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
- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital... .... Identify and present cases of possible quality of care deviations... ...by medical providers to evaluate the medical necessity, appropriateness...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
$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- ...Autonomous Driving Edge Case Task Evaluator is a remote evaluation track for reviewing autonomous driving edge case task evaluation prompts and responses against AuraOne's quality rubric. Reviewers compare paired outputs, label edge cases, and write the kind of structured...Remote jobHourly payFor contractors10 hours per week
$50 per hour
...transcribing, annotating, and evaluating Hindi audio and video to help... ...engagement performed remotely, with occasional in-person collaboration... ...Identify linguistic edge cases such as colloquialisms, grammatical... ...document them for consistent reviewer application. Run prompts...Remote workHourly payTemporary work10 hours per week- ...Providence is seeking a Utilization Review RN for a remote, full-time role in the California region. The position... .... Ideal candidates have an AD nursing degree, California RN license, and at least two years of remote UR or case management experience. #J-18808-LjbffrRemote workFull time
- 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
$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$26.41 - $51.49 per hour
...years of experience. Remote position, must reside... ...member services review assessment processes. Responsible... ...• Refers appropriate cases to medical directors (... ...model. • Adheres to utilization management (UM)... ...experience. • Registered Nurse (RN). License must be active...Remote workHourly payWork experience placementWork at officeMonday to FridayWeekend work$35 - $40 per hour
...Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and... ...services based on Medicare guidelines. Refer cases outside of established guidelines to the Utilization...Remote workContract workFlexible hoursWeekend work- ...Utilization Review Medical Appeals Nurse - USRN NTT DATA Services is currently seeking a Utilization Review... ...and Responsibilities: Prepares case reviews for Medical Directors by... ...analytic skills ~ Required shift timings - US daytime ~ Can work remotely...Remote workShift work
- ...Authorization Analyst Location: St. Louis, Missouri (Partial Remote) Role Overview We are seeking two detail-oriented... ..., specifically for Blue Cross Blue Shield cases. The successful candidates will be responsible for reviewing clinical notes and documents to ensure accurate...Remote 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$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- ...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
- ...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
$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- ...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
- ...analysis to process, evaluate and make recommendations... ...Responsibilities: • Reviews documentation and... ...Potential Quality of Care cases across all lines of business... ...• Registered Nurse in state of residence... ...have prior authorization utilization experience • Able to...Remote 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$30.64 - $45.8 per hour
...Utilization Review Nurse The Utilization Review Nurse gathers demographic and clinical information on prospective... ...length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position. Essential Functions &...Remote workHourly payFull timeWork at officeLocal areaFlexible hours- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
$35 - $45.94 per hour
...Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.... ...role: You will perform frequent case reviews, check medical records and... ...Review. Work Location: This is a remote position, open to candidates who reside...Remote workHourly payFull timeWork from homeHome officeWeekend work$30 per hour
...Compensation: $20-$30/hour Location: Remote Commitment: 10-40 hours/week Role Responsibilities Evaluate outputs from large language... ...rubrics and quality standards. Review multi-step agent workflows,... ...consistently while identifying edge cases and recurring failure patterns....Remote jobHourly payContract work$47 per hour
Pool Utilization Review Registered Nurse, Case Management, Per Diem, Shift Varies (Rotating Weekends) - 160045 Baptist Health is the region's largest not‑for‑profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers...Daily paidLocal areaShift workRotating shift$125 per hour
...outpatient psychotherapy and evaluations for ADHD and Autism. This role... ..., you will be trained to utilize standardized questionnaires and... ...discussed during interview Location Remote/Hybrid to start with the... ...Participate in bi-weekly case consultation and supervision...Remote workHourly payFull timePart timeFlexible hours$50 - $60 per hour
...while enjoying the flexibility of remote work and the freedom to set... .... In this role, you might: Review and improve AI Assistant... ...real-world scenarios and edge cases to see where their reasoning holds... ...diverse and complex problems and evaluate their outputs Evaluate the...Remote workHourly payFull timeContract workPart timeWork experience placementFlexible hours
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