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
- ...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
- ...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
- ...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
- ...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
$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 week$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 shift- ...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
- ...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 service utilization for patients in acute and post-...Full timeWork at office
- ...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...
$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 week- ...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
$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 paid- ...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
- ...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
- ...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
- ...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
- ...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
$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- ...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
- ...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 & 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
- ...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
- ...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
$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 work- ...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
$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 work- ...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 Health Plan Group is seeking an RN Utilization Review for a remote, per diem position in Los Angeles. You will be responsible for conducting... ..., benefits include a comprehensive package with health care options, retirement plans, and paid time off. #J-18808-Ljbffr...Remote workDaily paid
$1,949.74 per month
...Specialty Utilization Review Job ID 1797... ...Utilization Review RN Weekly Pay... ...Job Description Remote Utilization Review RN... ...reviews, and utilization management using InterQual criteria... ...guidelines in an acute care setting. Client...Remote workWeekly payShift work- ...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
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Utilization Review & Care Manager. Be the first to apply!


