Remote RN Reviewer - Utilization Review Expert
$65k - $75kGainwell Technologies LLC
Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical records, documenting findings, and supporting decision-making within healthcare guidelines. Candidates must have an active RN license, 5+ years of clinical experience, and 2+ years in utilization review or claims auditing. This full-time position offers health benefits starting on day one and a salary range of $65,000—$75,000 per year based on qualifications and experience. #J-18808-Ljbffr
- ...Location: Remote - TX Department: Utilization Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Responsible... ...Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate and fiscally responsible...Remote workFull timeShift workDay shift
$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- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote 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
$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access to a reliable high-... ...Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for... ...active and unencumbered Registered Nurse (RN) license in the District of Columbia required...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work2 days per week- ...Comagine Health in Oregon seeks a Clinical Reviewer to evaluate medical necessity and... ...review clinical documentation, perform utilization reviews, and document determinations in... ...across children, youth, and adults. This remote, Oregon-based role requires active licensure...Remote work
- ...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
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to...Remote workFull time
$219k - $286.9k
...Physician Reviewer - Utilization Management Remote Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving...Remote workFull timeLocal areaWork from homeHome officeWeekend 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
- ...Dane Street, a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...Remote work
$32 - $55 per hour
...A consulting firm is seeking a Healthcare Construction Plan Reviewer to evaluate electronic construction drawings for healthcare facilities, ensuring compliance with safety standards. This remote role requires 1+ years of relevant experience and a bachelor’s degree. Ideal...Remote workHourly pay- ...Orthopedic Spine Surgeon Reviewer Dane Street, a nationally recognized Independent Review Organization (IRO), is... ...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
$30 per hour
...Adam D'Angelo , Larry Summers , and Jack Dorsey . Position: Image Caption Review - English Generalist Type: Contract Compensation: $30/hour Location: Remote Role Responsibilities Review AI-generated image captions in English for accuracy...Remote workContract workSummer work- ...Overview We are looking for Humanities Experts to join our team and contribute their... ...quality AI systems. In this role, you will review questions and answers across a range of... ...and manage responsibilities in a remote environment. Responsibilities Review...Remote workTemporary workFor contractors
$174.07k - $374.92k
...health care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full time, Monday - Friday, 8am -5pm Salary: $230k per year Role Description:...Remote workHourly payFull timeLocal areaMonday to Friday$40 - $52 per hour
...Clinical Data Coordinator/OASIS Review VNA Health Group Remote Per Diem This position requires residency in NJ Certification Required... ...educational initiatives Qualifications • Current NJ RN License required • BSN preferred • OASIS Certified or...Remote workDaily paidWork experience placementWork at officeLocal area$120 per hour
...DAngelo Larry Summers and Jack Dorsey . Position: Legal Expert Litigation Type: Contract Compensation: $120/hour Location: Remote Role Responsibilities Review published legal-benchmark tasks in litigation and dispute...Remote workFull timeContract workSummer work- ...TEEMA is seeking a Registered Nurse for a remote role with Arizona hours (1st shift). You will review medical records for quality, safety, and utilization issues, identify PQIs, and support QA... ...Directors. Must hold an active RN license, have 3+ years of clinical experience...Remote workDay shift
- ...seeking a Pre-Authorization Registered Nurse for a remote, full-time role based in Virginia. The RN will review prior authorization requests, determine appropriate care settings, and educate providers on utilization and management processes. Requirements include an...Remote workFull time
- ...UnitedHealth Group is seeking a Telephonic Oncology Preservice Review Nurse (RN) to perform pre-service clinical reviews remotely across the U.S. You will evaluate services using benefit plan documents, guidelines, and policies to determine medical appropriateness....Remote workAfternoon shift
- ...Job 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
$60 per hour
...Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey . Position: Legal Reviewer — Document QC Type: Contract Compensation: $60/hour Location: Remote Role Responsibilities Create rubrics to grade legal documents that are...Remote workContract workSummer work- ...Job Title In this remote role, you will perform utilization reviews, ensuring compliance with clinical guidelines and patient care standards. Collaborate with interdisciplinary teams to assess patient needs and facilitate care coordination. Your expertise in medical...Remote workWeekly pay
$1,949.74 per month
...Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review RN Weekly Pay $1949.74 Shift... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift work- ...Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to support compliant, cost...Remote workFull time
- ...VNA Health Group is seeking an experienced RN to join our Coding Review team as a Clinical Data Coordinator/OASIS Review. You will review OASIS... ...documentation excellence across the organization. This remote, per diem role requires NJ residency and an active NJ RN license...Remote workDaily paid
- ...BJC HealthCare seeks a PRN Utilization Review RN to support hospital resource utilization from a remote location within one hour of St. Louis, MO. You will review admissions for medical necessity and educate providers on appropriate care levels. Two years UR experience...Remote workFull timeReliefShift work
- ...United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...care management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time
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