Remote RN Utilization Review Specialist
1001 ProMedica Shared Services, LLC
ProMedica is seeking a Registered Nurse (RN) to join the Care Coordination team as the coordinator of a patient's plan of care. The RN will assess, diagnose, plan, implement, and evaluate care, working with patients, families, and the health care team to improve outcomes. This per diem, remote position is limited to certain US states; Ohio license, CPR, and required certifications are needed. A Bachelor's in nursing is preferred, and benefits include 401k, EAP, and employee discounts.
#J-18808-Ljbffr$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday work- ...seeking experienced nursing professionals to review medical records and ensure appropriate... .... Candidates must have a valid California RN license and at least two years of clinical... ...degree in a related field. The position offers remote work with emphasis on critical thinking...Remote work
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
- ...treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews,... ...School diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) preferred Minimum of three years'...Remote workFull time
- ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities...Remote workWork at officeFlexible hours
$50k
...lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote work- ...Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR...Remote workFull timeMonday to FridayFlexible hours
$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal area$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health‑sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal area- ...Health Business Solutions LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate level... ...criteria, and collaborate with insurers on denials. Requires RN license (US multi-state/compact), BSN preferred, 2+ years UR experience...
$60k - $75k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US 14 days ago Requisition... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The... ...license or relevant certification, such as RN, LPN/LVN, LMSW, LPC, CADC, LADAC, CCM,...Remote workFull timePart timeWork at office$110k
...outcomes in the expected time frame and with the most efficient utilization of resources. Carries out activities related to utilization... ...physician regarding appropriate documentation for justification. Reviews the patient’s plan of care in conjunction with the clinical...Daily paidFull timePart timeFlexible hoursShift work- ...Mass Digital Health is seeking a Utilization Review Nurse in Quincy, Massachusetts. This role involves evaluating patients for appropriate admission... ...coordination. This position requires at least two years of RN experience in care management or utilization management. The...
$35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 200... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...Remote workFull timeTemporary workWork at officeMonday to Friday- Kingman Healthcare Incorporated (KHI) seeks an experienced Utilization Review Nurse to support case management in Arizona. You will conduct medical... .... Ideal candidates hold a BSN (MSN preferred), have 3+ years RN hospital experience, and UR or CM exposure. #J-18808-Ljbffr
- ...Excellus BCBS in New York seeks a Utilization Management professional to coordinate behavioral... ...services for members. You will perform clinical reviews, ensure medical necessity, and... ...Requirements include an associates degree with NYS RN license and at least three years of UM...Work at office
- ...A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...Monday to Friday
$68 per hour
...Job Title: Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation... ...(MRP) $100,500/yr Work Model: Remote – offsite Responsibilities... ...prospective, concurrent, and retrospective reviews for authorization, appropriateness...Remote workContract workTemporary workLocal area$28.5 - $38.5 per hour
...Medical Necessity Reviewer Sanford Health, the largest rural health... ...-site with consideration of remote work after 6 months to 1 year... ...'s medical records. Performs utilization management (UM) activities in... ...registered nurse (RN) license with the State Board...Remote workFull timeLocal areaMonday to FridayShift workWeekend workDay shift- ...UofL Health in Louisville, KY seeks an experienced Utilization Review RN to support the Utilization Management function. You will assess medical necessity for admissions and continued stay, coordinate with physicians and case managers, and document in Case Management Software...
$30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ...along with experience in Epic EHR and Utilization Review. The selected candidate will perform... ...program metrics. This position is remote and offers a pay range of $30-$45 per...Remote jobHourly payContract work$45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $45 to $50 per hour Shift Information... ...Management Location: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/19/2026 Hours: 40 hours...Remote workHourly payFull timeContract workWork experience placementImmediate startMonday to FridayShift workWeekend work$38 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $38 to $45 per hour Shift Information... ...Position Travel Registered Nurse – Utilization Review (Remote) Location: Fort Myers, Florida Facility: Lee Health –...Remote workHourly payFull timeContract workWork experience placementMonday to FridayShift workWeekend work$45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc... ...Location: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/19... ...goals. Our team of experienced career specialists takes the time to understand your...Remote workHourly payLong term contractPermanent employmentFull timeContract workTemporary workWork experience placementWork at officeMonday to FridayShift workWeekend work- ...Job Description Job Description Utilization Review Specialist Job Description Unique opportunity to join Maryhaven, Central Ohio’s largest and... ...Health Records. Must have LPCC, LSW, LCDC III or RN. Utilization Review Specialist Requirements ~ Salary...
- ...through improvement huddles, employee surveys, and town hall meetings Job Description A Day In The Life The Utilization Review Specialist (RN) is responsible for ensuring appropriate utilization of healthcare services across the continuum of care. This role...Work at officeWeekend work
- ...Job Description Job Description Position Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management for participants enrolled in the Program for All-Inclusive Care for the Elderly. The position ensures that services are medically...Work at office
- Gateway Regional Medical Center, Inc. is seeking a full-time Utilization Review Specialist RN responsible for conducting admission and concurrent reviews to avoid payment denials, while managing appeals. This role requires collaboration with interdisciplinary teams to...Full time
- ...a Pre-Authorization Nurse to review prior authorization requests for... ...decision-making abilities. Remote position from LA with a choice... ...Thurs), 8-hour shifts. Active RN license in Louisiana and 2+... ...are required; health plan or utilization management background is a plus...Remote workShift work
- ...United States is seeking an Inpatient Utilization Management Clinician to evaluate... ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...care management to ensure timely reviews, document outcomes, and maintain...Remote workFull time
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