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

Remote Utilization Management Specialist - RN or MSW

Logan Health

Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation and determining appropriate admission status across the hospital system.

You will collaborate with physicians, case management and insurers to authorize care and ensure medical necessity. The position emphasizes strong clinical judgment, communication and EMR proficiency, with a four-day work week and remote options for Montana residents.

#J-18808-Ljbffr
Vacancy posted 10 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Specialist - RN or MSW in Montana vacancy
  • $72.8k - $130k

     ...an occasional opportunity for remote work based on business needs.   As a Sr Utilization Management Nurse in the Springfield MA Regional...  ...~ Must be a Registered Nurse (RN) with a current, active,...  ...Massachusetts ~ Must currently have OR be able to obtain an RAC/CT MDS... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Casual work
    Live in
    Work at office
    Local area

    Optum

    Amherst, MA
    4 days ago
  • $101.72k - $198.36k

     ...California - Ability to work remote, but selected candidate must...  ...position requires California RN Licensure. Candidates must have...  ...of the following functions: utilization management, care management, behavioral...  ...regulation, business operating model, or state board licensing... 
    Remote work
    Contract work
    Work experience placement
    Work at office
    Local area

    Molina Healthcare Careers

    Bakersfield, CA
    28 days ago
  • $63.1k - $94.65k

     ...technology-enabled revenue cycle management solutions for health systems...  ...*Must have current compact RN license, or be willing to obtain* Schedule Information: Our Utilization Review team provides...  ...Abilities Required: This is a remote role which requires access... 
    Remote work
    Temporary work
    Part time
    Work at office
    Local area
    Flexible hours
    Shift work

    Ensemble Health Partners

    Columbus, OH
    2 days ago
  • $100k - $130k

     ...those who need it most. The Utilization Management (UM) team plays a vital role...  ...guidelines. As the Lead RN, Utilization Management, you...  ...Bachelor of Science in Nursing or equivalent relevant experience...  .... Additionally, we embrace a remote-first culture that supports... 
    Remote work
    Full time
    Work experience placement
    Work at office
    Flexible hours

    Clover Health

    Remote
    10 days ago
  • $53.19k - $82.43k

     ...Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization...  ...information is current and complete. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia,... 
    Remote work
    Full time

    Cedars-Sinai

    Georgia
    7 days ago
  • Highmark Health is seeking a remote Care Manager RN to support utilization management and care coordination. The role requires weekend availability (Saturday...  ...with providers to optimize care. A PA RN license (or multi-state via eNLC) is preferred, with substantial clinical... 
    Remote job
    Weekend work
    Weekday work

    Highmark Health

    Kansas City, MO
    3 days ago
  • $90.9k - $129.9k

     ...for this role, rather you will provide utilization review and quality assurance. Your role...  ...outcomes into the Medicaid Management Information System (MMIS) for processing...  ...should expect in this role ~100% Remote home office. ~ Full-time position.... 
    Remote work
    Full time
    Work experience placement
    Home office
    Flexible hours

    Gainwell Technologies LLC

    Wisconsin
    3 days ago
  • $69.39k - $88.61k

    Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and...  ...s degree in a related field, an active RN/Social Work/Clinical Counselor license,... 
    Remote job
    Full time

    Cincinnati Children's

    New York, NY
    4 days ago
  •  ...Case Manager - Utilization Review Specialist - Remote Full-Time Position You must reside in one of these states to be eligible for position: Arkansas...  .../TRAINING & EXPERIENCE: Current state-issued RN license. Knowledge in areas such as InterQual Level of... 
    Remote work
    Full time

    Quorum Health

    Massachusetts
    15 hours ago
  •  ...Adventist Health in Roseville, CA, is seeking a registered nurse in Utilization Management to ensure high-quality patient care while optimizing resources. You will review medical records for appropriateness of treatments, collaborate with healthcare providers and insurers... 

    Adventist Health

    Roseville, CA
    4 days ago
  • $47.03 - $63.48 per hour

     ...enabled revenue cycle management solutions for health...  ...possible in healthcare. RN, Senior Utilization Review Quality will...  ...other UR Quality Specialist and UR team members to...  ...Specialty/Major: Nursing or related field...  ...experiences This is a remote position; however, candidates... 
    Remote work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    Columbus, OH
    2 days ago
  • Cedars-Sinai is seeking a skilled Utilization Management Specialist to support UR Nurses in timely, compliant utilization review processes. You will manage case portfolios, assemble documentation for payer submissions, and monitor payer timelines to prevent delays. In collaboration... 
    Remote job

    Cedars-Sinai

    Sacramento, CA
    2 days ago
  • $133.25k - $199.87k

     ...We’re seeking a vision-driven Clinical Manager (RN or MSW) to partner with our Care Coordination Director and shape the future of our Case...  .... Current or previous hospital case management or utilization review experience. Current or previous case management or... 
    Full time
    Work experience placement
    Relocation package

    Seattle Children's

    Washington DC
    4 days ago
  • Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know...  ...incumbents to operate a INTEGRIS-owned vehicle OR personal vehicle (non INTEGRIS-owned) and... 
    Remote work
    Full time
    Work at office
    Weekend work

    INTEGRIS Health

    New York, NY
    1 day ago
  • Utility Vegetation Management Specialist Job Type - Full Time Who You Are: You’re energetic and enjoy working outdoors. You understand that this space...  ...operation and foot patrol of utility power lines; remote locations as well as urban, city environment; physical... 
    Remote work
    Full time

    Atlas Field Services, LLC

    Royal Oak, MI
    2 days ago
  •  ...of a partner company, who manages all applications and next steps...  ...for a Case Manager – Utilization Review Specialist based in the United States....  ...payer requirements. In this remote role, you will oversee admission...  ..., active registered nurse (RN) license issued by a U.S.... 
    Remote work
    Full time
    Live in

    Jobgether

    Wyoming State
    2 days ago
  • MU Health Care is seeking a Utilization Management Analyst RN to oversee patient admissions, reviews, and ensure medical necessity and efficient care. The role emphasizes maximizing reimbursements while advocating for patients, educating staff and physicians on utilization... 

    MU Health Care

    Columbia, MO
    4 days ago
  • Summa Health System is seeking a Full-Time Utilization Management Nurse to optimize cost-effective care across the hospital care continuum. The role involves performing initial and concurrent reviews, aligning with Medicare/ payer guidelines, and applying clinical criteria... 
    Full time

    Summa Health System

    Cleveland, OH
    1 day ago
  • $2,221 per week

     ...Registered Nurse (RN) | Case Manager Location: Portland, OR Agency: Atlas MedStaff Pay: $2,221 per week Shift Information: Days - 5 days...  ...not either since a lot of our team has been working remote since the pandemic), but you are part of the Atlas Community... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Work at office
    Shift work
    Weekend work

    TravelNurseSource

    Portland, OR
    1 day ago
  • $60.53k - $129.63k

     ...person, one family and one community at a time. Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) Remote | Full-Time | Monday-Friday Are you a...  ...similar UM platforms ~ Ambulatory surgery or outpatient clinical experience ~ Bachelor... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Work from home
    Monday to Friday
    Afternoon shift

    CVS Health

    Delaware State
    2 days ago
  •  ...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

    First Connect Health

    Austin, TX
    2 days ago
  •  ...Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation... 
    Remote work

    Guide-Health

    Gary, IN
    10 hours ago
  •  ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare... 
    Remote work
    Contract work

    The Judge Group

    Chicago, IL
    10 hours ago
  • $128k - $191k

    Job Title Principal Consultant - Utility Revenue Requirements Specialist Location Marlborough, MA or Washington, DC; open to remote employees Company Description Concentric Energy...  ...( (“Concentric”) is an employee‑owned management consulting and financial advisory firm... 
    Remote work
    Work at office
    Flexible hours

    Concentric Energy Advisors

    Marlborough, MA
    4 days ago
  •  ...Arkansas Blue Cross and Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions...  ...to guide cost-effective care. Candidates should have an RN license in good standing, a Bachelor's degree in Nursing preferred... 
    Remote work
    Home office

    Arkansas Blue Cross and Blue Shield

    Arkansas
    10 hours ago
  •  ...CVS Health is seeking a Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) to support treatment decisions remotely. You will collaborate with providers and apply clinical judgment for the right care at the right time. An active RN license... 
    Remote work
    Work at office

    CVS Health

    Crystal Bay, NV
    10 hours ago
  •  ...is seeking an experienced Registered Nurse to join the Utilization Management team in a remote, full-time role focused on Medicare joint procedures. You...  ...appropriate services. Ideal candidates have an active RN license in their state, 3+ years of RN experience, and... 
    Remote work
    Full time
    Work at office

    CVS Health

    West Virginia
    10 hours ago
  • Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. The role reports to the Manager of Utilization... 
    Remote job

    Humana

    Columbus, OH
    5 days ago
  • Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and serve on the One Home/Home... 
    Remote job

    Humana

    Kansas City, MO
    4 days ago
  •  ...Utility Project Support Specialist ERM is hiring remote Utility Project Support Specialists to support our client based in the Danville, IL area. In this critical...  ...of 12 months, extendable. Responsibilities Manage large amount of inbound and outbound phone calls... 
    Remote work
    Part time
    Fixed term contract
    Casual work
    Shift work

    Erm LLC

    Kankakee, IL
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management Specialist - RN or MSW. Be the first to apply!