Remote Utilization Management Nurse Reviewer
Dane Street
A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records, and collaborating with healthcare providers to optimize care. Candidates must have a valid nursing license and a minimum of two years of clinical experience. The position offers a competitive salary range, remote work options, and a comprehensive benefits package including health insurance, retirement plans, and performance bonuses. #J-18808-Ljbffr
$45k - $70k
A healthcare management firm is seeking a Utilization Management Nurse Reviewer to ensure efficient use of medical services. The role involves reviewing medical records, assessing treatment necessity, and collaborating with healthcare providers. Candidates should possess...Remote job$45k - $70k
A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote job$45k - $70k
...A leading healthcare company in the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical services and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for candidates having...Remote work$45k - $70k
A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote job$40 per hour
PT (20-30 hours week) - Remote Work Environment Non-Exempt:... ....00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role... ...and applicable policies Manage end-to-end case screening processes... ...industry standards, utilizing research of relevant ICD-10...Remote workContract workWork at officeLocal areaImmediate start- Location: Remote with on‑site visits across Illinois... ...are currently seeking Nurses who reside in central... ...Position Overview: The Nurse Reviewer conducts provider... ...compliance findings. Utilize technology and web‑... ...collaborate across levels of management and staff. Ability to...Remote workFlexible hours
$78k - $88k
...a talented individual for a Nurse Reviewer (RN) who will be responsible... ...criteria, coverage policies, and utilization and practice guidelines as... ...as required. Assists management in training new Nurse Reviewers... ...Friday work schedule. Remote position; employees must be...Remote workPermanent employmentFull timeContract workTemporary workMonday to FridayFlexible hours- ...Clinical Nurse Reviewer Quality Management Saint Peter's is among the few hospitals in the world to have... ...through a secure, Web‑based system. Utilize software applications for data collection... ...located on‑site with limited remote work hours as allowed based on Director...Remote workFull timeWork experience placementShift work
- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
- ...classified as hybrid, onsite or remote. While the majority of our... ...of study or Post High School Nursing Diploma or Certification (LPN... ...for improvement to supervisor/manager; Support/mentor team members... ...Knowledge of managed care, utilization management, and quality management...Remote jobFull timeContract workWork experience placementWork at office1 day per week
- ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers, apply payer rules for authorizations... ...include a NLN-accredited nursing program, at least 3 years acute care nursing...Remote jobPart timeWork from home
- ...A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high typing speed and self-motivation along with the ability to work independently. Candidates must...Remote workWork from home
- ...Nurse Reviewer (LPN/RN) Pay rate: $27.50/hr W2 Location: Fully Remote - US Only Assignment: September 2026 through... ...Workers Compensation Case Management Occupational Health... ...Medicine Home Health Utilization Review or Medical Review...Remote work
$90k - $99k
DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes great... ...in conjunction with the Medical Director. Assists management with training new reviewers to include daily...Remote jobFull timeWork from homeFlexible hours- ...Refer a Friend Back Remote Work from Home Share This... ..., MD 21076 Category: Nursing Schedule: Day Shift... ...Health Plans (JHHP) is the managed care and health services business... ...8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- ...A major healthcare organization is seeking a Utilization Management Registered Nurse to join their team in Richmond, Virginia. This remote role requires an RN license and a minimum of one year of clinical experience in an acute care setting. Responsibilities include coordinating...Remote work
$71.1k - $97.8k
...A healthcare solutions company is looking for a Utilization Management Registered Nurse to interpret and coordinate medical services. This fully remote position requires a Compact RN license and over a year of clinical experience. The role focuses on improving consumer...Remote work- ...A health insurance company is seeking a Utilization Management Registered Nurse to leverage clinical skills for coordinating medical services within a remote setting. The role involves interpreting medical documentation and collaborating with healthcare providers. Ideal...Remote work
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work$71.1k - $97.8k
...A major healthcare provider is seeking a Utilization Management Registered Nurse based in Maryland. The role involves coordinating medical services,... ...clinical information, and facilitating care while working remotely. Candidates must possess a Compact RN license and have...Remote work$29.1 - $62.32 per hour
...care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule : Tuesday-Saturday 9:30am-6:00pm...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$71.1k - $97.8k
...A leading health insurance company is seeking a Utilization Management Registered Nurse to leverage clinical skills in coordinating and documenting medical services for members. This remote role emphasizes compassionate care, requiring at least one year of RN experience...Remote work$71.1k - $97.8k
...A leading health services company is looking for a Utilization Management Registered Nurse based in Ohio. The role involves using clinical skills to... ...year of clinical experience. This position allows for remote work with occasional travel to company offices. Competitive...Remote work$71.1k - $97.8k
...A healthcare organization is seeking a Utilization Management Registered Nurse to support the coordination and documentation of medical services. This remote position requires a valid RN license and clinical experience. Responsibilities include interpreting medical information...Remote work- ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
$71.1k - $97.8k
...A healthcare company in the United States is seeking a Utilization Management Registered Nurse to utilize clinical skills in coordinating medical services... ...one year of clinical experience. The position offers a remote work option and includes a comprehensive benefits...Remote work- ...Blue Cross and Blue Shield of Kansas City is looking for a Clinical Review Nurse to utilize clinical expertise in managing healthcare services efficiently. Candidates must have at least 3 years of direct patient care experience and an Associate degree in nursing, along...Remote work
- ...Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote work
- A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
$71.1k - $97.8k
...A healthcare organization is seeking a Utilization Management Registered Nurse in Baton Rouge. In this remote position, you will use clinical skills to support medical service coordination and determinations, and communicate with providers and members. Candidates must...Remote work
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