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$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 workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area$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 workContract workWork experience placementWork at officeLocal area$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 workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$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 workFull timeWork experience placementWork at officeFlexible hours$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 workFull time- 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 jobWeekend workWeekday work
$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 workFull timeWork experience placementHome officeFlexible hours$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 jobFull time- ...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 workFull time
- ...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...
$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 workTemporary workWork at officeLocal area- 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
$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 timeWork experience placementRelocation package- 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 workFull timeWork at officeWeekend work
- 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 workFull time
- ...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 workFull timeLive in
- 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...
- 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
$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 workHourly payFull timeContract workWork at officeShift workWeekend work$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 workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon 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
- ...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
- ...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 workContract work
$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 workWork at officeFlexible hours- ...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 workHome office
- ...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 workWork at office
- ...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 workFull timeWork at office
- 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 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
- ...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 workPart timeFixed term contractCasual workShift work
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!
- technology integration specialist Montana
- deployment specialist Montana
- qc specialist Montana
- ecommerce specialist Montana
- title specialist Montana
- records management specialist Montana
- prior authorization specialist Montana
- placement specialist Montana
- color specialist Montana
- provider relations specialist Montana






