Remote RN Clinical Review Nurse: Utilization & Discharge
Centene Corporation
Centene Corp. is seeking a fully remote nurse reviewer to evaluate concurrent care plans and determine appropriate levels of care for members. The role prefers an active NY State RN license and requires availability Monday–Friday, 8:30 AM–5:00 PM ET with a one-hour lunch.
Responsibilities include reviewing acuity and discharge planning, collaborating with Medical Affairs, documenting findings, and educating providers on utilization processes. Pay ranges are stated and benefits are offered.
#J-18808-Ljbffr- Centene Corp. is seeking a Remote Nurse Care Reviewer to perform concurrent reviews and validate the appropriate... .... The role supports inpatient and discharge planning across states including... ...weekends/holidays. Ideal candidates hold RN or LPN licensure, 2+ years of acute...Remote jobWeekend work
- Centene Management Company LLC is seeking a remote Nurse Reviewer to support Marketplace/Ambetter members... ...determining appropriate level of care, discharge planning, and collaboration with... ...-effective care. Ideal candidates hold RN or LPN licensure, have acute care experience...Remote job
- CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary... ...years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate degree (...Remote jobWork from homeMonday to FridayWeekend work
- ...Centene Corporation seeks a remote RN for concurrent reviews to determine appropriate care levels and discharge plans. The role supports Ambetter members in Georgia with... ...acute care experience and familiarity with utilization management are preferred. Responsibilities...Remote work
- ...HealthEdge is seeking a highly motivated Utilization Review RN to join our team. The role involves... ...outpatient settings. The position supports remote work in the US, requires an... ...and may include responsibilities around discharge planning, documentation, and coordination...Remote workContract work
- ...Ensemble Health Partners is seeking a remote Utilization Review RN to assess and optimize patient care utilization... ...and at least three years of acute care nursing experience, with experience in utilization review or discharge planning preferred. Competitive pay with...Remote workFlexible hoursShift work
- ...Ascension seeks an experienced RN for Utilization Management in a fully remote, day-shift role. You will review admissions to ensure medical necessity and guide patient... ...management, coordinating care transitions and discharge planning. Responsibilities include...Remote workDay shift
- ...Group seeks an Inpatient Care Management Nurse RN for a remote role across the U.S. The position focuses on reviewing inpatient cases, coordinating plans of care... ...medical directors to ensure appropriate utilization and discharge planning. Strong nursing experience and...Remote work
- ...Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana... ...medical necessity, insurance requirements, and discharge planning in collaboration with physicians and care...Remote workPart timeRelief
- ...HealthEdge Software, Inc. is seeking a highly motivated Utilization Review RN to join our team. The RN will perform prospective, concurrent... ...include authorizing services, coordinating discharge planning, and documenting outcomes while maintaining regulatory...Remote workContract work
- ...Asante is seeking a Utilization Review Nurse to monitor utilization from preadmission to discharge, ensuring cost-effective, quality patient... ...regulatory compliance in a remote, full-time role. The position... ...for appropriate status. Oregon RN licensure and 2 years of acute...Remote workFull timeShift workWeekend work
- ...Sentara Health Plans is hiring a Utilization Review RN for Imaging/Commercial with remote flexibility. The role requires a Virginia- or compact-licensed RN,... ...Responsibilities include prior authorization, discharge planning, and appeals where needed. Remote opportunities...Remote workWeekend work
- ...Health Partners is seeking a Lead Utilization Review RN to drive medical necessity reviews, discharge planning, and appeals... ...collaborating with physicians, nurses, and payors. The role supports... ...and patient care quality in a remote US-based environment. You will...Remote work
- ...Travel RN - Case Management/Utilization Review - Case ManagementAmerican TravelerSan Francisco... ...case management and discharge planning experience for a... ...2 days onsite and 3 days remote per weekFloats between Emeryville... ...preferredPrevious charge nurse experience...Remote workWeekly payContract workLocal areaShift workNight shift
- ...BlueCross BlueShield of South Carolina is seeking a Remote RN Medical Reviewer II to perform medical reviews using clinical documentation and established guidelines. You... ...medical necessity, and support claims and utilization practices in a work-from-home setup. The...Remote workWork from home
- ...Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case Management... ...that appropriate and accurate clinical information is communicated to payers... ...Assists in sending admitting and discharge clinicals on all patients Review Process...Remote workWork at officeFlexible hours
- HonorHealth is seeking an RN Utilization Review Specialist to review and monitor health care service utilization, ensuring appropriate levels... ...AHCCCS, self-pay, and other payers from admission through discharge. You will work with the Care Management team to ensure documentation...Remote jobDaily paid
- ...Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote work with a Central Time Zone... ...determining level of care, and contributing to discharge planning. Qualifications include a... ...) and compact nursing licensure (RN/LPN/LVN). Requires 1+ years of...Remote workWeekend work
- ...Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-... ...to hire. The role is remote with work location listed as... ...necessity, and contribute to discharge planning according to care policies... ...an Associate degree, RN license in MS or a compact state...Remote workContract work
- Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service... ...supports complex cases and discharge planning across the... ...organization. The role requires Texas RN licensure and a nursing...Remote job
- ...has been placing experienced nurses and therapists in home care,... ...with a need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an... ...experience, managed care, and discharge planning experience to be considered...Remote workContract workMonday to FridayFlexible hours
- ...navigation organization is seeking a Utilization Review Nurse in Dublin, OH. The role involves... ...medical service requests, assessing clinical criteria, and facilitating discharge planning for patients. Candidates should have a current RN license in Ohio, with a minimum of...Work at office
$2,627 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Dalton... ...an RN Case Manager with discharge planning experience,... ...6 months Prior travel nursing experience required Candidates who have been remote for the past 6 months must...Remote workWeekly payPermanent employmentShift workWeekend workDay shift$47.03 - $63.48 per hour
...in healthcare. The RN, Senior Utilization Review Quality will play an... ...medical necessity, clinical documentation, compliance... ...; Specialty/Major: Nursing or related field... ...Utilization review/discharge planning experience... ...experiences This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area$30.37 - $59.21 per hour
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req) CA, United States and 5 more... ...Summary Provides support for clinical member services review... ...model. Adheres to utilization management (UM) policies... .... Registered Nurse (RN). License must be active...Remote jobHourly payFull timeWork experience placementWork at office$1,400 - $1,550 per week
...Job Summary Travel RN Utilization Review - Discharge Planner - CA 301024 Talented Medical Solutions Full-time, Contract In-Office | Willows... ...The name of the Job Order is CA - Utilization Review Nurse Job order number is 301024 Full Details of Job...Hourly payFull timeContract workWork at officeShift work- ...Join our team as a remote (Oklahoma City) full... ...every other weekend RN Case Manager -Utilization Review at INTEGRIS Health,... ...assessment of patients clinical, psychological and... ...necessary, a plan for discharge, including referrals... ...hire RN (Registered Nurse) Current licensure...Remote workFull timeWork at officeWeekend work
$63.1k - $94.65k
...current compact RN license, or be willing... ...seeking Virtual Utilization Review Specialist with... ...approved clinical review criteria to... ...the physicians, nurses, multidisciplinary... ...Utilization review/discharge planning experience... ...Required: This is a remote role which...Remote workTemporary workWork at officeLocal areaMonday to FridayShift work$25k
...Click Here Position: UTILIZATION REVIEW RN- Case Management (IN PERSON... ...using evidence-based clinical guidelines. Identifies and... ...outreach to coordinate post-discharge care, encourage use of in-network... ...follow-up. Applies the nursing process and critical...Permanent employmentWork at officeRelocation package$81.95k - $110.24k
...healthcare. The Lead Utilization Review RN is a key contributor... ..., quality, and clinical performance of the organization... ...with physicians, nurses, other patient care... ...readmissions to the liaison. DISCHARGE PLANNING: Through... ...#LI-LS1 #LI-REMOTE Join an award-winning...Remote workFull timeWork at officeLocal area
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