Remote Utilization Management RN - Physical Health
Humana
Humana is seeking an Utilization Management RN - Physical Health to support coordination, documentation, and communication of medical services and benefit determinations. This full-time role is remote with periodic travel to Humana's Oklahoma City office and residency in Oklahoma.
The ideal candidate holds an active Oklahoma RN license with 3+ years of clinical experience in acute, skilled, or rehab settings and is prepared to apply nursing expertise to care coordination and benefit processes.
#J-18808-Ljbffr- Humana is seeking an Utilization Management RN - Physical Health to support coordination, documentation, and communication of medical services and benefit determinations. This full-time role is remote with periodic travel to Humana's Oklahoma City office and residency in...Remote jobFull timeWork at office
- ...Trillium Health Resources is seeking a Nurse Manager, Utilization Management – Physical Health to lead day-to-day utilization management operations... ...area. The role requires an RN with NC licensure and... ...travel within the catchment; remote work options are available for...Remote work
- ...powerful: to enhance the health and well-being of... ...an on-site Hospital Utilization Management (UM) Nurse, you are the... ...compliance. Unlike remote roles, this position... ...a Registered Nurse (RN) responsible for performing... ...). By being physically present, one is able...Remote workFull timeImmediate startShift work
$71.1k - $97.8k
...Healthy Horizons is more than a health plan. We're human care.... ...achieve their best health. The Utilization Management (UM) Nurse uses clinical... ...Licensed Registered Nurse (RN), unrestricted ~3+ years of... ...EPIC Programs Previous remote work experience Work at Home...Remote workFull timeTemporary workApprenticeshipWork experience placementWork at officeLocal areaWork from homeHome officeFlexible hoursWeekend work$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for... ...disease management or population health programs to support continuity and... ...marital status, familial status, physical, sensory, or medical disability,...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Excellus BCBS in New York is seeking a Utilization Management professional to coordinate the use of physical health services for members, applying clinical criteria and policies to determine care appropriateness. You will collaborate with Case Management, providers...Remote work
- ...Alliance Health is seeking an UM Clinical Specialist RN-Physical Health (Remote, NC Based) to assess medical necessity and oversee reviews across inpatient, outpatient... ...3–5 years of nursing experience and prior Utilization Management exposure. Strong communication and...Remote workWork at office
- ...resources to meet their care conditions. Reports to the Health Plan Manager of Utilization Management. This position will be an integral member of... ...processes that span the realm of Utilization Management. PHYSICAL REQUIREMENTS: The physical demands described here are...Remote workCasual workWork at officeShift work
$68.81k - $120.72k
...being Resources ~ Mental Health Resources and Support... ...requirements and manages concurrent and pre-bill... ...for in-house patients, utilizing daily commercial authorization... ...: Registered Nurse (RN) [Required] AND... ...Manager (CCM) [Preferred] Physical Requirements: (Please...Remote workFull timeWork experience placementLocal areaShift workWeekend work$63.1k - $94.65k
...enabled revenue cycle management solutions for health systems, including... ...have current compact RN license, or be... ...are seeking Virtual Utilization Review Specialist with... ...Required: This is a remote role which requires... ...designed to support the physical, emotional, and financial...Remote workTemporary workWork at officeLocal areaMonday to FridayShift work- ...Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of... ...Role: Job Summary The Director of Utilization Management (UM) is responsible for leading and... ...and to provide continuity of care. Physical Demands Weight Lifted: Up to 20 lbs...Remote workShift workDay shift
$81.95k - $110.24k
...technology-enabled revenue cycle management solutions for health systems, including... ...healthcare. The Lead Utilization Review RN is a key contributor to the... ...required #LI-LS1 #LI-REMOTE Join an award-winning... ...designed to support the physical, emotional, and financial...Remote workFull timeWork at officeLocal area- ...Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, benefit inquiries, and inpatient/outpatient services. This role requires interpreting evidence-based criteria, guidelines, and policies...Remote workWork from home
- ...Arkansas Blue Cross and Blue Shield is seeking an RN Utilization Management Nurse to perform clinical reviews for medical necessity across various services. The role involves weekend coverage and work from home within Arkansas and several western states. The ideal candidate...Remote workWork from homeWeekend work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination... ...care services including SNF, Home Health and DME, aiming to ensure members... ...care in the right setting. This remote role requires US RN licensure in the state of residence...Remote workWork from home
$62.4k - $117.62k
...integrating, and monitoring the utilization of physical health (PH) medical and healthcare... ...and work closely with Case Management to address member needs.... ...degree and active NYS RN license required. Bachelors... ...There may be opportunity for remote work within all jobs posted...Remote workFull timeContract workWork at office- ...Alliance is seeking a Director of Utilization Management (Physical Health) to lead the UM team in a fully remote role with occasional travel to the Morrisville, NC home office... ...across the department. The role requires RN licensure (BSN or MSN preferred) and several years...Remote workHome office
- ...Preferred- Experience in Case Management or Utilization Review Business and... ...as well as understanding of Health Care Delivery Systems Certifications Required-Current RN License in the state of practice... ...status, or disability status. Physical and Environmental Demands The...Remote jobWork experience placementLocal areaImmediate startFlexible hoursWeekend work
- ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote workWork from home
- ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a...Remote workWork from homeWeekend workAfternoon shift
- ...Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will coordinate with providers and members...Remote work
- Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate... ...care programs (SNF, Home Health, DME). The role involves... ...documentation while working remotely with periodic travel to... ...needed. You must have a Compact RN license, 1+ year of RN experience...Remote work
$39.4 - $53 per hour
...technology-enabled revenue cycle management solutions for health systems, including... ...Overview The Lead Utilization Review RN is a key contributor to the... ...Monster Top Workplace for Remote Work 2024 Great Place to... ...designed to support the physical, emotional, and financial...Remote workWork at officeLocal area- Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and... ...inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote jobWork from home
$101.72k - $198.36k
...Location: California - Ability to work remote, but selected candidate must... ...position requires California RN Licensure. Candidates must have significant... ...all of the following functions: utilization management, care management, behavioral health and other programs. Leads team...Remote workContract workWork experience placementWork at officeLocal area- ...Logan Health is seeking a Utilization Management Specialist to join our team in a fully remote role focused on inpatient admissions reviews, physician documentation assessment, and authorizations across the Logan Health system. The position emphasizes collaboration with...Remote work
- ...CVS Health is seeking a Utilization Management Nurse Consultant (Remote) to support Florida Medicare home-care requests. You will review cases, determine coverage, and... ...-time setting. The position requires an active RN license, 2+ years of experience (including 1+ year...Remote workFull time
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination... ..., and teams to facilitate care.The role requires an RN license in the state of residence, 1+ year of clinical RN experience in hospital/SNF/home health,J-18808-Ljbffr...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will work with physicians and care providers to make determinations using established...Remote work
- ...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
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