Remote Utilization Review Lead — Case Management
CorVel Corporation
- Remote job
CorVel Corporation in the United States is seeking a Case Management Supervisor to direct operations within the Case Management department. 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 management skills are essential for success in this role. #J-18808-Ljbffr CorVel Corporation
- Acentra Health is seeking a Supervisor of Clinical Review to manage Utilization Management activities and ensure high-quality clinical programs. This position requires strong leadership skills and a deep clinical background. Responsibilities include overseeing prior authorization...Remote job
$77.96k - $120.37k
...Utilization Review Supervisor RN The Utilization Review Supervisor... ...service, and limited sales management. This is a remote position. Essential functions... ...activities Overseeing case management clinical... ...roles (I, II, III, Senior, Lead, etc.) new hires may be slotted...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care.... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are essential...Remote workContract work
$2,210 per week
...independent leader in personalized managed health care, focused on... ...Work-life balance. Remote/hybrid setting (once... ...DESCRIPTION: This individual will utilize clinical knowledge and... ...to a second level reviewer. This individual interfaces with case managers and disease management...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J-1...Remote workContract work
$89.07k - $162.8k
...In-patient Utilization Review RN In-patient Utilization Review RN experience highly preferred... ...activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks... ...Collaborates with the physician nurse case manager social worker and other members...Live in- ...Hospital Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations*... ...Commission/ Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote 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... ...Utilization Management, Utilization Review, or Case Management Preferred Certifications...Remote workContract workImmediate startMonday to Friday- ...responsible for providing skilled nursing care, case management, and hospice care to individuals... ...& Certifications: Experience in Utilization Review or case management roles.... ...Strong ability to work independently in remote settings. Must be able to handle...Remote workFlexible hours
- ...Group to support behavioral health and substance abuse case management through utilization reviews and care coordination. While not a member facing role,... ...level of care at the right time. This is a fully remote position with a Monday-Friday schedule during standard...Remote workMonday to Friday
- ...Summary Utilization Review Nurse - Case Management Full-time, day shift (varies 7:30a-4:00p or 8:00a-4:30p) Hybrid (remote with rotating in house coverage) 72-hour position - Rotating 4/5 days, works every 5th weekend Job Description Ensure the efficient and effective...Remote workFull timeWeekend workDay shift
$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE)... ...physician reviewers to support case review processes. Assist... ...required timelines. Support case management activities and identify... ...working independently in a remote or office-based setting. Working...Remote workWeekly payContract workWork at officeMonday to Friday$65k - $75k
...Hospital is seeking a full-time UR Case Manager responsible for managing caseloads... ...clinical teams while conducting reviews to ensure optimal client coverage.... ...Mental Health, with experience in utilization review preferred. This remote role offers a pay range of $65-75k...Remote jobFull timeMonday to Friday$41 - $45.5 per hour
...Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL,... ..., health education, and utilization management. Key... ...concurrent, and retrospective reviews for inpatient, rehab,... ...partners to industry-leading MSP programs including Kelly...Remote work- ...Registered Nurse - Utilization Review (Nursing) Location: Aurora, CO. Location: Colorado Military... ...Category: Registered Nurse – Utilization Management. Current POP ends 11/30/25. TO POP ends... ..., Medical‑Surgical Nursing or Nursing Case Management through the American Nurses...Remote workContract workWork from homeMonday to FridayNight shift
- Case Management Society of America (CMSA) ® is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, Texas. The role involves evaluating the appropriateness of medical services while collaborating with healthcare professionals to enhance patient outcomes. The...Remote jobFlexible hours
- ...Currently seeking a Utilization Management RN . Please see details and qualifications... ...below: Position is remote - candidate must reside in... ...conditions through medical record review to determine medical... ...information when needed. Refer cases that do not meet criteria to...Remote workImmediate startDay shift
- Miami Jewish Health in Florida is seeking an Utilization Review Nurse to conduct prospective, concurrent, and retrospective reviews ensuring... ...level of care. You will collaborate with hospital UR/Case Management, the IDT, and providers to facilitate timely care transitions...Remote job
- yourcommission in Bellaire, Texas is seeking a Utilization Management Review Nurse (UMRN) to evaluate medical services and ensure appropriate care... ...flexible work hours including telecommute options. Experience in Case Management is preferred. #J-18808-Ljbffr yourcommissionRemote jobFlexible hours
$35 - $40 per hour
...- $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in... ...on Medicare guidelines. Refer cases outside of established guidelines... ...customer service support to payer case managers, patients, and provider teams....Remote workContract workFlexible hoursWeekend work- Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to ensure timely, compliant determinations...Remote jobFull time
$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th... ...durable medical equipment Refer cases to Medical Directors as needed/appropriate... ...UM. Candidates with only case management experience are not a fit. Experience...Remote workHourly payMonday to Friday- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital... ...They effectively and efficiently manage a diverse workload in a fast-... .... Identify and present cases of possible quality of care deviations...Remote workFull time
- ...Case Manager RN (U) The Case Manager RN (U) coordinates the overall interdisciplinary plan... ...avoidable days. Enter Ancillary notes utilizing the templates for care facilitation.... ...physicians(s) to develop patient care plans and review medical needs for continued hospital...Remote work
- ...SIGN-ON BONUS: $5,000 FOR A 2 YEAR COMMITMENT**JOB TITLE: UTILIZATION REVIEW/CASE MANAGEMENT – NurseDEPARTMENT: CASE MANAGEMENT (QUALITY)HOURS & SHIFT... ...Full time position. Hybrid (combination of in person and remote considered)GENERAL SUMMARYThe Utilization Review/Case...Remote workFull timeSecond jobWork at officeRelocation packageShift work
- ...vary by location and is determined by employment status Summary: The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet’s Case Management strategy with the specific focus on Utilization Review for the designated Market....Full timeFlexible hoursShift work
- ...faculty or staff position, please review this tip sheet ( . The Case Manager RN (U) coordinates the overall interdisciplinary... ...days. Enter Ancillary notes utilizing the templates for care... ...university-based health system, provides leading-edge patient care powered by the...Remote workFull timeTemporary workWorldwide
$30.64 - $45.8 per hour
...CA Utilization Review Nurse I The Utilization Review Nurse gathers demographic... ...while supporting the goals of the Case Management department and of CorVel. This is a remote position. Essential... ...leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...delivery of such care; achieved via managing the cost of care while... ...Functions Applies approved utilization criteria to monitor... ...levels of care and continued stay review. Communication to third-... ...with physician/provider and case manager/discharge planner when...Remote workWork at officeShift workNight shiftRotating shift
- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a... ...patient outcomes and resource management. This role demands a solid clinical... ...review meetings to discuss cases, discharge plans, and... ...as required for facility based staff; optional for remote staff.Remote workWork at office
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