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 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 work- Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service necessity and efficiency, ensuring quality care based on clinical guidelines. The UMRN will work closely with various departments...Remote jobFlexible hours
$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 work$80k - $99.2k
...Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that... ...with the Medical Director. Assists management with training new reviewers,... ...experience required. 3+ years of utilization review experience or claims auditing...Remote workFull timeFlexible hours$72.59k - $119.77k
...Clinical Nurse Reviewer Quality Management Saint Peter's is among the few hospitals in the world... ...through a secure, Web-based system. Utilize software applications for data... ...Position located on-site with limited remote work hours as allowed based on Director...Remote workFull timeWork experience placementShift work$88.85k
...Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12988 Salary Range: $88,854.00 (Min.) - $115,509.00...Full time- ...Truman Medical Centers is seeking a Utilization Management RN for a part-time position working from home. The role involves partnering with... ...with regulatory standards. Applicants should have a BSN or a Nursing graduate degree, an active RN license in Missouri, and at least...Remote workPart timeWork from home
$70k - $80k
...Gainwell Technologies is seeking a Nurse Reviewer, Associate, who will conduct clinical reviews to assess if medical records support the need for services based on defined criteria. In this home-based full-time role, you will review and interpret medical documentation...Remote workFull timeWork from home$33.12 - $56.77 per hour
...Elevance Health is seeking a Nurse Reviewer I to conduct preauthorization reviews for diagnostic imaging. This is primarily a virtual role based in Washington DC, suitable for new graduates. You will collaborate with healthcare providers to ensure proper treatment approvals...Remote work- ...leading healthcare provider is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license...Remote workWork from home
- ...Projections. This includes reviewing records, preparing the... ...Degree or Diploma in Nursing required • 3-5 years... ...bill reviews and utilization reviews in injury cases... ...CNLCP), Certified Case Manager (CCM), Medical Coding,... ...#LI-ZP1 #LI-Remote About Us For over...Remote workFull time
$88.85k
...safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves... ...telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers...- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- ...Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities... ...service eligibility and facilitating care. This remote role requires an RN license and clinical experience. Benefits...Remote jobWork from home
- ...Dane Street, LLC is seeking a remote Physician Reviewer for full-time work from home. The role requires an MD or DO, board-certified in Internal or Family Medicine, to perform utilization reviews, including preauthorization and appeals. Ideal candidates will have prior...Remote workFull timeWork from home
- 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 jobFull timeWork at officeWork from home
- ...integrator of professional, technological and management solutions services. Founded in 1998,... ...? Avosys is seeking a Surgical Case Nurse Reviewer to provide services to the Travis... ...for the program through the effective utilization of the hospital medical record system....Remote workFull timeFor contractorsWork at officeLocal areaMonday to FridayShift work
- ...The Peer-to-Peer (P2P) Utilization Review Nurse is an integral member of the MGB Central Utilization Management team, specializing in identifying, preparing, and clinically reviewing... ...tools. Schedule and Work Model ~ Remote / Work from Home. ~32 hours per week on...Remote workWork 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
$52 per hour
...JobRx, Inc. is seeking a Work From Home PharmD Utilization Management Pharmacist. In this full-time role, you will use your clinical expertise to review medication requests, ensuring appropriate care through analysis and documentation. The position offers competitive pay...Remote workDaily paidFull timeWork from home- ...a Friend ~ Back Remote Work from Home Share... ...Hanover, 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 timeWork from homeMonday to FridayDay shift
- ...Mass General Brigham Health Plan is hiring for a role that utilizes clinical expertise for utilization management in a remote environment. Ideal candidates should hold an Associate's Degree in Nursing, possess strong decision-making and problem-solving skills, and have...Remote work
- ...Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote work
- ...Intellect Resources is seeking a recruiter with deep expertise in utilization management and case management. This role supports healthcare... ...and Microsoft Tech Stack (Office 365, Teams and Copilot) Remote. Ability to engage, focus, and thrive in a work from home environment...Remote workWork at officeWork from home
- ...analytics, Guidehealth leverages remotely‑embedded Healthguides™ and a centralized Managed Service Organization to build... ...through precise and timely Utilization Review. In this role, you will apply... ...growth aligned with Illinois nursing regulations and contemporary clinical...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home
$29.1 - $62.32 per hour
...schedules will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary: Utilize your clinical experience and skills in a... ...Required Qualifications: Registered Nurse Education: Diploma RN acceptable; Associate...Remote workHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend work- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...Curana Health, Inc. is seeking a Utilization Management Nurse to join their remote team. In this role, you will review healthcare services' utilization to ensure cost-effective care while actively coordinating transitions and discharges for patients. You will engage closely...Remote work
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