Remote Utilization Review RN - Case Management
HealthEdge
- Remote job
HealthEdge is seeking a motivated Utilization Review RN to join our team. You will perform prospective, concurrent and retrospective reviews of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, length of stay and level of care, including appeals. Responsibilities include authorizing requests, coordinating discharge planning, analyzing care patterns, resolving benefits issues, and educating providers on policies and benefits. This is a remote, full-time US role. #J-18808-Ljbffr HealthEdge
- ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning,... ...work experience preferred Certification in case management, pharmacy, rehabilitation...Remote workFull timeWork experience placement
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and... ...s degree in a related field, an active RN/Social Work/Clinical Counselor license,...Remote workFull time- ...HealthEdge Software, Inc. seeks an experienced Utilization Review RN to perform prospective, concurrent and retrospective reviews across... ...license with 2+ years of clinical experience and may have Case Management certification in progress or preferred. #J-18808-LjbffrRemote work
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care... ...The ideal candidate has an RN license with 1 year UR/UM or Case Management experience and 3 years RN in acute care, with strong...Remote job
$2,150 per week
AMN Healthcare Nursing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description... ...experience (hospital-based) Skilled experience with remote work LENGTH OF ASSIGNMENT - 13 weeks SHIFT / HOURS PER WEEK...Remote workTemporary workLocal areaImmediate startShift workNight shiftWeekend work- Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong nursing experience. The...Remote job
- HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity... ...others from admission onward. You will work with the Care Management team to address documentation issues, support data...Remote job
- Alignment Health is seeking an experienced inpatient review nurse to join the remote utilization management team. You will review inpatients with complex... ...effective levels of care. Minimum 3 years of general case management with Milliman Care Guidelines experience...Remote job
- ...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
- ...and therapists in home care, hospice, and case management for over 30 years. We offer flexible work options... ...of ours with a need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an activeMA RN license....Remote workContract workMonday to FridayFlexible hours
- 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. You...Remote jobFull time
- 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
- CorVel in the United States is seeking a Utilization Review Case Manager to gather demographic and clinical information, certify medical necessity... ...length of stay for inpatient and outpatient treatment. This remote role requires strong CPT/ICD coding knowledge, meticulous...Remote job
$1,759.5 per week
...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas, United States Position ID: P-756324 Position status: On Hold... ...is hiring a Utilization Management RN for a fully remote role requiring TX or compact RN licensure and 2 years of...Remote workWeekly payLocal areaShift work$3,268 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler San Francisco, California, United States Position ID: P-7... ...needed Hybrid schedule with 2 days onsite and 3 days remote per week Day shift schedule, 5x8-hour shifts from 08...Remote workWeekly payContract workLocal areaShift workDay shift3 days per week$52 - $56 per hour
...both. We're hiring a contract RN for a New York health plan... ...judgment you built in utilization management. 100% remote (U.S.) | Contract | $52-$56... ...intake, investigation, clinical review, decision and notification... ...home health, DME and LTSS cases Prepare case files for Medical...Remote jobContract workAfternoon shift- ...to the LTSS department. RN will be responsible for providing case management services and evaluating... ...authorization and concurrent review. Provides monthly... ...of treatment setting by utilizing the applicable medical policy... ...Info: *possible remote opportunity after training...Remote workContract workMonday to FridayFlexible hours
- 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...Remote jobRelief
$2,784 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Bethel, Alaska, United States Position ID: P-770659 Position... ...to improve outcomes. Hospital housing provided in a remote area with shared common spaces and private bedrooms (...Remote workWeekly payWork experience placementShift workDay shift- Location Remote - TX Department Utilization Shift First Shift (United States of America) Standard... .... Works with the Department Manager and Team Lead to assure the timely... ...Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate...Remote workShift workDay shift
- ...System team, and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And Quality... ...to provide evidence that the UR process for the case was followed. Attend all staff meeting when scheduled...Remote workFull timeWork at officeShift workWeekend work
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient’s PCP, facility case manager, discharge planner, and... .... The role requires a CA LVN/RN license, 3+ years in case management...Remote work
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J-1...Remote workContract work
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatients and collaborate with physicians, case managers and facilities to ensure... ...will hold an active LVN or RN license, have at least 3 years in case...Remote work
- ...Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure... ...appropriate resources while working remotely. Key responsibilities Assist in building... ...for members through coaching and case management interventions Educate stakeholders...Remote workFull time
$1,813 - $1,908 per week
...Registered Nurse:Utilization Review,16:00:00-04:30:00 Location: Torrance, California... ...Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review*... ...Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/...Remote work- ...Utilization Review Nurse Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're... ...reducing the cost of healthcare claims through bill review, case management, and utilization review. Our mission is "To make lives...Remote workFull time
$1,600 - $1,800 per week
...Hiring: Registered Nurse – Utilization Management Location: Buckley AFB &... ...no holidays, no telehealth/remote work Minimum Qualifications... ..., active, and unrestricted RN license Certifications... ...Management, Utilization Review, or Case Management Preferred Certifications...Remote workContract workImmediate startMonday to Friday$1,766.5 per month
...Specialty Utilization Review Job ID 3851... ...Opportunity for a Utilization Management Registered Nurse!... ...Department operating fully remote - Provide... ...- Admissions - Case management - Discharge... ...Experience: - Licensed RN (multistate or TX RN)...Remote workWeekly payWork experience placementShift work
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