Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Utilization Review Nurse: Medicare & Home Health

Medix

A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with healthcare teams. Qualifications include an accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr

Vacancy posted 21 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Nurse: Medicare & Home Health in United States vacancy
  •  ...plays an integral role in the review process as they are responsible...  ...computer work. WORK FROM HOME TECHNICAL REQUIREMENTS:...  ...media stipend are provided for remote workspace.  ABOUT DANE STREET...  ..., Disability, Auto, and Group Health Carriers, Third-Party Administrators... 
    Remote work
    Work from home
    Temporary work
    Work at office

    Dane Street, LLC

    Remote
    10 days ago
  • A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have... 
    Remote work
    Contract work

    IntePros

    United States
    3 days ago
  •  ...Description: Nurses – are you looking for a change...  ...medical and behavioral health and/or substance use disorder...  ...-life balance. ~ Remote setting ROLE...  ...This individual will utilize clinical knowledge and...  ...decision to a second level reviewer. This individual... 
    Remote work
    Temporary work
    Work at office
    Monday to Friday
    Flexible hours

    Hines and Associates

    Rockford, IL
    1 day ago
  •  ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital...  ...(InterQual/MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient...  ...with other members of the health care team to ensure the above according... 
    Remote work
    Full time

    CHRISTUS Health

    Alamogordo, NM
    21 hours ago
  •  ...Hines & Associates, Inc. is seeking a Nursing Review professional to validate outpatient and inpatient services against established criteria...  ...This is a Monday–Friday position with standard daytime hours and remote setting options stated in the benefits. #J-18808-Ljbffr... 
    Remote work
    Monday to Friday

    Hines and Associates

    Salem, OR
    1 day ago
  • $65k - $88.6k

     ...Licensed Behavioral Health Utilization Management...  ...Licensed Registered Nurse ( RN ) – Multi-State...  ...resolve within a remote environment Preferred...  ...medical necessity reviews against criteria...  ...Work at Home Requirements: To ensure...  ...life for people with Medicare and Medicaid,... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Home office
    Monday to Friday

    Humana

    Oklahoma
    4 days ago
  • CVS Health is seeking a remote Community Care Case Manager to coordinate care for Medicare members. You’ll assess, plan and facilitate services, communicating with doctors, insurers...  ...Medicare. 2+ years in case management or home health is preferred, with bilingual Spanish... 
    Remote job
    Work from home

    CVS Health

    Columbus, OH
    1 day ago
  •  ...Job Announcement: Health Policy and Research Fellow...  ...…there is even a new Medicare billing code for Community...  ...you get to work from home. Interested? Read on...  ...risks. In this fully remote role for 10-20 hours...  ...sources, including peer-reviewed journals, grey literature... 
    Remote work
    Work from home
    Contract work
    Part time
    10 hours per week

    IMPaCT Care

    Remote
    2 days ago
  • Suvida Healthcare LLC is seeking a Bilingual Community Health Worker to serve Medicare-eligible Hispanic seniors in the Katy, TX area. The...  ...cultural competency, and the ability to work across home, clinic, and remote environments. Certification and a preferred Bachelor’... 
    Remote work
    Work from home

    Suvida Healthcare LLC

    Katy, TX
    4 days ago
  • $71.1k - $97.8k

     ...The Field Care Manager Nurse 2 assesses and evaluates...  ..., and psycho-social health issues. Identifies and...  ...~3 or more years of in-home assessment and care coordination...  ...: While this is a remote position, occasional...  ...of life for people with Medicare and Medicaid, families,... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Home office
    Monday to Friday

    Humana

    South Carolina
    5 days ago
  •  ...Representative to support members, providers, and patients with their health plan information. You will handle inquiries in Member Services, Medicare, and Billing, and document interactions with accuracy. This remote, home-based role emphasizes HIPAA compliance, privacy, and high-... 
    Remote job
    Work from home

    VXI Global Solutions

    Austin, TX
    1 day ago
  • $59.3k - $80.9k

     ...Manager, Telephonic Behavioral Health, assesses and evaluates...  ...such as hospital discharge to home or outpatient care). You will...  ...Information Workstyle: Remote with occasional travel for business...  ...quality of life for people with Medicare and Medicaid, families, individuals... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work experience placement
    Live in
    Work at office
    Home office
    Monday to Friday

    Humana

    South Carolina
    4 days ago
  • $40k - $52.3k

     ...community Full-Time, Remote Telephonic...  ...administration of utilization management by performing...  ...shared mailboxes, reviewing and routing...  ...cable modem for a home office Must be passionate...  ...their best health – delivering the care...  ...life for people with Medicare and Medicaid, families... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Home office

    Humana

    Remote
    2 days ago
  • $65k - $88.6k

     ...Healthy Horizons is more than a health plan—we deliver human care. We...  ...working with Medicaid or Medicare Enrollees to coordinate services...  ...adults Workstyle: This is a remote, field-based position serving...  ...:00 a.m.–5:00 p.m. Work at Home Requirements: To ensure Home or... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Local area
    Home office
    Monday to Friday

    Humana

    South Carolina
    3 days ago
  • $65k - $88.6k

     ...Kentucky is seeking a Utilization Management Behavioral Health Professional 2...  ...’s degree in nursing OR a master's...  ...with utilization review process....  ...Workstyle: This is a remote position. Workdays...  .... Work at Home Requirements: To...  ...for people with Medicare and Medicaid,... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Private practice
    Work at office
    Home office

    Humana

    Remote
    2 days ago
  • $71.5k - $97.5k

     ...Care Manager, Behavioral Health performs primarily face...  ...Responsibilities: Utilize high-quality, evidence-...  ...Services (IDHS), Center for Medicare and Medicaid Services (...  ...-based facilities and homes for face-to-face...  ...Workstyle: This is a remote position that will require... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Home office
    Monday to Friday

    Humana

    Remote
    19 days ago
  •  ...and creative outpatient mental health private practice that provides...  ...PAID SICK TIME ~ WORK FROM HOME AND IN-PERSON (if desired) ~...  ...CA fully licensed Psychiatric Nurse Practitioner (PMHNP) to join our...  ...offering flexibility for both remote telehealth services and 2-3... 
    Remote work
    Work from home
    Full time
    Private practice

    FUSION CARE GROUP, A PSYCHOLOGICAL PROFESSIONAL CORP.

    San Diego, CA
    5 days ago
  •  ...At Aylo Health, we work together to enrich the health and...  ...patient experience. Remote Teleradiologist Job Type...  ...assessments. Utilize PACS and RIS systems for imaging review and reporting. Communicate...  ...~100% Remote: Work from home. ~ Malpractice... 
    Remote work
    Work from home
    Part time
    Day shift

    Aylo Health

    Remote
    11 days ago
  • $89.54k - $136.47k

    City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must reside in the State of Virginia. As an integrated care manager, specializing in Utilization review, the registered nurse... 
    Remote work
    Full time
    Temporary work
    Shift work

    Sentara Health

    South Carolina
    3 days ago
  • $65k - $88.6k

     ...Field Care Manager, Behavioral Health assesses and evaluates member'...  ...of Ethics (la.gov) Work at Home Requirements: To ensure Home or...  ...information. Travel: While this is a remote position, occasional travel to...  ...of life for people with Medicare and Medicaid, families, individuals... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Home office

    Humana

    Louisiana
    21 hours ago
  •  ...Newark NJ rest of role will be remote This position is...  ...Responsibilities: 1. Conducts on-site reviews at participating provider...  ...patterns for quality improvement and health management. 4. Assists the...  ...2. Requires License Practical Nurse License or an active New... 
    Remote work

    Winston Medical Staffing

    Newark, NJ
    8 days ago
  •  ...American Health Plans, a division of Franklin, Tennessee-based American Health...  ...facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical...  ...Program JOB SUMMARY: The Utilization Review Nurse is to assess the medical necessity... 
    Remote work
    Full time
    Temporary work
    Local area

    TruHealth

    Remote
    11 days ago
  • $115k - $120k

     ...Licensed Mental Health Therapist | LCSW, LMFT, LPCC Location: California Work Setting: Remote / Telehealth Position: Full-Time Schedule:...  ...relationship concerns, major changes at home or work, or other issues that...  ...time for notes, case review, and professional development.... 
    Remote work
    Work from home
    Full time
    Monday to Friday

    Gotham Enterprises Ltd

    Remote
    12 days ago
  • A healthcare company in Houston is seeking a Behavioral Health Care Manager to support patients and caregivers dealing with neurodegenerative...  .... The position offers competitive compensation, a work-from-home stipend, and a supportive growth-oriented environment. #J-18808-... 
    Remote work
    Work from home

    Synapticure

    Houston, TX
    21 hours ago
  • $70 - $100 per hour

     ...Psychiatric Mental Health Nurse Practitioner (PMHNP) Fort Defiance, Arizona We are a clinician-led, patient-centered, collaborative...  ...patient cases or clinical topics. Clinical work is performed from home, days and hours are per the clinician's choosing (this includes... 
    Remote work
    Work from home
    Hourly pay
    Day shift
    Afternoon shift

    BlueSky Telepsych, LLC

    United States
    4 days ago
  • $156k - $187.2k

     ...Remote Behavioral Health Therapist (LCSW, LMFT, LPCC, LP) | Youth & Adults | Bakersfield, CA Work from home in Bakersfield or anywhere in the U.S., see Kaiser Permanente members by video, and earn $75–$90 per session. Our Kaiser program has a 96% caseload fill rate... 
    Remote work
    Work from home
    Contract work
    For contractors
    Monday to Friday
    Weekend work

    Daybreak Health

    California
    3 days ago
  • $55k - $70k

    A behavioral health provider in New York is looking for a dedicated Nurse Practitioner to deliver psychiatric evaluations and medication management. The ideal candidate...  ...,000 to $70,000 annually with comprehensive benefits and the opportunity to work from home. #J-18808-Ljbffr
    Remote work
    Work from home
    Part time

    Reklame Health

    New York, NY
    21 hours ago
  • $25k

     ...caring community The Community Health Worker 1 contributes to...  ...locked door that can be used as a home office to ensure continuous privacy...  .... Travel: While this is a remote position, occasional travel to...  ...of life for people with Medicare and Medicaid, families, individuals... 
    Remote work
    Work from home
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Home office

    Humana

    Hamilton, OH
    2 days ago
  • $2,400 - $10,000 per month

     ...ComplexCare Solutions (CCS) is seeking a Nurse Practitioner for per diem work to perform in-home and telehealth assessments across Jefferson County and other markets. You will assess health status, identify gaps in care, and develop care plans to keep members out of hospitals... 
    Remote work
    Work from home
    Daily paid

    ComplexCare Solutions

    Denver, CO
    6 hours ago
  •  ...CVS Health is hiring for a full-time, work-from-home telehealth therapist to provide counseling to patients 13+ across eligible states. Current, active licenses (LCSW/LCMHC/LPCC/LMFT) in CA, OR, or UT are required, with willingness to obtain additional state licensure... 
    Remote work
    Work from home
    Full time

    MePA

    Oregon State
    21 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Review Nurse: Medicare & Home Health. Be the first to apply!