Remote Nurse Supervisor - Utilization & Clinical Quality
Oscar Health
A leading health insurance company is hiring a Nurse Supervisor for their Utilization Management Clinical Quality team. In this remote role, you will oversee daily operations and staff, manage compliance and quality metrics, and support strategic initiatives. Candidates should possess an RN license and significant healthcare leadership experience. This position offers a competitive salary and excellent benefits, including unlimited vacation and performance bonuses. #J-18808-Ljbffr
$91.91k - $120.63k
...Hi, we're Oscar. We're hiring a Nurse Supervisor to join our Utilization Management Clinical Quality team. Oscar is the first health insurance company built around... ...Manager, Clinical Programs. Work Location This is a remote position, open to candidates who reside in:...Remote workQualityFull timeWork from homeHome office- ...Guidehealth leverages remotely-embedded Healthguides™... ...partners to deliver high-quality healthcare focused on... ...Review & Clinical DeterminationsComplete... ...aligned with Illinois nursing regulations and contemporary... ...settings.Knowledge of utilization review, managed care processes...Remote workQualityBi-weekly payFull timeTemporary workFor contractorsLocal area
$268k - $414k
...collaborate with management teams to deliver quality, cost-effective care while ensuring compliance with health and utilization management protocols. The ideal candidate... ...certified in Psychiatry. Flexibility to work remotely within the U.S. is provided. The role offers...Remote workQuality$223.8k - $313.1k
...Jefferson City, Missouri. The role involves conducting clinical reviews of inpatient records and making utilization management determinations. Candidates should... ...annually, with additional benefits and a commitment to high-quality healthcare standards. #J-18808-Ljbffr...Remote workQuality- ...Medix™ is looking for experienced Utilization Management Medical Directors for a remote contract opportunity. This role... ...necessity, and collaborating with clinical teams. Strong candidates will have... ...in this field, making a direct impact on care quality. #J-18808-Ljbffr...Remote workQualityFull timeContract workFlexible hours
$110.88 - $124.74 per hour
...is seeking a Medical Director of Utilization Management to oversee and coordinate clinical management, ensuring compliance... ...Physician license. The position is remote, allowing for a flexible... ..., and involves participation in quality improvement initiatives and audits...Remote workQualityHourly payDaily paidFlexible hours$130 - $140 per hour
...Remote Medical Director - Utilization Management (6-12 month contract, potential for long-term hire!) Must hold MD... ...seamlessly integrate into a high-impact clinical review team. You will support the organization’s commitment to quality care and operational excellence by...Remote workQualityHourly payContract workFlexible hours$120 per hour
...Group Medical Director – National Utilization Management Team (One Weekend per Month) Location: Remote (U.S. only; must reside in the... ...records, analyze complex clinical scenarios, and make expert determinations... ...for productivity, quality, and compliance metrics Adapt...Remote workQualityOngoing contractPermanent employmentFull timeContract workImmediate start- ...Medical Director – Utilization Management Remote | Full-Time (40 hrs/week) We are partnering with a national... ...to support a high-volume, payer-side clinical review operation. This role is part... ...efficiency, consistency, and quality of medical necessity determinations....Remote workQualityFull timeContract workImmediate start
- ...Now Hiring: Medical Director – Utilization Management 100% Remote | Must work PST hours Medicare Advantage... ...Utilization Management) to help lead clinical integrity and medical necessity decision... ...care decisions that support quality outcomes, cost efficiency, and regulatory...Remote workQualityImmediate start
$250k - $325k
...Medical Director - Utilization Management (Part Time)... ...closely with outpatient clinical leadership, UM operations... ...Health, and UM nursing teams to align utilization... ...improve cost efficiency and quality outcomes. Serve as... ...This is a Remote - US based position....Remote workQualityPart time$190k - $200k
...healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight for high-volume cases. The ideal... ...case reviews, and collaborating on quality improvement initiatives. Salary ranges from...Remote workQuality- ...outpatient behavioral health utilization management clinicians:... ...services. This role serves as a key clinical decision-maker, exercising independent... ..., with a focus on clinical quality and compliance. Key... ...Demands: • Primarily remote role with periodic travel to...Remote workQualityWork at office
- ...seeking a Per Diem Medical Director to oversee Utilization Management. The role involves collaborating with physicians, enhancing care quality, and developing policies within a managed... ...should have at least 12 years in clinical practice, a Doctor of Medicine degree, and...Remote workQualityHourly payDaily paid
$275k
...Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time Remote (Post-Onboarding) U.S. Licensed... ...clinical consultation and support to nursing and interdisciplinary teams... ...strategies to enhance care quality while reducing external review...Remote workQualityFull timeRelocation packageMonday to Friday$110 - $130 per hour
...A healthcare staffing company is seeking a Medical Director to lead utilization management and quality improvement for Medicare inpatient care. This remote role requires board-certified physicians with active medical licenses in FL and TX. Key responsibilities include...Remote workQuality- ...seeking a Medical Director National OP Medicare to utilize clinical expertise and medical judgment in determining... ...physicians and internal teams to ensure quality care and effective resource utilization. Humana offers a remote work model with competitive salary and...Remote workQuality
- ...oversee inpatient medical necessity reviews and utilization management. This role requires strong... ...skills, as well as 5+ years of clinical experience post-residency. Ideal candidates will have a dedication to quality care and enjoy working in a structured, team...Remote jobQuality
$248.5k - $373k
...Connecting. Growing together. Clinical Advocacy & Support has an... ...benefit coverage determinations, quality improvement and cost... ...clinical knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S....Remote workQualityMinimum wageWork experience placementLocal area- ...for the National OP Medicare. This role involves using clinical expertise to determine authorization for services and... ..., ensure compliance with regulations, and support quality, coordination, and resource utilization. Ideal candidates will have an MD or DO degree, extensive...Remote jobQuality
- ...overseeing and performing utilization reviews, prior... ...Director will serve as a key clinical expert, ensuring... ...discussions. This is a remote position requiring a "... ...internal teams, including Nurse Practitioners, Care... ...protocols. Participate in quality improvement...Remote workQualityFull timeFlexible hours
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...program.At Optum, you'll have the clinical resources, data and support... ...the flexibility to work remotely * from anywhere within the U.... ...organizational confidentialityProvides quality assurance and education of...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$250k
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests... ...of observed trends, potential quality concerns, or opportunities to... ...Expectations Full-time remote role requiring consistent availability...Remote workQualityFull timeTemporary workLocal area- ...Job Title Clinical Nurse Supervisor Job Description At NorthBay Health... ...Care Services Division Utilizes Jean Watson's Theory of Caring... ..., and commitment to high-quality patient care. Why NorthBay... ...and role requirements. Remote Work Disclosure NorthBay...Remote workQualityFull timeShift workNight shift
$119.4k - $150.56k
...Payroll Title: CLIN NURSE SHS SUPV 2 (000402)... ...Benefits Type of Remote or Hybrid Work Arrangement... ...Duties: The Clinical Nurse Educator/Supervisor is required to... ...personnel to ensure quality patient care and meet... ...appropriate appointment utilizing the computerized...Remote workQualityFull timePart timeSummer workLocal areaAfternoon shift$225.7k - $428.9k
...Director to oversee medical management and quality improvement initiatives. This role... ...Louisiana state license and experience in utilization management. Responsibilities include directing... ...complex cases, and collaborating with clinical teams to optimize patient care....Remote jobQualityFull timeFlexible hours$57.37 - $85.33 per hour
...Weekend Home Health Nurse Supervisor Partnering for a stronger... ...more than 2,300 clinics, care sites and 158... ...coverage 0830-1700 - remote Job Summary: We are... ...the delivery of high-quality patient care. Responsibilities... ...risk management, and utilization review strategies....Remote workQualityFull timeFor contractorsReliefShift workWeekend work$101.74k - $163.8k
Manager, Clinical Utilization Management & Transitions of Care Requisition Number... ...April 28, 2026 Full‑Time Remote Salary range: $101,740 USD... ...efficiency, and high‑quality member outcomes. The role plays... ...Have a bachelor’s degree in nursing or an advanced clinical degree...Remote workQualityFull timeTemporary workPart timeWork experience placementWork at officeTrial periodFlexible hours$110k
Overview The Nurse Clinical Supervisor, UM Denial Compliance oversees the denial process within the utilization management (UM) department, ensuring that all denials are handled efficiently... ..., and work plans. Conduct internal quality audits for the denial process. Develop...QualityCasual workRelocation package- Alignment Healthcare LLC is seeking a Lead Utilization Management Nurse, responsible for reviewing inpatient... ...a team of UM Nurses. This fully remote position demands strong communication... ...training, along with participation in quality assurance. Join a passionate team...Remote jobQuality
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