Remote RN Utilization Review Specialist - Case Management
NurseRemotely
- Remote job
HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The ideal candidate has an RN license with 1 year UR/UM or Case Management experience and 3 years RN in acute care, with strong collaboration across disciplines and payer interfaces. #J-18808-Ljbffr NurseRemotely
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team... ...Collaborate with Branch Directors, Clinical Managers, and field clinicians Support...Remote workMonday to FridayWeekend workWeekday work- ...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...SuggestedFull time
- Kingman Healthcare Incorporated (KHI) seeks an experienced Utilization Review Nurse to support case management in Arizona. You will conduct medical necessity... ...candidates hold a BSN (MSN preferred), have 3+ years RN hospital experience, and UR or CM exposure. #J-1880...Suggested
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- CorVel Corporation is seeking a Utilization Review Intake Specialist for a remote role. You will support the UR/Case Management department by handling calls, verifying information, and entering data in CareMCsystem. Ideal candidates will have a High School diploma (associate...Remote job
- ...Job Description A Day In The Life The Utilization Review Specialist (RN) is responsible for ensuring appropriate utilization of... ...practice. Working collaboratively with physicians, case managers, nursing staff, payers, and interdisciplinary teams, the...Full timeWork at officeWeekend work
- ...responsibility and clinical excellence. The Utilization Review Specialist Senior responsibilities include:... ...Critical Care or Emergency Nursing RN. Position details: Location:... ...(Registered Nurse) Preferred ACM (Case Management) Preferred CCM (Case Manager) Education...Full timeMonday to FridayWeekend work3 days per week
- ...seeking experienced nursing professionals to review medical records and ensure appropriate... .... Candidates must have a valid California RN license and at least two years of clinical... ...degree in a related field. The position offers remote work with emphasis on critical thinking...Remote work
- ...Description Job Description The utilization review and management (UM) component program ensures that external... ...: Work closely with medical staff, case managers, and other healthcare... ...for lunch This is an in-office, no remote work capability position Travel...Remote workWork at office
$2,150 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort Myers, Florida. Job... ...experience (hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT – 13 weeks SHIFT / HOURS...Remote workTemporary workZero hours contractImmediate startShift workNight shiftWeekend work$63k - $65k
...Financial Services & Insurance Utilization Review RN As a nurse at Sedgwick, you... ...experience to assist in the management of complex medical... ...and well-being of others in a remote work environment. Enjoy flexibility... ...preferred. Certification in case management, pharmacy,...Remote workWork experience placementFlexible hours$2,038 per week
...Solutions is seeking a travel nurse RN Case Management for a travel nursing job in Fort Myers... ...currently looking for a Registered Nurse - Utilization Review for a Travel contract. Job Details... ...literate; experience working remote; degree accreditation verification or...Remote workPermanent employmentContract workZero hours contractReliefLocal areaShift workRotating shift$44.7 per hour
...The Utilization Review (UR) RN evaluates the medical necessity appropriateness and efficiency of healthcare... ...works closely with clinical teams case management and payers to support safe efficient... ...is a WSNA union covered position Remote Work : No Employment Type :...Remote workHourly payPart timeShift workNight shiftWeekend workAfternoon shift- AvonRisk is hiring a Medical Case Management nurse in Texas for a hybrid role combining case management and utilization review. You will coordinate care, assess medical necessity, and... ...position requires an active California RN license and at least 1 year of clinical experience...
- Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong nursing experience. The...Remote job
- Florida PACE Centers, Inc. is seeking a Utilization RN to conduct prospective, concurrent, and retrospective reviews ensuring medical necessity and appropriate level... ...continuum. The role collaborates with hospital UR/Case Management, IDT, and community providers to support...Remote job
- Cohere Health seeks an experienced RN Reviewer to perform prospective, concurrent, and retrospective reviews ensuring medical necessity... ...for Commercial, Medicare, and Medicaid lines. The role is fully remote, requires strong communication, and entails 40 hours per week...Remote jobFlexible hours
- ...sites. Job Summary The Utilization RN is responsible for... ...and retrospective clinical reviews to determine medical necessity... ...collaborates closely with hospital UR/Case Management, facility and community... ...Environment Work Conditions ~ Remote role with reliable high-...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
- CorVel Corporation is seeking a Utilization Review Case Manager for a fully remote role in the United States. The position requires current nursing licensure and 4+ years of clinical experience with preferred exposure to utilization review. Responsibilities include data...Remote job
- CorVel in the United States is seeking a Utilization Review Case Manager to gather demographic and clinical information, certify medical necessity... ...length of stay for inpatient and outpatient treatment. This remote role requires strong CPT/ICD coding knowledge, meticulous...Remote job
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
$1,759.5 per week
...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas, United States Position ID: P-756324 Position status: On Hold... ...pay) Description American Traveler is hiring a remote Utilization Management RN with a TX or compact license...Remote workWeekly payWork experience placementLocal areaShift work$35 - $40 per hour
...through service offerings for clinical, case management, member engagement, provider... ...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely... ...require weekends. Location: Fully remote work at home role. Secure, private...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend work- ...to the LTSS department. RN will be responsible for providing case management services and evaluating... ...authorization and concurrent review. Provides monthly... ...of treatment setting by utilizing the applicable medical policy... ...Info: *possible remote opportunity after training...Remote workContract workMonday to FridayFlexible hours
- ...Location: Remote - TX Department: Utilization Shift: First Shift (United States of America)... ...members. Works with the Department Manager and Team Lead to assure the... ...Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate...Remote workFull timeShift workDay shift
$38 - $44 per hour
...care they need. The RN UM Team Lead makes... ...happen — coaching reviewers to apply medical-... ...turn to when a case gets complicated and... ...barriers to the UM Manager with a... ...license Experience in utilization management, clinical... ...Familiarity with remote collaboration tools...Remote workHourly payWork at officeMonday to Friday$35 - $40 per hour
...through service offerings for clinical, case management, member engagement, provider... ...employees across 5 countries. Job title: RN Utilization Management Reviewer Job Description: We are currently... ...require weekends This is a fully remote work at home role. You must have a...Remote workHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- ...Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization... ...Utilization Management (UM) Specialists perform UM activities, such... ...that the UR process for the case was followed. ~ Attend...Remote workFull timeWork at officeShift workWeekend work
$16.74 - $26.92 per hour
...Job Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services including... ...supporting the goals of the Utilization Review / Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS &...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours
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