Remote Utilization Management Nurse (LVN/LPN)
NeueHealth
NeueHealth is seeking a Utilization Management Nurse (LVN/LPN) for a remote role based in California. The position focuses on reviewing prior authorizations, ensuring alignment with coverage policies and medical necessity, and collaborating with providers, patients, and health plans.
Qualifications include an active CA nursing license and 2–3 years of clinical nursing experience with at least 1 year in utilization review.
#J-18808-Ljbffr$65k - $85k
...Description: Position Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is responsible for... ...skills, and the ability to work independently in a fully remote environment. Budgeted Compensation: $65,000 - $85,...Remote workWork at office$27.1 - $40.65 per hour
...better care experience for all. JOB SUMMARY The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to... ...: Licensed Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California nursing license...Remote workHourly payFull timeContract workWork at officeWork from home$60k
...Integra is looking for a LPN/LVN experienced in the managed care payor environment to... ...-service and post-service utilization reviews and appeals for DMEPOS... ..., Licensed Vocational Nurse, or Licensed Practical Nurse... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area- Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will oversee inpatient case reviews, coordinate referrals, and collaborate with physicians, discharge planners, and ancillary services to ensure safe, cost-effective...Remote job
- 100% Remote | Contract-to-Hire | Monday-Friday 8-5pm | California License Required We are seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) with a strong background in Inpatient Utilization Management to join a growing healthcare organization...Remote workContract workWork at officeMonday to Friday
- ...Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...to optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote work
- Alignment Health seeks an inpatient review nurse to join its remote utilization management team. You will assess inpatient stays, collaborate with PCPs, discharge... ...and cost-effective care. The role requires LVN or RN licensure (CA) with willingness to obtain licenses...Remote job
- ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a... ...competitive compensation with benefits, remote opportunities across multiple... ...with UM experience in managed care are encouraged to apply. #J...Remote job
- Integra Partners is seeking a Licensed Practical Nurse to perform pre-service and post-service utilization management reviews and appeals within a NCQA-compliant UM... ...payor environments. The role requires an active LPN/LVN license, at least 3 years of nursing in acute or...Remote job
$30 - $35 per hour
...Department: Enhanced Care Management (ECM) Reports To: Registered Nurse Clinical Case Consultant... ...Licensed Vocational Nurse (LVN) serves as a vital member... ...a combination of remote work, field-based member... ...Pacific Health Group utilizes AI-assisted tools to support...Remote workHourly payTemporary workWork at officeLocal areaMonday to FridayFlexible hoursAfternoon shift- ...Blue Zones Health seeks a Licensed Vocational Nurse (LVN) for Utilization Management & Inpatient Case Management in a fully remote role based in California. You will monitor inpatient services, perform concurrent reviews, and coordinate transitions of care while collaborating...Remote work
- ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. You will collaborate with... .... This role requires 3+ years of nursing experience, 2+ years in UM, and strong communication...Remote work
- ...Partners is seeking a licensed LPN/LVN with managed care UM experience to... ...pre-service and post-service utilization reviews and appeals for DMEPOS... ...with NCQA standards. The UM Nurse will review requests using... ...others to the Medical Director. Remote opportunities are available...Remote work
- ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote workWork from home
- ...CVS Health in Florida is seeking a Utilization Management Nurse Consultant. This full-time remote (work from home in Florida) role requires an active Florida RN license and at least 3 years of inpatient nursing experience. You will review medical necessity, coordinate...Remote workFull timeWork from homeWeekend workAfternoon shift
- Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required...Remote jobContract work
- Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care across multiple states. The role emphasizes applying clinical criteria, ensuring medical necessity, and coordinating with...Remote jobWork from home
- Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote jobWork from home
$65.8k - $130.8k
...Job Title Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST Salary Range: $65,800 - $130,800/Annually Employment Type 2 - Staff: Career Duration indefinite Primary Duties And Responsibilities...Remote workMonday to FridayFlexible hours$77.91k - $116.86k
...Together. Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist... ...have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately...Remote jobImmediate startMonday to Friday- Astrana Health is seeking a CA-licensed Utilization Review Nurse to support the Health Services Department. You will review outpatient services... ...and refer cases to Medical Directors as needed. This is a remote role for CA-licensed RNs/LVNs, with candidates living in California...Remote jobCasual workWork at office
- Astrana Health is seeking a Utilization Review Nurse with a Texas LVN license to support our Health Services Department in reviewing a high volume of outpatient... ...weekend and holiday rotation. The position is fully remote and will align with PST hours during probation,...Remote jobTrial periodWeekend work
$30 - $40 per hour
Astrana Health, Inc. is seeking a Utilization Review Nurse with a Texas LVN license to support the Health Services Department. The position is fully remote with open availability from 8:00 AM to 8:00 PM PST, Monday through Sunday, and weekend/holiday rotation. The target...Remote jobHourly payTrial periodWeekend work- ...Day (United States of America) Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the clinical floor and administrative compliance. Unlike remote roles, this position relies heavily on real-time, face-to-face...Remote workFull timeImmediate startShift work
$60.53k - $129.63k
...bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) Utilization Management Nurse Consultant - Remote Make a difference in patient care from the comfort of home. We're seeking experienced Registered Nurses...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$54.1k - $155.54k
...of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Registered Nurse (RN) - Remote Make a meaningful impact on patient care from wherever you work. We are seeking an experienced Registered...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$29.1 - $62.32 per hour
...schedules will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary Utilize your clinical experience and skills in a... .... Required Qualifications Registered Nurse Education: Diploma RN acceptable; Associate...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeShift workWeekend work$65.52k - $118.56k
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and candidates... ...members, providers, and regulatory organizations. #LI-Remote Pay ranges vary based on the candidate's work location....Remote workFull timeWork at officeImmediate startWork from homeFlexible hours$54.1k - $116.77k
...one community at a time. Schedule: Standard business hours Monday-Friday 8:00am-5:00pm CST Position Summary The Utilization Management Nurse Consultant utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- ...Job Description Job Description Position Summary: The Utilization Management Nurse (UMN) works under general supervision of the Director and/... .... Qualifications: Current unrestricted Florida RN or LPN License. Minimum of two years of utilization review...Remote workWork at officeWeekend work
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