Remote Utilization Review Nurse — Case Evaluator
$65k - $75kPiper Companies
- Remote job
Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to make high-quality care decisions. The ideal candidate will hold an active RN license with relevant experience. The position offers a salary between $65,000 and $75,000 along with company-subsidized benefits, including medical, dental, and vision. #J-18808-Ljbffr Piper Companies
- ...Summary: This position has a remote option for those living... ...as needed. The Utilization Review Nurse is responsible for determining... ...guidelines. Identify and present cases of possible quality of care... ...by medical providers to evaluate the medical necessity,...Remote workFull time
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position Type Full... ...time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review...Remote workHourly payFull timeWork at officeRelocation packageShift work- ...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...Remote workContract work
$130 per hour
A leading technology firm is seeking a Medical AI Quality Analyst to work remotely. The role involves evaluating AI-generated medical responses for accuracy and clinical relevance, and it requires experience in medical research and writing. Compensation is set at $130...Remote jobHourly payPart time- ...Description: Nurses – are you looking for a... ...Work-life balance. Remote setting ROLE DESCRIPTION... ...individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces with case managers and disease... ...review is required. Evaluates appropriateness of...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are...Remote workContract work
- ...Location: 100% Remote Schedule: M-F... ...Works with the Utilization Management team primarily... .../utilization review and other utilization... ...daily review and evaluation of members that require... ...with and refers cases to Client medical... ...State Registered Nursing (RN) license in good...Remote workContract work
- ...a Friend Back Remote Work from Home Share... ...MD 21076 Category: Nursing Schedule: Day Shift... ...- 5:00 PM As a Utilization Review Registered Nurse for... ...variety of settings Evaluate member benefits and... ...and responsibility. In cases where the range is displayed...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating... ...with Medicare guidelines. Refer cases outside established guidelines to... ...Physician Advisor for further evaluation. Maintain accurate records of authorizations...Remote workContract workWeekend work$33.6 - $51.39 per hour
...Missouri Categories: Case Coordination Job... ...opportunity for a local remote position. There is no... ...~2 years of Utilization Review (UR) experience reviewing... ...safe and quality care. Evaluate the cost and quality of... ...Requirements Education ~ Nursing Diploma/Associate's -...Remote workHourly payFull timeWork experience placementReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation:... ...homecare services, and durable medical equipment Refer cases to Medical Directors as needed/appropriate Maintain knowledge...Remote workHourly payMonday to Friday$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...Utilization Management, Utilization Review, or Case Management ~• Preferred Certifications...Remote workContract workImmediate startMonday to Friday- ...Currently seeking a Utilization Management RN .... ...: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact... ...RN , you will evaluate members’ clinical... ...through medical record review to determine... ...needed. Refer cases that do not meet criteria...Remote workImmediate startDay shift
- ...Functions Applies approved utilization criteria to monitor... ...levels of care and continued stay review. Communication to third-... ...with physician/provider and case manager/discharge planner when... ...with payer as determined by nursing judgment and/or collaboration...Remote workWork at officeShift workNight shiftRotating shift
- ...Position Summary The Utilization Review Nurse works as responsible for ensuring the receipt of high quality, cost efficient medical outcomes for... ...be responsible for maintaining a caseload for concurrent cases/ assisting in caseload coverage for the team. Establishes and...Remote workWork at office
$78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced... ...care. The role involves reviewing medical cases, collaborating with healthcare teams, and...Remote work- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor... ...(e.g., InterQual) to evaluate the appropriateness of care... ...review meetings to discuss cases, discharge plans, and barriers... ...for facility based staff; optional for remote staff.Remote workWork at office
$34 - $40 per hour
...Remote Clinical Review Nurses Urgent hiring for "Remote Clinical Review Nurses... ...Review approximately 20 cases a day for medical necessity... ...Qualifications: ~3+ years of utilization management, concurrent... ...sourcing, screening, and evaluating candidates. AI helps...Remote workContract workTemporary work$30 - $38 per hour
...Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time... .... Identify and refer potential cases to case management, wellness, chronic... ...communication skills to successfully perform in a remote healthcare environment. Ability to...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend work$30.64 - $45.8 per hour
...CA Utilization Review Nurse I Job Category: Case Management This is a remote position. Description The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment...Remote workHourly payFull timeWork at officeLocal areaFlexible hours- ...Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and appropriateness of medical services. The UMRN... ...license, and strong clinical experience, particularly in Case Management. The position allows for telecommuting and flexible...Remote workFlexible hours
$64.17k - $96.26k
...medical management. The Utilization Management Nurse and the Personal... ...provides utilization review/pre-certification on... ...specific and external case managers. All Medical... ...Collecting, analyzing, and evaluating clinical... ...functions. ~ Remote Work Environment...Remote workLocal areaRelocation packageFlexible hoursWeekend work$30.64 - $45.8 per hour
...The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective... ...of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours$41 - $45.5 per hour
...Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL... ..., monitoring, and evaluating healthcare services for... ...health education, and utilization management. Key Responsibilities... ..., and retrospective reviews for inpatient, rehab,...Remote work$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR... ...The Utilization Management Nurse evaluates clinical service requests to ensure... ...medical necessity Escalate complex cases to Medical Directors and request additional...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday$28.85 - $31.25 per hour
...recruiting firm is seeking a qualified professional to conduct utilization reviews in Fort Lauderdale, FL. The ideal candidate will have a... ...surgical or critical care, as well as utilization review and case management. Responsibilities include conducting pre-admission...Hourly pay$35.29 - $47.37 per hour
...individual and their work-life balance ~ Remote work options and Flexible scheduling... ...currently hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed nurse with... ...the coordination of care. Prepares any case that does not meet medical necessity guidelines...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours$34 - $40 per hour
...Base pay range $34.00/hr - $40.00/hr Remote (Compact Licensure Required) - Open to... ...Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient... ...with Medicare guidelines . Refer cases outside established guidelines to the...Remote workFull time$55 per hour
...from Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location: Remote (must be based in California) Employment... ...clinic setting. Preferred: Experience in case management, utilization management, or discharge planning....Remote workFull timeContract workTemporary workLocal area- ...remote position in any state except, NY, CA, HI, or AK max bill rate:... ...Discharge Care Coordination And Review Activities For Determining Efficiency... ...Of Care, Identify And Report Cases, And Provide Information Regarding Utilization Management Requirements And Operational...Remote workContract work
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