Remote Utilization Management Nurse - (LVN/RN)
$77.91k - $116.86kE2E Alignment Healthcare USA, LLC
E2E Alignment Healthcare USA, LLC is seeking a remote Utilization Management Nurse to review prior authorization requests for medical necessity. The role requires a valid LVN or RN license in California, along with experience in nursing and utilization management. Successful candidates will review pre-certification requests and work closely with medical directors to ensure members receive timely care. The position offers competitive pay between $77,905 and $116,858 per year. #J-18808-Ljbffr
- 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 skills and a valid California LVN or RN license. The role includes mentoring and...Remote job
$77.91k - $116.86k
...Alignment Healthcare USA, LLC is hiring for a remote Utilization Management (UM) Nurse position focused on pre-service reviews. This role requires active California LVN or RN licensure and involves reviewing prior authorization requests to ensure quality care. Candidates...Remote work$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States NeueHealth is a value-driven healthcare... ...Education: Registered Nurse (RN) or Licensed Vocational/Practical Nurse... ...: Corporate office preferred / remote may be considered Collaborative environment...Remote workHourly payWork at office$85.7k - $128.54k
The Supervisor, Utilization Management (UM), reports to the Manager of UM and oversees the UM department... ...of an accredited Registered Nursing Program or Vocational Nursing program.... ...Licensure: Active, valid, and unrestricted RN or LVN license in California (non‑compact). Upon...Remote jobLocal area- ...The Peer-to-Peer (P2P) Utilization Review Nurse is an integral member of the MGB Central Utilization Management team, specializing in identifying... ...reconsideration (CONI) processes through RN-to-RN collaboration with... ...and Work Model ~ Remote / Work from Home. ~32...Remote workWork from home
$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of...Remote workHourly payFull timeContract workWork at officeWork from home$34.98 - $42.85 per hour
...Clever Care is hiring a UM Nurse I - RN to conduct clinical reviews of authorization requests in California. The role involves... ...of three years of clinical experience, preferably in utilization management. This remote position offers a wage range of $34.98 to $42.85 per...Remote workHourly pay$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... ...KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area$45 - $45.5 per hour
...Overview Job Title: Nurse Case Management Senior Analyst Location: REMOTE Duration: 5-6 Months (Contract possibly Extension... ...the physician treatment plan. Utilizes clinical skills to assess, plan, implement... ...from more junior team members. RN and current unrestricted nursing...Remote workContract workImmediate startMonday to FridayAfternoon shift- ...Job Description Future Opportunities: Nurse (LPN/LVN/RN) Positions - Join our Talent Network... ...Baltimore Business Journal, is a public-sector management consulting firm serving federal... ...EEO employer -M/F/Vets/Disabled Telework/Remote Work policies are contingent upon client...Remote workFull timeContract work
- ...Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be... ...(LPN) or Registered Nurse (RN) with strong critical thinking skills... ...computer skills, and the ability to manage multiple tasks efficiently. #J-1...Remote job
$30 - $34 per hour
...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...Remote workHourly pay- ...Are you an experienced Registered Nurse (RN) – Utilization Management / Case Management (Medicare) with a desire to excel? If so, then Talent Software... ...On-site training required (1–6 weeks depending on role) Remote/hybrid flexibility available post-training based on...Remote workContract workLocal area
$34.98 - $42.85 per hour
...Remote in California only Are you ready to make a lasting... ...Job Summary The UM Nurse I - RN performs clinical review of... ...policies. This role conducts utilization review activities under established... ...one (1) year in utilization management or case management preferred...Remote workHourly payWork at office- Senior Utilization Management Nurse - Field RN Location: Boston, MA Regional Area Schedule: Full-time | Weekdays only — no weekends, no holidays, no... .... This is a field-based role with some flexibility for remote work based on business needs. You’ll partner closely with...Remote workFull timeWeekday work
- ...A healthcare provider in the United States is seeking a Utilization Management Nurse to work remotely. This role involves performing clinical utilization reviews, collaborating with healthcare partners, and adhering to national standards and regulations. Candidates must...Remote workWork at office
- ...Utilization Management, Registered Nurse (RN) Remote - USA At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through...Remote workWork at officeFlexible hours
- ...Wound Care Nurse (RN or LPN) Looking for qualified Wound Care Nurse (RN or LPN) to join... ...skilled team and provide high-quality wound management and support to our residents. If you... ...adults. From telemedicine services and remote health monitoring to advanced diagnostic...Remote workFull timeLocal areaShift workNight shiftDay shiftAfternoon shift
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position Type Full Time... ...Full time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review...Remote workHourly payFull timeWork at officeRelocation packageShift work$35.5 - $53.25 per hour
...11215 Behavioral Health Contract Management Group: Charlotte - Utilization Management Status: Part... ...Graduation from an accredited School of Nursing required. Bachelor's degree in nursing preferred. applicable state RN licensure required. Related experience...Remote workDaily paidFull timeContract workTemporary workPart timeWork at officeFlexible hoursShift workDay shift- ...looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and... ...effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant experience in...Remote workWork from home
- ...Truman Medical Centers is seeking a Utilization Management RN for a part-time position working from home. The role involves partnering with interdisciplinary... ...regulatory standards. Applicants should have a BSN or a Nursing graduate degree, an active RN license in Missouri, and at...Remote workPart timeWork from home
- ...seeking a dedicated person with excellent time management skills to fill our Program Director, Registered Nurse (RN) or Licensed Nurse (LVN) position! If you are a currently state... ...Schedule Expectation Assigned facility No remote scheduling available Facility schedule as...Remote workWork at office
$72.8k - $130k
...Sr Utilization Management Nurse Optum Insight is improving the flow of health data and information to... ...there is an occasional opportunity for remote work based on business needs. As a... ...Qualifications: ~ Must be a Registered Nurse (RN) with a current, active, unrestricted...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area$25 - $27 per hour
...providers to deliver value-based care management initiatives for their patients. Our clinicians... ...the direction of the Lead Triage RN, the triage nurse will be responsible for providing... ...nursing Experience in Triage required Remote Requirements Must have active high-speed...Remote workFull timeHome officeNight shift$60.2k - $107.4k
...Inpatient Care Management Nurse Optum is a global organization that delivers... ...for ensuring proper utilization of our health services. This... ...have the flexibility to work remotely* as you take on some tough challenges... ...~ Active, unrestricted RN license in state of...Remote workMinimum wagePermanent employmentFull timeWork experience placementWork at officeLocal areaMonday to FridayNight shift- A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities... ...service eligibility and facilitating care. This remote role requires an RN license and clinical experience. Benefits include...Remote jobWork from home
- Humana Inc is seeking a Utilization Management RN based in Atlanta, Georgia. This role involves collaborating with healthcare providers to evaluate medical care against established guidelines. Candidates must hold an active RN license, have over 5 years of clinical experience...Remote jobWeekend work
- ...Looking for qualified Nursing Supervisor (RN or LPN) to join our team! Location: Jamestown Health... ...Lead & Supervise Nursing Staff - Manage daily staffing needs, ensuring adequate... ...adults. From telemedicine services and remote health monitoring to advanced diagnostic...Remote workFull timeLocal areaShift workNight shiftWeekend workDay shiftAfternoon shift
$25k
...Clinical Care Nurse (RN) Become a part of our caring community... ...(TOC), reduce avoidable ED utilization, and drive Medicare Advantage... ...University City, Patton Ave (Remote), River Hills (Remote). As... ...in chronic disease self-management, particularly in DM, HTN, CHF...Remote workTemporary workWork at officeMonday to Friday
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