Remote Inpatient Utilization Review Nurse
Alignment Healthcare
Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient’s PCP, facility case manager, discharge planner, and contracted providers to ensure appropriate, cost-effective levels of care while maintaining safety and quality.
The role requires a CA LVN/RN license, 3+ years in case management, and experience with Milliman Care Guidelines. Schedule is Mon-Fri 8:00 AM-5:00 PM Pacific Time.
#J-18808-Ljbffr$65k - $78k
...development. Your Role In Our Mission Review admissions, procedures, services, and... ...systems. Assist in training new nurses, provide feedback, and stay updated on clinical... ...~ Active RN license. ~3+ years of inpatient clinical experience. ~1+ year in prior...Remote workFull timeWork at officeWork from homeFlexible hours$41 - $45.5 per hour
...Direct Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL, TX,... ...assessments, health education, and utilization management. Key... ...concurrent, and retrospective reviews for inpatient, rehab, referrals, and select...Remote job- ...Description: Nurses - are you looking for a change... ...-life balance. * Remote setting ROLE DESCRIPTION... ...This individual will utilize clinical knowledge and... ...treatment or inpatient confinement. This individual... ...decision to a second level reviewer. This individual...Remote workTemporary workMonday to FridayFlexible hours
- ...great opportunity for a local remote position. There is no... ...commercial, behavioral health, inpatient, etc.) PRN (at minimum, two... ...hospitalized patients ~2 years of Utilization Review (UR) experience reviewing... ...Education ~ Nursing Diploma/Associate's - Nursing...Remote workFull timeReliefLocal areaMonday to FridayFlexible hoursShift work
- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness... ...an active Maine RN license and at least 3 years of inpatient clinical experience. Additional benefits include...Remote workFlexible hours
- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail... ...Responsibilities Perform utilization reviews for inpatient, outpatient, observation, and post-acute care...Remote workFull timeSecond jobWork at office
$95k - $107.5k
...Full-time Description Title: Nurse Reviewer, Utilization Management Job Type: Full-time... ...per week in Brighton, MA office; 1 day remote FLSA Status: Exempt About Us... ...Discharge Coordination Perform inpatient concurrent review, monitor length of...Remote workFull timeLocal area- ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization... ...Perform utilization and concurrent reviews of inpatient cases using Milliman, Aetna, and BCBS criteria. Conduct...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
$77.08k - $119.47k
...00 Responsible for Utilization Management, Quality Screening... ...1. Registered nurse with a New York State... ...applicable to utilization review process. 8.... ...10. Understanding of Inpatient versus Outpatient surgery... ...cannot be done from a remote location. Other Requirements...Remote workShift work- ...for performing Workers' Compensation utilization review, which includes prospective, concurrent... ...retrospective utilization management, including inpatient services, outpatient services,... ..., Associate, bachelor's degree in nursing, or Master's level (or higher) degree...Remote workLong distance
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization... ...MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient List). They effectively and efficiently manage a...Remote workFull time
$40 - $50 per hour
Utilization review Registered Nurse ( Post service Medical Review 3) Working Shift - (08:00 AM - 05:00 PM) Remote in California 6+ Months Summary: The Facility Compliance Review team reviews... ...managed care experience including inpatient claims or concurrent review...Remote workContract workWork at officeLocal areaShift work- ...Management Location: 100% Remote Schedule: M-F 9:00am to... ...Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management... ...IL State Registered Nursing (RN) license in good...Remote workContract work
- Currently seeking a Utilization Management RN . Please see... ...below: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact to include... ...medical record review to determine medical necessity... ...medical necessity for inpatient admissions, continued...Remote workImmediate startDay shift
$55 per hour
...Akkodis is hiring a Concurrent Review Nurse to support our client in the... ...Healthcare space. Location: Remote (must be based in California... ...concurrent reviews of inpatient activities. This role is responsible... ...in case management, utilization management, or discharge planning...Remote workFull timeContract workTemporary workLocal area- Spectraforce is seeking an Utilization Review Registered Nurse (Post-service Medical Review 3) for remote work in California. The role focuses on retrospective utilization... ...5+ years in managed care, experience with inpatient reviews, and solid EMR and #J-18808-Ljbffr SpectraforceRemote jobContract work
- Akkodis is seeking a Concurrent Review Nurse for a remote role based in California. This position involves conducting concurrent reviews of inpatient activities, ensuring compliance with care standards, and collaborating with healthcare providers. The ideal candidate will...Remote jobContract work
- Iconma Portal is seeking a Registered Nurse-Review Analyst for a remote position with a Health Insurance client. You will conduct prospective, concurrent, and retrospective reviews across inpatient, outpatient, ambulatory, and ancillary services to verify medical necessity...Remote job
$17.83 - $23.55 per hour
...Center - EH Duluth Department: 2813340 INPATIENT REHAB - IRF Job Description: Apply... ...care! We are looking for a Compassionate Nursing Assistant to join our Inpatient Rehab Unit... ..., and wellness activities. 0.4 Possible Remote/Hybrid Option: Shift Rotation: Day/Eve/...Remote workLocal areaWork from homeFlexible hoursShift workNight shiftRotating shiftWeekend workDay shiftAfternoon shift- ...Institute is seeking an Advanced Practice Provider (APP) to join our inpatient cancer team at Geisinger Medical Center (GMC) in Danville, PA.... ...'s Degree-Physician Assistant (Required), Master's Degree-Nurse Practitioner (Required) About Geisinger OUR PURPOSE & VALUES...Full timePart timeShift workNight shift
- Ally Psychiatry is seeking compassionate PMHNPs and PAs to join our 100% remote inpatient call center team, providing overnight coverage and consult liaison services for hospitals across our network. You'll collaborate with experienced psychiatrists, hospital staff, and...Remote jobWork from homeFlexible hoursNight shift
- ...Remote role but will need to go to Newark, NJ to pick up equipment and orientation one day... ...Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess... .... 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
- ...developing, dynamic and collaborative Inpatient Transplant Nephrology team... ...pancreas transplant. As a Nurse Practitioner (NP) or... ...the early post-operative and remote post-transplant phase. Provide... ...The complete interview will be reviewed by a Mayo Clinic staff member...Remote workFull timeFlexible hoursNight shiftRotating shiftWeekend workDay shift
- ...developing, dynamic and collaborative Inpatient Transplant Nephrology team... ...pancreas transplant. As a Nurse Practitioner (NP) or... ...the early post-operative and remote post-transplant phase. Provide... ...The complete interview will be reviewed by a Mayo Clinic staff member...Remote work
$93.5 per hour
...range of professionals, including doctors, nurses, business people, tech experts,... ...designated patient population in the ambulatory, inpatient, operative, and/or procedural setting.... ...cardiac surgery or related specialty. Remote Type Onsite Work Location 75 Francis...Remote workHourly payDaily paidShift work- ...Institute is seeking an Advanced Practice Provider (APP) to join our inpatient cancer team at Geisinger Medical Center (GMC) in Danville, PA.... ...'s Degree-Physician Assistant (Required), Master's Degree-Nurse Practitioner (Required) About Geisinger OUR PURPOSE & VALUES...Full timePart timeShift workNight shift
- TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers’ compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to determine medical necessity and appropriateness...Remote job
$59.04 - $83.59 per hour
...range of professionals, including doctors, nurses, business people, tech experts,... ...designated patient population in the ambulatory, inpatient, operative, and/or procedural setting.... ...cardiac surgery or related specialty. Remote Type: Onsite Work Location: 75 Francis...Remote workHourly payDaily paidShift workRotating shift- ...Utilization Review Nurse Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a very broken healthcare system...Remote workFull time
- ...who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...company match Employee Referral Bonus Program JOB SUMMARY The Utilization Review Nurse is to assess the medical necessity and quality of healthcare...Remote jobFull timeTemporary workLocal area
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