Remote Utilization Review RN - Managed Care
Johns Hopkins Medicine
Johns Hopkins Medicine is seeking a Utilization Review Registered Nurse based in Hanover, MD. This full-time role allows you to leverage your clinical expertise to enhance member care through effective monitoring and communication. Your insights on managed care will be essential to the decision-making process.
Join a forward-thinking team advocating innovative approaches to healthcare delivery. Enjoy perks like tuition assistance, work-life balance, and comprehensive insurance benefits while working remotely.
#J-18808-Ljbffr- ...Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to... ...entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care... ...hours per day, requiring an RN with a Bachelor's degree, state...Remote jobWork from homeMonday to Friday
$2,210 per week
...leader in personalized managed health care, focused on what's... ...Holidays Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- Job Title Utilization Review/Case Management - Nurse Department Case Management (Quality) Hours & Shift Requirements... ...Hybrid (combination of in person and remote considered) General Summary The... ...teams ensures safe transitions of care. Responsibilities Coordinate and...Remote workFull timeShift work
- ...Case Manager, RN- Utilization Review Under the general supervision of the Utilization Management Manager... ...to the most appropriate level of care based on nationally recognized admission... ...interdisciplinary collaboration in a remote or hybrid work environment. Qualifications...Remote workFull timeMonday to FridayShift work
- ...and monitoring the utilization of behavioral health... ...Director for review and works closely with Case Management to address member needs... ...benefits, and efficient care delivery processes.... ...and active NYS RN license required. Bachelors... ...be opportunity for remote work within all...Remote workContract workWork at office
$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... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate... ...Office, and 2+ years in UM within managed care. Prior experience in various reviews and...Remote workWork at office
- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established... ...successful candidate will bring 3+ years of acute care experience, knowledge of InterQual/MCG guidelines...Remote job
- ...Description Job Description The utilization review and management (UM) component program ensures that external... ...at the appropriate level of care, while supporting regulatory compliance... ...for lunch This is an in-office, no remote work capability position Travel...Remote workWork at office
- ...seeks an experienced RN to support Arizona Plan... ...clinical member services review processes. The role... ...license and experience with utilization management, prior authorization,... ...outpatient settings. Remote position, must reside... ..., quality member care through integrated #J...Remote job
- ...Hopkins Health Plans is seeking a Utilization Review Registered Nurse to apply clinical, managed care and utilization review expertise... ...improve member outcomes. This remote role supports the organization with... ...discharge planning. Maryland RN license (or compact) and 3+ years...Remote job
- ...completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...first week. This role will be remote BUT regular meetings/trainings... ...patients, including critical care, for appropriateness of...Remote workReliefWeekend work3 days per week
- ...Health Plans (JHHP) is the managed care and health services business... ...are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns... ...Work-life balance - This is a remote role! Candidates in the... ...Unencumbered Registered Nurse (RN) license in Maryland (or...Remote workFull timeMonday to Friday
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity... ...advisors, and collaborate with care management and financial clearance teams to... ...resources. Must hold an unrestricted RN or LPN license and have 3+ years...Remote job
$77.96k - $120.37k
...Job Description Job Description The Utilization Review Supervisor RN is responsible for directing the operations of their designated... ...resources, customer service, and limited sales management. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- UnitedHealth Group, via OptumCare, seeks a Concurrent Review Case Manager to monitor and document care, compare it with guidelines, and support discharge... ...coordination with medical leadership and multiple care teams. Remote work from anywhere in the U.S. is offered, with in-...Remote jobWork at office
$84.56k - $126.84k
...: Regular Job Overview The Utilization Review RN participates as a member of... ...Department Name: Utilization Management Job Status: part time, 24 hours... ...position will be primarily remote but there may be occasions... ...Assesses the continuity of care in conjunction with the Case...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has... ...UMRN). These will be completely remote positions, working entirely from... ...Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- ...community-driven Coordinated Care Organization (CCO)... ...preventative care to managing chronic conditions, we... .... Position Title Utilization Review Nurse Department Umpqua... ...Standard Time) Location Remote position Salary Wage... ...Registered Nurse (RN), BSN (Bachelor of Science...Remote workFull timeWork at officeLocal areaMonday to FridayFlexible hours
- ...oriented Registered Nurse (RN) to join a... ...specialized Critical Incident Management team within a... ...traditional bedside care and take on a position... ...be responsible for reviewing and evaluating... ...structured environment while utilizing technology to support remote and hybrid work...Remote workWork from home
$70k - $75k
...Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to... ...Job Description The Utilization Management Registered... ...performing utilization review activities in compliance... ...services Quality of care concerns Interfacing...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Details: Setting: Fully Remote – Utilization Review Schedule: Full-Time,... ...Job Requirements: Active RN license with Multi-State/Compact... ...nursing experience (acute care/hospital preferred)... ...medical necessity, utilization management, healthcare reimbursement,...Remote workFull timeMonday to Friday
$40.5 - $64.8 per hour
...our mission to deliver world-class care. Here, you'll work alongside some... ...Description **This is a remote casual position supporting Utilization Review at Catherine Gratz Griffin Lake Forest... ...to 6p or 6p to 6a. ** The Case Manager, RN (PT)reflects the mission, vision,...Remote workHourly payDaily paidWork experience placementCasual workLocal areaRelocation packageFlexible hoursRotating shiftWeekend workWeekday work- ...Details: Setting: Fully Remote – Utilization Review Schedule: Full-Time, Monday... ...Requirements: Active RN license with Multi-State/Compact... ...insurance-only Utilization Management experience is not eligible... ...Minimum 3 years of acute care/hospital RN experience...Remote workFull timeMonday to Friday
$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced Utilization Review... ...Specialist (RN) to join our remote home health team.This role is ideal... ...Branch Directors, Clinical Managers, and field cliniciansSupport quality...Remote workMonday to FridayWeekend work$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one... ...operations and utilization review. You will be responsible... ...services, coordinating care, and ensuring members receive...Remote workDaily paidContract workTemporary workMonday to FridayShift workWeekend work$63k - $65k
...RN Utilization Review By joining Sedgwick, you'll be part of something truly... ...with us, experience our caring culture, and enjoy work-life... ...to assist in the management of complex medical conditions... ...well-being of others in a remote work environment. Enjoy...Remote workWork experience placementLocal areaFlexible hours- ...Job Description Job Description Remote Utilization Review Registered Nurse (UR RN) Location: Remote (Texas RN... ...) to join our growing Utilization Management team. This fully remote position plays... ...medically necessary, high-quality care while promoting appropriate resource...Remote workFull timeWork at office
- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time remote role supports compliant, cost-effective care under Alabama...Remote jobFull timeContract work
- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote jobHourly payDaily paidDay shift
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