Remote Utilization Review Nurse
$85.99k - $105.34kUmpqua Health
A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams. Applicants should have an active RN license and at least five years of direct patient care experience. The position offers a competitive salary from $85,990 to $105,344, along with a generous benefits package including healthcare and 401k options. #J-18808-Ljbffr
- Gainwell Technologies is seeking a skilled Utilization Review Nurse to conduct prior authorization and reviews for medical necessity, following clinical criteria and policies. This home-based role supports providers and requires accurate documentation and collaboration...Remote job
- Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote job
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. Description Astrana Health is looking for an experienced...Remote jobHourly payMonday to Friday- ...Utilization Review Nurse- Remote American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing...Remote jobFull timeTemporary workLocal area
- ...The role may supervise multiple functions including human resources and limited sales management, and is fully remote. The position requires RN licensure, nursing education, and several years of clinical and supervisory experience. Strong communication and project...Remote work
- ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical review and provider collaboration. The position requires an active RN license, 3+ years...Remote workFull time
- ...Clinical Quality Consultant for the Oncogenetic Program to guide utilization management of advanced molecular and genetic testing in... ...pathology, 5+ years in oncology/genetics, and proficiency with NGS tools; remote-friendly in a fast-paced tech-enabled #J-18808-Ljbffr...Remote work
- ...Management Location: 100% Remote Schedule: M-F 9:00am to 5... ...Summary Works with the Utilization Management team primarily responsible... ...necessity/utilization review and other utilization management... ...IL State Registered Nursing (RN) license in good standing...Remote workContract work
- ...AHCCCS is seeking a Behavioral Health Prior Authorization Utilization Review Consultant to monitor and decide on medical and behavioral health... ..., and standards of care. The position supports AHCCCS’ remote-work options within Arizona, emphasizes collaboration with providers...Remote work
- ...first 25 applicants This is full-time remote, but candidates must reside in IL or TX... ...performing accurate and timely medical review of claims suspended for medical necessity... ...and prioritization skills. ~ Registered Nurse (RN) with unrestricted license in state...Remote workFull timeContract work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
$35 - $40 per hour
...Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of...Remote workContract workFlexible hoursWeekend work- ...healthcare team, the full-time California Licensed Utilization Management LVN will manage authorization processes, perform utilization reviews, and collaborate with healthcare providers and insurance representatives in a remote setting. Key responsibilities Interface with...Remote workFull time
- ...: Job Summary Responsible for reviewing electronic medical records, retrieving and... ...interpretation of data and reports. Supports utilization review processes by planning, analyzing... ...and interprets reports for physicians, nursing, and ancillary services. • Coordinates...Remote workFull timePart timeReliefInternshipShift work
- ...time RN Referral Analyst will monitor and review referrals, assess cases for medical... ...outreach plans for members while working remotely. Key responsibilities Monitor and review... ...Required qualifications 5+ years of clinical nursing and patient assessment experience Related...Remote workFull timeWork experience placement
$35 - $43 per hour
...pay range $35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must reside in CA or hold an active... ...Review Nurse – Concurrent Review will perform utilization management functions to ensure members receive the right...Remote work- ...hospitals and nearly 300 sites throughout the greater Puget Sound region. Job Summary and Responsibilities As our Utilization Review Nurse, you will ensure the medical necessity and appropriateness of care for all hospitalized patients, promoting fiscal...Remote work
$34 - $40 per hour
...with your recruiter to learn more. Base pay range $34.00/hr - $40.00/hr Remote (Compact Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based...Remote workFull time$57.24k - $62.18k
...Nurses - are you looking for a change? Want to work no nights, no... ...Holidays ~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and... ...defer decision to a second level reviewer. This individual interfaces with...Remote workTemporary workWork at officeMonday to FridayFlexible hours$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than a healthcare organization...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
- ...meet QM objectives Responsibilities: Reviews documentation and evaluates Potential Quality... ...years of experience as an RN ~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience with Medcompass...Remote work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
$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 time- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
- ...Utilization Review Medical Appeals Nurse - USRN NTT DATA Services is currently seeking a Utilization Review Medical Appeals Nurse - USRN to join our... ...Able to work independently, strong analytic skills ~ Required shift timings - US daytime ~ Can work remotely...Remote workShift work
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to Friday- ...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, assisting...Remote work
$35 - $45.94 per hour
...Description Job Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role:... ..., Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida...Remote workHourly payFull timeWork from homeHome officeWeekend work
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