Utilization Review Nurse

Santa Barbara Cottage Hospital

Humana is seeking a Compliance Nurse 2 to review utilization management activities and documentation, ensuring adherence to policies, procedures, and regulations. The role involves analyzing data to assess outcomes and operational metrics and making independent judgments within guidelines. Schedule features a four-day workweek of ten hours, with Wednesday–Sunday or Thursday–Sunday layouts, and shifts between 8:00 a.m. and 8:00 p.m. EST. #J-18808-Ljbffr

Apply

Vacancy posted 1 day ago

Similar jobs that could be interesting for youBased on the Utilization Review Nurse in New York, NY vacancy

Utilization Review Registered Nurse
...a nationally recognized health system, seeks an experienced RN to join our per diem utilization management team from home in Pennsylvania. The role supports medical necessity reviews and level of care determinations. You will review cases, ensure documentation accuracy...
Suggested
Daily paid
Santa Barbara Cottage Hospital
New York, NY
3 hours ago
Utilization Review Nurse
$18k
...healing ministry within the communities we serve. Our doctors, nurses, and allied health professionals are a regular self-contained... ..., performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources...
Suggested
Full time
Part time
Live out
Santa Barbara Cottage Hospital
New York, NY
3 days ago
Utilization Review Nurse
A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...
Suggested
Remote work
Flexible hours
Weekend work
Day shift
The Judge Group, LLC
New York, NY
3 days ago
Utilization Review Nurse
$35 - $43 per hour
...Base pay range $35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only –... ...The Clinical Review Nurse – Concurrent Review will perform utilization management functions to ensure members receive the right care...
Suggested
Remote work
IMCS Group
New York, NY
3 days ago
Remote Utilization Review Nurse: Medicare & Home Health
A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with...
Suggested
Remote work
Medix
New York, NY
3 days ago
Utilization Review Nurse
...Responsibilities Responsible for utilization review work for emergency admissions and continued stay reviews. Review and evaluate electronic... ...in emergency room, critical care and/or medical/surgical nursing At least 2 years utilization management experience in acute...
For contractors
Work at office
Remote work
Netsmart
New York, NY
3 days ago
Utilization Review Nurse
...Currently seeking a Utilization Management RN . Please see details and qualifications below... ...Must have an active PA license or a Nurse Licensure Compact to include PA. ** Minimum... ...conditions through medical record review to determine medical necessity for services...
Immediate start
Remote work
Day shift
The Judge Group, LLC
New York, NY
1 day ago
Remote Utilization Review Nurse - Case Management
A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...
Contract work
Remote work
IntePros
New York, NY
3 days ago
Remote Utilization Review Nurse (LPN/LVN) - UM & Appeals
...Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit...
Remote work
Santa Barbara Cottage Hospital
New York, NY
3 days ago
Utilization Review Nurse
$35 - $45 per hour
Base pay range $35.00/hr - $45.00/hr Direct message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs while ensuring compliance with federal...
Contract work
Remote work
Weekend work
IntePros
New York, NY
3 days ago
Utilization Review Nurse
...PA, NJ, or DE Employment type: Contract to full-time hire Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This position is ideal for an RN with prior work in insurance utilization...
Full time
Contract work
Remote work
IntePros
New York, NY
4 days ago
Utilization Review Nurse: Drive Efficient Patient Care
An established industry player in healthcare is seeking a dedicated Utilization Review Nurse to join their team. This role involves conducting critical reviews to ensure efficient resource use and high-quality patient care. You will collaborate with clinical staff and...
Santa Barbara Cottage Hospital
New York, NY
3 days ago
Utilization Review Nurse
$65 per hour
Job Title: Registered Nurse (RN) - Case Management Location: New York, NY 10037 Start... ...resources, and ensure appropriate utilization of healthcare services while maintaining... ...discharge planning. Conduct utilization review to ensure appropriate level of care and...
Hourly pay
Weekly pay
Local area
Shift work
Pride Health
New York, NY
3 days ago
Utilization Review Nurse - 244996
$34 - $40 per hour
.../hr - $40.00/hr Remote (Compact Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health services. In this role, you will coordinate and...
Full time
Remote work
Medix™
New York, NY
3 days ago
Utilization Review Nurse: Optimize Care & Compliance
A community hospital in Arizona is seeking a Utilization Management Nurse to ensure healthcare efficiency and quality through diligent review of medical records and adept communication. You'll engage with multiple stakeholders to uphold clinical decision-making and regulatory...
Santa Barbara Cottage Hospital
New York, NY
3 days ago
Utilization Review Nurse Analyst | Quality & Compliance
A healthcare solutions company is seeking a Utilization Management Nurse Reviewer to assess the appropriateness of medical services and collaborate with healthcare professionals. This role requires a Licensed Practical/Vocational Nurse with clinical experience and skills...
Dane Street
New York, NY
3 days ago
Remote Utilization Review Nurse (LVN/LPN)
Molina Healthcare is seeking a Remote Medical Review Nurse (LVN/LPN) for PST schedule in the United States. The role involves reviewing documentation to ensure medical necessity and appropriate level of care, with focus on coding accuracy and reimbursement. The candidate...
Remote job
Shift work
Molina Healthcare
New York, NY
4 days ago
Remote Utilization Review Nurse | P2P & Denials Expert
Mass General Brigham Incorporated is seeking a P2P Utilization Review Nurse to join the Central Utilization Management team. You will identify, prepare, and clinically review cases requiring payer peer-to-peer discussions, focusing on concurrent level-of-care denials and...
Remote job
Santa Barbara Cottage Hospital
New York, NY
5 days ago
Travel Nurse RN - Progressive Care Unit - $1,763 to $3,145 per week in New York, NY
$1,763 - $3,145 per week
...Registered Nurse (RN) | Progressive Care Unit Location: New York, NY Agency: job.com Pay: $1,763 to $3,145 per week Shift Information: Days - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position Registered...
Weekly pay
Full time
Contract work
Immediate start
Shift work
job.com
New York, NY
5 days ago
Travel Nurse RN - Progressive Care Unit - $1,824 to $2,630 per week in New York, NY
$1,824 - $2,630 per week
...Registered Nurse (RN) | Progressive Care Unit Location: New York, NY Agency: job.com Pay: $1,824 to $2,630 per week Shift Information: Nights - 4 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource...
Weekly pay
Full time
Contract work
Immediate start
Shift work
Night shift
TravelNurseSource
New York, NY
5 days ago
Travel registered nurse care
$2,836 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York City, NY Agency: Cynet Health Pay: $2,836 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 9/7/2026 About the Position TravelNurseSource...
Full time
Contract work
Flexible hours
Shift work
TravelNurseSource
New York, NY
1 day ago
Travel Nurse RN - Neuro - $55 to $60 per hour in New York, NY
$55 - $60 per hour
...Registered Nurse (RN) | Neuro Location: New York, NY Agency: MD Nurse Staffing, LLC. Pay: $55 to $60 per hour Shift... ...condition. Support efficient patient flow and effective utilization of clinical resources. Demonstrate professional communication...
Hourly pay
Weekly pay
Full time
Contract work
Local area
Monday to Friday
Shift work
MD Nurse Staffing, LLC.
New York, NY
18 hours ago
Travel Nurse RN - Neuro - $2,237 per week in New York City, NY
$2,237 per week
...Registered Nurse (RN) | Neuro Location: New York City, NY Agency: Prime Staffing... ..., Purposeful Hourly Rounding, Medication Review, Discharge Wrap Up, and MD/RN Unit... ...institutional chain of command protocol. 9. Utilizes institutional information technology by documenting...
Hourly pay
Daily paid
Permanent employment
Full time
Contract work
Temporary work
Local area
Shift work
Night shift
TravelNurseSource
New York, NY
1 day ago
TRAVEL/TEMP Registered Nurse (RN)
$2,328 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York, NY Agency: OneStaff Medical Pay: $2,328 per week Shift Information: Rotating - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 7/31/2026 About the Position TravelNurseSource...
Hourly pay
Full time
Contract work
Temporary work
Work experience placement
Work at office
Flexible hours
Shift work
TravelNurseSource
New York, NY
1 day ago
Travel RN (Registered Nurse) | Urgent Needs
$2,578 - $2,757 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York, NY Agency: Host Healthcare Pay: $2,578 to $2,757 per week... ...that was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...
Full time
Contract work
Local area
Immediate start
Shift work
TravelNurseSource
New York, NY
1 day ago
Travel RN (Registered Nurse) | Urgent Needs
...Registered Nurse (RN) | Wound/Ostomy Location: New York, NY Agency: Lancesoft Inc Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 4 days x 9 hours Contract Duration: 14 Weeks Start Date: ASAP About the Position...
Weekly pay
Full time
Contract work
Immediate start
Shift work
Lancesoft Inc
New York, NY
1 day ago
Travel registered nurse care
$1,756 - $1,848 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York, NY Agency: Specialty Professional Services Pay: $1,756 to $1,848 per week Shift Information: 8 hours Contract Duration: 14 Weeks Start Date: 9/21/2026 About the Position Our Client...
Extra income
Full time
Contract work
Shift work
Specialty Professional Services
New York, NY
1 day ago
Travel / registered nurse / care nurse
$3,242 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York City, NY Agency: Cynet Health Pay: $3,242 per week Shift... ...available community resources helpful to clients and assist them in utilizing such resources. Manage assets related to rented equipment,...
Full time
Contract work
Shift work
Cynet Health
New York, NY
1 day ago
Travel Nurse RN - Neuro - $57 to $65 per hour in New York, NY
$57 - $65 per hour
...Registered Nurse (RN) | Neuro Location: New York, NY Agency: MD Nurse Staffing, LLC. Pay: $57 to $65 per hour Shift Information: Nights - 3 days x 12 hours Start Date: 8/31/2026 About the Position RN – Neuro | Manhattan, NY | 13-Week Contract...
Hourly pay
Weekly pay
Full time
Contract work
Local area
Shift work
Night shift
MD Nurse Staffing, LLC.
New York, NY
8 days ago
TRAVEL/TEMP Registered Nurse (RN)
$2,328 per week
...Registered Nurse (RN) | Wound/Ostomy Location: New York, NY Agency: OneStaff Medical Pay: $2,328 per week Shift Information: Rotating - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 7/31/2026 About the Position We. Are. OneStaff...
Hourly pay
Full time
Contract work
Temporary work
Work experience placement
Shift work
OneStaff Medical
New York, NY
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Utilization Review Nurse. Be the first to apply!