Remote Utilization Review RN Case Manager (PRN)
OU Health
OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations and coordinating with payors, patients, and interdisciplinary teams. This role emphasizes HIPAA compliance and strong communication across stakeholders for optimal financial reimbursement.
The candidate will review medical records, apply evidence-based criteria, and participate in quality improvement initiatives while maintaining regulatory alignment and
#J-18808-Ljbffr- ...University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care....Remote workFull time
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- ...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know Your Team: INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking a...Remote workFull timeWork at officeWeekend work
- ...seeking a Registered Nurse Case Manager for a 13-week assignment in... ...Austin, TX. This role focuses on utilization review, discharge planning, and... ...care UM experience and a TX RN license. Proficiency with InterQual... ...insurers is a plus. Remote work experience is noted. #J...Remote jobWork experience placement
- CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills. Responsibilities include...Remote job
- ...Job Description Job Description PRN RN CASE MANAGER – UTILIZATION REVIEW Northwest Florida Community Hospital (NFCH) Department: Med-Surg / Utilization Review Position Type: PRN (As Needed) Location: Chipley, Florida Position Summary Northwest...Relief
- ...All Jobs Utilization Review Nurse (PRN/Weekend Shift) Fully Remote • FL Description The Utilization Review (UR)... ...collaboratively with physicians, case managers, revenue cycle staff, and interdisciplinary... ...unrestricted Registered Nurse (RN) license. Minimum five (5)...ReliefRemote workDaily paidWork at officeShift workWeekend work
- ...Responsibilities Review and evaluate electronic... ...and ensure proper utilization of healthcare... ...and unrestricted RN license At least... ...years utilization management experience in acute... ...in Nursing (BSN) Case Management Certifications... ...Comfortable with remote work arrangements...ReliefRemote workFor contractorsWork at office
- ...Description: This is a remote, PRN position but will... ...Conduct clinical reviews of patient records... ...resource utilization and care planning... ...and ongoing patient cases; recommend or upscale... ...Registered Nurse (RN) program; Bachelor... ...utilization review, case management, or payer review...ReliefRemote workFull timePart timeWork at officeLocal areaShift workRotating shiftDay shift
- ...opportunity for a local remote position. There is no... ...health, inpatient, etc.) PRN (at minimum, two 8hr... ...Requirements ~2 years of RN experience performing... ...patients ~2 years of Utilization Review (UR) experience... ...resources to help you manage your physical, emotional...ReliefRemote workFull timeLocal areaMonday to FridayFlexible hoursShift work
- ...Case Manager RNThis Case Manager RN role is with the Costco Team and is fully remote; however, candidates must reside within... ...quarterly meetings or PRN meetings. Normal... ...and information/data review, conducts an evaluation... ...claim management. Utilizes case management processes...ReliefRemote workTemporary workWork at officeLocal areaMonday to Friday
- ...RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico... ...Albuquerque *Inpatient *Outpatient *Utilization Management *SRMC Care... ...from 8-430pm. · Weekend and PRN availability · There is required... ...is supported by a chart review for the level of care and correcting...ReliefRemote workFull timePart timeWork from homeRelocation packageMonday to FridayShift workNight shiftDay shiftAfternoon shiftWeekday work
- ...Select Specialty Hospital in Springdale seeks a Case Manager (PRN) responsible for managing patient discharge planning and treatment... ...in critical care or acute care settings. Duties include utilization reviews, resource management, and maintaining financial responsibilities...ReliefShift workWeekday work
$72.5k - $90.6k
...Quartz is seeking a Utilization Management RN Case Manager to review prior authorization requests, coordinate transitions, and collaborate with physicians... ...no weekends or holidays, with in-person, hybrid, or remote options and a pay range of $72,500–$90,600. Wisconsin...Remote workMonday to Friday- ...Job Description Eagle One Case Management Solutions, Inc RN Case Manager Summary... ...will be available for weekly review Tasks must be kept... ...to proceed as necessary Utilizes appropriate cost management... ...clinics as needed ~ If PRN case manager, perform tasks...ReliefRemote jobFull timePart timeWork at officeImmediate startHome office
- ...Acentra Health is seeking a Psychiatrist Physician Reviewer to provide leadership in peer review and utilization activities. The role involves phone... ...Medicaid Fee-For-Service beneficiaries. Position is PRN and remote within Illinois. The ideal candidate is licensed...ReliefRemote work
$72.5k - $90.6k
...Overview Are you a licensed RN who is interested in using... ...consider joining Quartz as a Utilization Management Registered Nurse (RN) Case Manager. This role is responsible for review of prior authorization... ...work in-person, hybrid, or remote available Compensation pay...Remote workFor contractorsMonday to Friday- Job Title: Utilization Review Coordinator Department: Med/Surg FLSA... ...: Full-Time/Part-Time/PRN Location: Harrison... ...oriented with the ability to manage multiple tasks and meet... ...Registered Nurse (RN) license in the state of... ...Utilization Review or Case Management (e.g., ACM,...ReliefFull timePart time
- ...Utilization Review Case ManagerEmployment Type: Full timeShift: Day ShiftHours: Monday-Friday: Days; no holidaysAbout The JobThe Utilization Review Case Manager responsibilities include case screening, insurance approval, assurance of timely services, and facilitation...Local areaMonday to Friday
- ...RN BLS Case Managers, Utilization ReviewA Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states... ...Therapy and Nursing.Case Management, Utilization Review ExperienceRegistered RN, BLS• Ability to multi-task while...
- ...Ahhmgt is seeking a Case Management RN to lead the utilization review and resource management efforts across the facility. The role involves planning, coordinating, and administering activities that support quality and cost-efficient patient care. The incumbent will...
- ...Saint Agnes Medical Center in Fresno, CA, is seeking a Part-time RN to coordinate utilization review across the acute care continuum. The role involves discharge planning, utilization management, and care coordination with an interdisciplinary team to optimize hospital...Part timeNight shift
$47.58 - $76.68 per hour
...California is hiring for a position that involves managing admissions and conducting patient reviews in accordance with established regulations. The... ...including a BSN. Experienced candidates in Utilization/Quality/Case Management will thrive in this supportive environment...Hourly pay- ...RN Case Manager (Utilization Review Experience Preferred) page is loaded## RN Case Manager (Utilization Review Experience Preferred)locations: Visalia, Californiatime type: Full timeposted on: Posted Todayjob requisition id: R26\_0000000022Kaweah Health is a publicly owned...Full timeShift work
- ...Netpace Inc. is seeking a motivated RN Case Manager to join our team in a contract role. Responsibilities include initial patient assessments... ...candidate holds an Active CA RN License, with strong Utilization Review and InterQual experience, supporting utilization...Contract workDay shift
- ...Registered Nurse Case Manager Inova Fairfax Medical... ..., part-time and PRN availability.... ...work schedules, and remote and hybrid career... ...Registered Nurse (RN) Case Manager 1 Job... ...excess days, resource utilization, readmission rates... ...needs through review of patient information...ReliefRemote workFull timePart timeRelocation packageMonday to FridayFlexible hoursWeekend work
- The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent... ...Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS &... ...in the state of operation required;RN is required unless local state regulations...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours
$31.94 - $43.92 per hour
...psychosocial assessments Create and manage discharge plans... ...care planning discussions Utilization Management Review medical necessity & admission... ...Option 1: 3+ years recent Case Management (acute care) OR Option 2: 3+ years RN in: Med/Surg Telemetry...Relocation packageShift workWeekend workAfternoon shift$48 per hour
...Gateway Regional Medical Center is looking for a Utilization Review Specialist RN to join our Case Management team in Granite City, Illinois. This full-time role is ideal for nurses eager to transition into a more analytical and administrative position, focused on service...Full time- ...UCI Health Case Manager UCI Health is one of California's largest academic... ...and coordinates resource utilization throughout the health system... ...the appropriate utilization review functions utilizing medical staff... ...skills in English Current RN License Computer literacy and...Remote jobWork at officeMonday to Friday
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