Remote RN Reviewer, Utilization Management
Cook Children's Health Care System
Fort Worth, TX
- Remote job
Cook Children's Health Care System is seeking a Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer to coordinate the efficient utilization of health care resources for CCHP members and ensure timely, quality care throughout the continuum.Working with the Department Manager and Team Lead, you will assess clinical information, determine medical necessity with the Medical Director, and communicate with providers to facilitate appropriate care transitions, whileJ-18808-Ljbffr Cook Children's Health Care System
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote RN Reviewer, Utilization Management in Fort Worth, TX vacancy
$52 - $56 per hour
...that uses both. We're hiring a contract RN for a New York health plan (Medicare... ...necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52-$56/hr based... ...end: intake, investigation, clinical review, decision and notification Apply medical...Remote jobContract workAfternoon shift- ...That's the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And Quality Assur-Weston Hospital Job Code 000446 Shift Days Schedule...Remote workFull timeWork at officeShift workWeekend work
- Coastal Care Services, Inc. is seeking an LPN licensed Utilization Management Nurse Reviewer for a work-from-home opportunity serving the Miami, FL area. Work schedule is 10am to 7pm, with every other Sunday and a weekday off for a total of five days per week. The role...Remote jobWeekday work
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...Ability to obtain additional RN licensure across the enterprise including... ...Package Flexible work solutions include remote options, hybrid work schedules,...Remote workMonday to FridayFlexible hoursWeekend work
AmeriHealth Caritas
Newtown Square, PA5 days ago - ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
ExamWorks
United States5 days ago $86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...most. We offer integrated managed care products, pharmaceutical... ...of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...unencumbered Registered Nurse (RN) license in the District of...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work2 days per weekAmeriHealth Caritas
Washington DC1 day ago- ...Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...business background required Experience in Utilization Management with criteria review utilizing standard practice guidelines...Remote work
Dane Street
United States2 days ago $219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a... ...weekend every 16 weeks Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend workOscar Health
Phoenix, AZ4 days ago- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
ExamWorks UM Strategies
United States4 days ago - ...Flexible Independent Contractor (1099) Remote Opportunity Required State Medical... ...ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...) specializing in technology-driven utilization management and clinical medical review solutions....Remote jobFor contractorsFlexible hours
- Location Remote - TX Department Utilization Shift First Shift (United States of America) Standard Weekly... ...members. 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
$230k
...Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...time. Company: Oak Street Health Location: Fully Remote Hours: Full-Time, Monday - Friday, 8am -5pm CST...Remote workFull timeMonday to FridayCVS Corporation
United States2 days ago- Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will apply UM criteria and clinical judgment to determine coverage for inpatient and outpatient services, coordinating with care teams to ensure appropriate...Remote jobFull time
- Oscar Health seeks a Physician Reviewer to join the Utilization Management team in a remote US-based role. You will determine the medical appropriateness of services and document decisions using evidence-based guidelines and Oscar workflows. Responsibilities include timely...Remote job
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and... ...post-acute care. You will work remotely, reporting to the Manager of... ...include an active RN license in your state and 1+... ...candidates have UM/utilization review experience, knowledge of Milliman...Remote work
Humana
Florida, NY4 days ago - ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM... ...brings proven experience conducting utilization reviews within a SNF, health plan, or managed care...Remote workFull timeMonday to Friday
Medix™
New York, NY5 days ago - ...Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho... ...prospective, concurrent and retrospective reviews to ensure medical necessity and promote cost-...Remote work
Cambia Health Solutions
United States1 day ago - ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
Cleveland Clinic
United States1 day ago - ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN performs telephonic review of hospital admissions and recommends alternative levels of care when appropriate. This role...Remote workPart timeMonday to Friday
The Judge Group
Philadelphia, PA2 days ago $59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend workkozmetickesluzby.vecnakraska.sk - Jobboard
United States3 days ago$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote ~ Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare... ...Nurseis responsible for performing utilization review activities in compliance with federal and state regulations...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States2 days ago- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
The Judge Group
United States5 days ago - ...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
First Connect Health
Austin, TX1 day ago - ...CVS Health is seeking an experienced Utilization Management Nurse Consultant (RN) to remotely review authorizations and assess medical necessity across multiple specialties. You will collaborate with care teams to ensure compliant, evidence-based reviews and timely decisions...Remote work
CVS Health
Oklahoma City, OK3 days ago - ...Overview This remote position in Utilization Management requires a Registered Nurse with 2 years of experience. Responsibilities include working with providers, managing reviews, and utilizing EMR systems. The role follows a Monday through Friday schedule with...Remote workWeekly payMonday to FridayWeekend work
Slate Healthcare
Fort Myers, FL2 days ago - ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary... ...fully remote in EST hours. This position will be reviewing prior authorization requests, assessing medical necessity...Remote workContract workTemporary workMonday to FridayShift work
InterSources
United States2 days ago - A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
$47.37 per hour
Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care, and ensure... ...regulations. The role requires an active RN/LPN/LVN license and 2-4 years of clinical...Remote jobHourly pay$101.72k - $198.36k
...California - Ability to work remote, but selected candidate must... ...requires California RN Licensure. Candidates must have... ...of the following functions: utilization management, care management, behavioral... ...proactive care coordination/care review and management. • Develops...Remote workContract workWork experience placementWork at officeLocal areaMolina Healthcare Careers
San Diego, CA22 days ago$47.03 - $63.48 per hour
...of technology-enabled revenue cycle management solutions for health systems, including... ...possible in healthcare. The RN, Senior Utilization Review Quality will play an essential role... ...patient and client experiences This is a remote position; however, candidates must be...Remote workTemporary workWork at officeLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Reviewer, Utilization Management. Be the first to apply!
Related searches
- public health registered nurse Fort Worth, TX
- temporary rn Fort Worth, TX
- cath-lab rn Fort Worth, TX
- perioperative rn Fort Worth, TX
- part time rn Fort Worth, TX
- pacu rn Fort Worth, TX
- travel registered nurse l&d Fort Worth, TX
- nicu registered nurse Fort Worth, TX
- telephonic rn Fort Worth, TX
- rn urgent care Fort Worth, TX