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
- ...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
- 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 jobContract work
- ...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
$35 - $45.94 per hour
...Utilization Review Nurse Remote Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the Role You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed...Remote workHourly payWork from homeHome officeWeekend work$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges... ...clinical criteria for decision-making, referring complex cases to Medical Directors when needed. Engage with providers...Remote workFull timeContract workWork at officeWork from homeFlexible hours$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$30 - $40 per hour
...RN Clinical Review Nurse (Utilization Review Nurse)The Clinical Review Clinician for Appeals is responsible... ...) standards.Responsibilities:Prepare case reviews for Medical Directors by... ...Leave)Workplace Type:This is a fully remote position.Application Deadline:This position...Remote workContract workTemporary 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
$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$30 - $40 per hour
...Job Title: RN Clinical Review Nurse (Utilization Review Nurse) Job Description... ...Responsibilities Prepare case reviews for Medical... ...Workplace Type This is a fully remote position. Application Deadline... ...sourcing, screening, and evaluating candidates. AI helps assess...Remote workContract workTemporary work- ...summary: Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure... ...in utilization review or case management is highly beneficial, particularly... ...week in the office and three days remote. Candidates must also have flexibility...Remote workWork at officeImmediate startFlexible hours2 days per week
$30 - $40 per hour
...changing decisions, one review at a time? Why... ...clean, well-documented case. Your reviews are the... ...medical-necessity reviews: Evaluate requested services... ...Graduate of an accredited nursing program (ADN or... ...similar setting) ~ Utilization review/utilization management...Remote workHourly payImmediate startMonday to FridayFlexible hours$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- ...Responsibilities Responsible for utilization review work for emergency... ...reviews. Review and evaluate electronic medical... .../or medical/surgical nursing At least 2 years utilization... ...in Nursing (BSN) Case Management... ...Expectations Comfortable with remote work arrangements and...Remote workFor contractorsWork at office
- 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 jobContract work
- Penn Medicine is seeking an Utilization Review Nurse in Bala Cynwyd, PA. The role supports timely and accurate utilization review to determine medical... .... Responsibilities include collaborating with physicians, case management, revenue cycle, and interdisciplinary teams to...Remote job
- Currently seeking a Utilization Management RN .... ...below: Position is remote - candidate must... ...active PA license or a Nurse Licensure Compact... ...RN , you will evaluate members’ clinical... ...through medical record review to determine... ...when needed. Refer cases that do not meet criteria...Remote workImmediate startDay shift
$1,966 per week
...first 25 applicants Nurses - are you looking... ...Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces with case managers and disease... ...is required. Evaluates appropriateness of...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours- ...Management Location: 100% Remote Schedule: M-F 9:0... ...Works with the Utilization Management team... .../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
- ...Francisco-based talent network, is seeking a remote Management Consultant Talent Network... ...grading criteria for consulting deliverables, evaluate AI-generated or human work, and develop financial models and business cases. This role requires 1+ years in management consulting...Remote jobFor contractors
- ...Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join... ...detail-oriented RN with experience in utilization review, case management, or behavioral health and enjoy...Remote jobWork at office
- ...Utilization Management Registered Nurse Duration: 6 Month Contract (Possibility... ...utilization review and prior authorization... ...medical records, evaluating the medical necessity... ...for complex cases, denial recommendations... ...independently in a remote environment. Comfortable...Remote workContract work
$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison,... ...alignment with Medicare guidelines. Refer cases outside established guidelines to... ...Physician Advisor for further evaluation. Maintain accurate records of authorizations...Remote workContract workWeekend work$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $... ...-homecare services, and durable medical equipment Refer cases to Medical Directors as needed/appropriate Maintain knowledge...Remote jobHourly payMonday to Friday- ...Performs medical record review for severity of... ...variance; evaluates plan of care to ensure... ...and Training: Nurse, Registered (RN) licensure... ...-5 years previous Utilization Review experience... ...nursing; hospital case management;... ...Days, Primarily remote; onsite orientation...Remote workShift workWeekend work
- ...Utilization Review Nurse We are seeking a detail-oriented and experienced Utilization Review Nurse to evaluate the medical necessity, appropriateness, and efficiency... ...providers and case management teams, and support... ...management department. Remote, hybrid, or on-site opportunities...Remote workWork at office
$36 - $40 per hour
...looking for a Clinical Evaluator - PRN to join our... ...(RC) across nursing homes, hospitals,... ...purpose, combining remote work from your home... ...Screening and Resident Review) assessments and... ...recommendations Utilize independent... ...education. As such, in cases where a Bachelor's...Remote workHourly payContract workReliefWork at officeLocal areaWork from homeHome office$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment... ...and guideline compliance. Evaluate diagnoses, treatment plans,... ...reviewers to support case review processes. Assist with... ...working independently in a remote or office-based setting. Working...Remote workWeekly payContract workWork at officeMonday to Friday$75 per hour
...contract Compensation: $45–$75/hour Location: Remote Commitment: 10–40 hours/week Role... ...for postsecondary education. Evaluate and review AI-generated coursework, assignments, and... ...Create lectures, learning modules, and case studies across core sociological topics...Remote workHourly payContract work- ...Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional... ...services against the clinical data provided Certify cases that meet clinical review criteria, guidelines and/or...Remote jobFull timeTemporary workLocal area
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