Remote RN Utilization Review Specialist
NeighborHealth
NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals and service authorization needs to ensure medical necessity aligns with CMS standards and organizational determinations. The role requires collaboration with RN Case Managers and the Medical Director to support timely decisions and effective patient care across a multi-site health plan. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote RN Utilization Review Specialist in Boston, MA vacancy
- ...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
Mass Digital Health
Quincy, MA11 hours ago - ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
Virtual Vocations Inc
United States3 days ago - ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with...Remote work
Santa Barbara Cottage Hospital
New York, NY3 days ago - ...Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients... ...skills. Preferred Qualifications: Registered Nurse (RN) license or equivalent clinical certification....Remote work
Bradford Health Services
United States3 days ago $50k
...the 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 workAdvanced Recovery Systems LLC
New York, NY3 days ago- ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services... .... Preferred Qualifications: Registered Nurse (RN) license or equivalent clinical certification. Experience...Remote workPart time
ADDICTION AND MENTAL
United States4 days ago - ...and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
Spectrum Billing Solutions
Skokie, IL2 days ago - ...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
Gateway Regional Medical Center
Granite City, IL11 hours ago $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$63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding... ...an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your daily...Remote workFull timeWork experience placementLocal areaFlexible hours- ...providing telephonic and e-referral case review and authorization of services utilizing established mental health and... ...This position is full-time, fully remote (work from home) and requires some... ...State of Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required....Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States3 days ago $23.76 - $51.49 per hour
...Molina Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly payMolina Healthcare
Nevada, IA2 days ago$65k - $85k
...Santa Barbara Cottage Hospital is seeking a Utilization Review Specialist (RN) for a remote position, specifically for candidates based in Florida. The ideal candidate will possess a valid Florida RN License and certifications in OASIS and coding. The role involves thorough...Remote workSanta Barbara Cottage Hospital
New York, NY1 day ago$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend workPacer Group
Everett, WA4 days ago$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart timeSanta Barbara Cottage Hospital
New York, NY3 days ago- ...healthcare practice, the contract-to-hire BCBA Licensed Utilization Review Specialist will perform prospective, concurrent, and retrospective reviews... ...medical necessity and appropriateness while working remotely. Key responsibilities Perform reviews to determine authorization...Remote workContract work
Virtual Vocations Inc
United States4 days ago - ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
Guidehealth
Chicago, IL22 hours ago - ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
HealthHelp
Houston, TX2 days ago - ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
TurningPoint Healthcare Solutions
Florida, NY2 days ago - ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
Gibson Area Hospital
Gibson City, IL3 days ago $84.56k - $126.84k
...Add to Favorite Jobs Email this Job Job Overview The Utilization Review RN participates as a member of a multidisciplinary team to... ...Sunday, Monday 1500 - 2300 This position will be primarily remote but there may be occasions when you are expected to work onsite...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shiftChildren's Hospital Colorado
Aurora, CO3 days ago$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly payAstrana Health
California, MO1 day ago- ...Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full‑time position involves managing utilization reviews and ensuring compliance with clinical policies for quality...Remote workFull time
COMAGINE HEALTH
Sacramento, CA1 day ago $51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in...Remote workDaily paidLive inShift workDay shiftProvidence Swedish Medical Center
Seattle, WA22 hours ago$29.62 - $45.31 per hour
...Department Coordinate and execute the review and research functions required to support... ...Critically assess and prepare all cases for RN/MD review of coverage (medical necessity,... ...inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work...Remote workMinimum wageFull timeWork experience placementLocal areaShift workProvidence Health & Service
Oregon, WI22 hours ago$30 - $38 per hour
...personifyhealth.com. Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis, working a minimum... ...communication skills to successfully perform in a remote healthcare environment. Ability to perform the essential job...Remote workHourly payFull timePart timeWork at officeMonday to FridayWeekend workSanta Barbara Cottage Hospital
New York, NY3 days ago- ...Utilization Review Registered Nurse (UR RN) The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery of appropriate, efficient... ...Support (BLS) certification as required for facility based staff; optional for remote staff. Nexus Health SystemsRemote workWork at office
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position... ...REQUIREMENTS: Full time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review/Case...Remote workHourly payFull timeWork at officeRelocation packageShift work- ...Job Description Job Description Salary: 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...Remote workFull timeMonday to FridayFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Utilization Review Specialist. Be the first to apply!
Related searches
- operating room travel rn Boston, MA
- home health rn case manager Boston, MA
- new grad registered nurse Boston, MA
- float pool registered nurse Boston, MA
- contract registered nurse Boston, MA
- hospice rn registered nurse Boston, MA
- wellness nurse rn Boston, MA
- psych nurse rn Boston, MA
- gastroenterology rn Boston, MA
- pediatric oncology rn Boston, MA