healthcare... ..., and discharge planning. Escalate... ...within the scope of RN practice in... ...Patient Case Manager UM LVN Delegation...Remote workFull timeContract workTemporary workLocal area$27.02 - $48.55 per hour
...Area: Clinical & Care Management Job... ...Performs concurrent reviews, including... ...and contributing to discharge planning according to care... ...Key Details: Remote role. Seeking a Licensed... ...Registered Nurse (RN) with an active Pennsylvania... ...Management (UM), or Utilization Review...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...WellSense Health Plan in the United States... ...Utilization Management Clinician to evaluate... ...treatment, and support discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree... ...to ensure timely reviews, document outcomes,...Remote workFull time
- ...Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ... ...and Managed Long-Term Care (MLTC). This is a 100%... ...utilization reviews within a SNF, health plan, or managed care setting... ...Care Transitions & Discharge: Monitor residents' length...Remote workFull timeMonday to Friday
- ...Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Utilization Management RN (Part-Time, Remote) Position... ...performs telephonic review of hospital admissions... ...alternative levels of care when appropriate. This... ...services, promotes timely discharge planning, and collaborates... ...Utilization Management (UM) Discharge Planning...Remote workPart timeMonday to Friday
- ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license... ...with Medical Affairs, and guiding discharge planning. The position offers competitive pay and...Remote workMonday to Friday
- ...As our Utilization Review RN, you will meticulously... ..., concurrent, and post-discharge reviews, ensuring compliance... ...physicians, payers, and Care Coordinators—regarding... ...This position is open to remote/out of state candidates... ...Manager (ACMRN), or UM Certification Proficient...Remote work
$31.94 - $43.92 per hour
...Description Job Description Care Coordination Perform... ...assessments Create and manage discharge plans Coordinate with MDs,... ...Utilization Management Review medical necessity & admission... ...care) OR Option 2: 3+ years RN in: Med/Surg Telemetry...Relocation packageShift workWeekend workAfternoon shift- ...Work Mode: 100% Remote - MS (candidates can... ...medical necessity reviews of inpatient admissions... ...policies, and plan-specific requirements... ...scope. Identify discharge planning needs and... ...safe transitions of care, reduced length of... ...Disqualifiers: Not a RN, No compact License...Remote workHourly payFlexible hoursShift workWeekend work
- ...personalized managed health care, focused on what's... ...also available! * 401k plan with company match,... ...Work-life balance. * Remote setting ROLE DESCRIPTION... ...to a second level reviewer. This individual interfaces... ...needs, implements discharge planning and/or case management...Remote workTemporary workMonday to FridayFlexible hours
- ...Utilization Management RN . Please see... ...below: Position is remote - candidate must... ...through medical record review to determine... ...clarify treatment plans and obtain additional... ...evaluation. Identify discharge planning needs... ...ensure appropriate care settings. Report...Remote workImmediate startDay shift
- ...Community Health Plan of Washington is... ...Utilization Management Clinician performs utilization review for medical or... ...of the health care team, the patient... ...unrestricted license as an RN or LPN. Have... ...to perform discharge planning.... ...communicates with the UM Manager, Medical...Full timeTemporary workPart timeWork at officeLocal areaTrial periodAll shiftsFlexible hours
- ...Position Title: Clinical Review Nurse - Concurrent... ...Review Work Location: Remote-MS CST Assignment... ...reviewing the type of care being delivered,... ..., and contributing to discharge planning according to care policies... ...Compact) Preferred: RN License Years of...Remote workContract workFlexible hoursWeekend work
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