Remote RN Reviewer — Utilization Review
Gainwell Technologies
A leading healthcare solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate will have over 5 years of clinical experience and must hold an active RN license. Responsibilities include reviewing medical records, performing prior authorizations, and documenting findings. This full-time position offers comprehensive benefits starting on the first day of employment, including health coverage and a supportive work environment focused on career growth. #J-18808-Ljbffr
- ...MVP Health Care is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team. In this remote role, you will conduct clinical reviews to ensure compliance with Medicare guidelines and support high-quality patient outcomes. The ideal candidate...Remote work
$65k - $75k
Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing... ..., 5+ years of clinical experience, and 2+ years in utilization review or claims auditing. This full-time position...Remote workFull time$37.14 - $61.9 per hour
Department Name: Utilization Mgmt Work Shift: Day Job Category: Clinical Care Additional... ...community. As a Registered Nurse RN Utilization Management Care Reviewer, you will be working in partnership... ...Care Reviewer position is a fully remote position with a work schedule of...Remote workFull timeWork experience placementLive inMonday to FridayShift work- ...A leading healthcare solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate will have over 5 years of clinical experience and must hold an active RN license. Responsibilities include reviewing medical records,...Remote workFull time
- Humana is offering a remote RN Internship designed for transitioning military service members and military spouses. Interns will perform clinical reviews, support healthcare providers, and engage with interdisciplinary teams. Must be an active RN in Kentucky or have an...Remote jobInternship
- ...A leading medical review organization is seeking Board‑Certified physicians in Pediatric Hematology Oncology for flexible, remote Utilization Reviews. This role requires conducting independent reviews of pediatric cases, engaging in peer-to-peer discussions, and ensuring...Remote workPart timeFlexible hours
- ...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
$174.07k - $374.92k
...person, one family and one community at a time. Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description: This full-time role is responsible for provisioning accurate and...Remote workHourly payFull timeLocal area- ...additional details. Office Location: Remote Option Available; Flexible for any of Partners... ...is responsible for facilitating the review of service plans and service... ...appropriate services at a given time. The IDD Utilization Management Reviewer screens authorization...Remote workWork at officeFlexible hours
- ...the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing... ...application. Work Arrangement Remote role Monday through Friday from 8... ...from date of hire Requirements for RN: Active and unencumbered RN license...Remote workWork at officeMonday to FridayFlexible hoursWeekend work
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...Ability to obtain additional RN licensure across the enterprise including... ...Package Flexible work solutions include remote options, hybrid work schedules,...Remote workMonday to FridayFlexible hoursWeekend work
$69.38k - $92.28k
...communities. About the Opportunity As a Sub-Acute RN UM Reviewer-Medicare, you will play a vital role in our Utilization Management team by conducting clinical reviews... .... Where you'll be: Location: Remote Pay Transparency MVP Health Care is...Remote work- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
$260k - $275k
...Medix™ is seeking a Board-Certified Physician for a fully remote, non-clinical role in Utilization Management. The position involves reviewing clinical documentation to determine the appropriateness of inpatient, outpatient, and pharmacy services. Ideal candidates will...Remote work$174.07k - $374.92k
...Oak Street Health, part of CVS Health, is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. This role requires at least one year of Utilization Management experience in Medicare...Remote workFull time- ...Remote Physician Reviewer – Utilization Management ****This Person Needs to sit in PA, NJ, or Delaware**** IntePros is seeking a Physician Reviewer to support a leading healthcare organization in a fully remote capacity. This role is responsible for reviewing medical necessity...Remote work
$33 per hour
...RN Reviewer The RN Reviewer position is a crucial role in our organization — in this role... ...and collaboration skills across remote teams Customer-focused mindset and ability... ...environment Solid understanding of utilization and case management programs Organized...Remote workHourly payFull timeFlexible hoursShift work$260k - $275k
...weekend every 16 weeks Position Type: Full-time | Remote | Non-clinical We are seeking a Board-Certified Physician to join a Utilization Management team in a fully remote, non-clinical role. This position focuses on reviewing clinical documentation and determining the...Remote workFull timeWeekend work- ...ChenMed is looking for a Licensed Physician Reviewer – Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician reviewers while participating in quality improvement efforts. The ideal...Remote work
- ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with...Remote workPrice workExtra incomeFor contractorsFlexible hours
$211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services... ...Director, Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United States...Remote workFull timeLocal areaWork from homeHome officeWeekend work- ...applicants Description Dane Street, a leading Independent Review Organization (IRO) and national provider of Utilization Review (UR) services, is currently expanding our... ...independent medical reviews on a flexible, remote (telework) basis. This is a non-clinical, contract...Remote workExtra incomeContract workFor contractorsFlexible hours
$174.07k - $374.92k
...one person, one family and one community at a time. Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description: This full-time role is responsible for provisioning accurate...Remote workHourly payFull timeLocal area- ...A healthcare organization is seeking a Physician Clinical Reviewer for a remote opportunity. In this role, you will be a key member of the utilization management team, performing medical reviews of service requests and collaborating with physicians to ensure compliance...Remote work
- ...A healthcare organization is seeking a Physician Clinical Reviewer specializing in Dermatology to join their utilization management team. This remote role involves reviewing medical service requests, collaborating with healthcare professionals, and ensuring compliance...Remote work
- ...pharmacy benefits manager is seeking a Physician Clinical Reviewer specialized in Dermatology for a remote role. This position involves reviewing clinical... .... This is an opportunity to contribute to effective utilization management processes while working within a...Remote work
$40.39 - $60.96 per hour
Intermountain Health in Las Vegas is seeking an RN Utilization Management Reviewer I to conduct utilization reviews, ensuring patient-centered care through effective resource management. This role involves collaborating with providers and patients, adhering to regulatory...Hourly payFull time$105 - $115 per hour
EPITEC is seeking a Physician Reviewer to evaluate clinical service requests and utilize medical expertise for decision-making. The role is non-patient-facing and... .... This position offers flexible hours, fully remote work (excluding CA, NY, HI, or AK), and competitive...Remote jobHourly payFlexible hours
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