Remote RN: Utilization Review & Care Manager
Guidehealth
A leading healthcare provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare settings. Responsibilities include conducting reviews, documenting findings, and collaborating with providers. This position offers the flexibility of remote work while supporting professional growth and a comprehensive benefits package. #J-18808-Ljbffr
Vacancy posted 9 hours ago
Similar jobs that could be interesting for youBased on the Remote RN: Utilization Review & Care Manager in Chicago, IL vacancy
- ...Guidehealth leverages remotely-embedded... ...and a centralized Managed Service Organization... ...DoingUtilization Review & Clinical DeterminationsComplete... ..., or quality-of-care review.Communicate... ...Registered Nurse (RN) license in... ....Knowledge of utilization review, managed care...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal area
Guidehealth
Peoria, IL9 hours ago - ...experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license and significant experience in healthcare. The...Remote workWork from home
Guidehealth
Peoria, IL9 hours ago - ...healthcare analytics firm is seeking a Registered Nurse for a remote role focused on utilization review and clinical determinations. The position requires... ...5+ years of varied healthcare experience, and an active RN license in Illinois. Responsibilities include conducting...Remote work
Guidehealth
Chicago, IL9 hours ago $35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX... ...Description of Project: Managing a case load for healthcare members... ...and will include 80% travel. Remote role. Will require a driver’... ..., and need for services for care plan development. Monitor...Remote workHourly payFull timeContract workImmediate startShift work3 days per weekMindlance Health
Corpus Christi, TX11 days ago- ...Nurse for a clinical role focusing on utilization review and care coordination. The ideal candidate will... ...healthcare, a strong understanding of managed care processes, and be proficient in Microsoft 365. This role offers remote work and a comprehensive benefits package...Remote work
Guidehealth
Rockford, IL9 hours ago $35.34 - $44.18 per hour
...want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast... ...requirements prior to starting. Click here ( to learn more! RN Care Manager - Utilization Review (1.0 FTE) Billings Clinic (Billings Clinic Main Campus)...Full timePart timeWorldwideFlexible hoursShift workNight shiftAfternoon shiftBillings Clinic
Billings, MT4 days ago- ...The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement... ...Associates or Bachelors Degree in Nursing required. State RN License required. Experience: Three to five years of...
Cookeville Regional Medical Center
Cookeville, TN3 days ago $35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX... ...Description of Project: Managing a case load for healthcare members... ...and will include 80% travel. Remote role. Will require a driver’... ..., and need for services for care plan development. Monitor...Remote workHourly payFull timeContract workImmediate startShift work3 days per weekTravelNurseSource
Corpus Christi, TX11 days ago- ...your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the... ...where your strategic vision transforms care coordination into measurable results... ...support, virtual nursing, and remote monitoring; clear investment in clinician...Remote workWeekend work
Clinical Management Consultants
Berkeley, CA2 days ago - ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
Freelanceshop
New York, NY1 day ago $35.87 - $51.57 per hour
...communities we serve. Summary: The Care Manager RN plays a crucial role in providing... ...within UNC Health. This position involves utilizing a variety of skills, including risk segmentation... ...Organization Unit: Utilization Review/Case Mgmt Work Type: Per Diem Standard...Hourly payDaily paidUNC Health Care
Siler City, NC9 hours ago- ...RN - Care Manager Utilization Review Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and...Full timeWork at office
- ...hiring a full-time Licensed Medical Review Nurse to conduct reviews of... ...documentation while working remotely. This role involves managing appeals and validating claims to... ...nursing experience, including utilization review, and a valid RN license in Florida or Kentucky....Remote workFull time
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New York, NY3 days ago - ...A leading healthcare organization is seeking a remote RN to ensure appropriate administration of hospital resources and quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations. The ideal candidate...Remote work
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Saint Louis, MO9 hours ago - ...Hospital, Inc. is seeking a full-time RN UR Specialist in Albany, GA. Responsibilities include managing insurance notifications and certifications for Utilization Review, ensuring compliance with regulations while supporting patient care. Candidates should possess an...Remote workFull time
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Albany, GA1 day ago - ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
NeuroPsychiatric Hospitals
Indiana, PA1 day ago $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 timeSanta Barbara Cottage Hospital
New York, NY3 days ago- ...COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services... ..., alongside a minimum of 3 years of direct patient care experience. The role involves applying Medicaid...Remote workFull time
COMAGINE HEALTH
Seattle, WA1 day ago - ...Providence Health & Services is seeking an RN Utilization Review for a part-time remote position. This role focuses on conducting clinical reviews and... ...years of experience in remote UR or acute hospital case management. A comprehensive benefits package, including...Remote workPart time
Providence Health & Service
Mission Hills, CA2 days ago - ...Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review... ...and Washington. This role encompasses care coordination and discharge planning, along with...Remote work
Providence Health & Service
Renton, WA2 days ago - ...MVP Health Care is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team. In this remote role, you will conduct clinical reviews to ensure compliance with Medicare guidelines and support high-quality patient outcomes. The ideal candidate...Remote work
MVP Health Care
New York, NY5 days ago - ...Behavioral Health Case Manager Responsible for... ...and e-referral case review and authorization of services utilizing established mental... ...to provide quality care appropriate to clinical... ...is full-time, fully remote (work from home) and... ...clinical license (RN, LMSW, LP, LPC, or LLP...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
MRINetwork
United States3 days ago $47.06k - $70.24k
...A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting... ...claims examiners. Candidates must have a current RN license and at least four years of clinical...Remote workCare Options For Kids
Fort Worth, TX9 hours ago- ...Concierge Home Care is seeking a Utilization Review Specialist (RN) for a remote opportunity. This position requires a Florida RN License, OASIS Certification, and Home Health Coding Certification. You will be responsible for reviewing home health clinical documentation...Remote workFlexible hoursWeekend workWeekday work
Santa Barbara Cottage Hospital
New York, NY3 days ago - ...Providence is seeking an experienced RN for Utilization Review to provide essential patient care while working remotely in Irvine, California. This role involves conducting clinical reviews and managing utilization efficiently in a dynamic regulatory environment. The...Remote workDaily paid
Providence Service
Irvine, CA1 day ago $49.34 - $76.59 per hour
...leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an... ...collaboration with physicians. This position manages medical management programs to optimize patient care. Competitive salary range for Portland is...Remote workProvidence Health & Service
Portland, OR9 hours ago- ...for clinical member services review assessment processes. Verifies... ...integrated delivery of care across the continuum. Contributes... ...care model. Adheres to utilization management (UM) policies and procedures.... ...experience. Registered Nurse (RN). License must be active and...Remote workWork at office
Molina Healthcare
United States1 day ago $57.28 - $88.92 per hour
...Providence Health Plan Group is seeking an RN for Utilization Review, working full-time in a remote position. The role involves conducting clinical reviews and managing utilization reviews across various health plans in Southern California. Required qualifications include...Remote workHourly payFull timeProvidence Health Plan Group
Irvine, CA1 day ago- ...optimal health, access to care and appropriate utilization of resources, balanced with... ...necessity. This position manages medical necessity process... ...delegated to Central Utilization Review LVN/LPN Case Manager and/... ...thru Saturday schedule. Remote, but you must live locally...Remote workWork at office
Santa Barbara Cottage Hospital
New York, NY3 days ago $25.08 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...care model. • Adheres to utilization management (UM) policies and procedures.... ...experience. • Registered Nurse (RN). License must be active and...Remote jobHourly payWork experience placementWork at office
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