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
- Oregon Health & Science University is seeking a part-time Utilization Review RN to work remotely. This role involves assessing the medical necessity of... ...will collaborate with various teams to enhance patient care and reduce readmission rates. Required qualifications include...Remote jobPart time
- ...Health is seeking a Travel Nurse RN Case Manager specializing in Utilization Review for a role in Somerville, Massachusetts... .... You will supervise a team of care coordinators, ensuring best... ...travel position offers a flexible remote working schedule from Monday to Friday...Remote workMonday to FridayFlexible hours
- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position... ...and communicate with medical teams to ensure appropriate care levels. Ideal candidates will have at least one year of utilization...Remote workContract workWork from home
- ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
- ...patients receive high-quality care while efficiently utilizing medical resources. Job... ...work. Job Summary: Reviews patient medical records,... ...Certifications: ~ Registered Nurse (RN) licensure in the state of... ...to the on-site care management teams when appropriate....Remote jobPart timeWork experience placement
- ...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
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
- ...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
- ...Humana is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship and is... ...military spouses. Interns will conduct clinical reviews, communicate with providers, and document...Remote workInternship
$69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum. This... ...are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent...Remote work$60.2k - $107.4k
...Corporation is looking for a Utilization Review Nurse, RN, based in California. As part of this role, you'll manage inpatient utilization... ...position offers the flexibility of remote work within the U.S.,... ...responsibilities like clinical review and care coordination. The role...Remote work- 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
$2,210 per week
...leader in personalized managed health care, focused on what's... ...Holidays Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- The Council of State and Territorial Epidemiologists is seeking a Clinical Utilization Review Nurse (RN) to conduct utilization management reviews remotely. Candidates must hold a BA/BS in Nursing, possess a current RN license, and have a minimum of 3 years of clinical...Remote jobFull time
- ...BJC HealthCare (New) is seeking a remote RN with Utilization Review experience. This role involves evaluating the appropriateness and efficiency of hospital resources to ensure quality patient care. Candidates must have 2 years of RN experience and live within one hour...Remote work
$23.76 - $51.49 per hour
...is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role... ...with teams to promote effective care. Qualified candidates should... ...and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly pay- ...Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New York Tri-State Area. The successful candidate will be responsible for assessing member needs and ensuring high-quality...Remote workFull time
- ...Humana is offering a remote internship for a Utilization Management Behavioral Health Registered Nurse (RN) Intern. This role supports the National Medicaid team, focusing on clinical reviews and patient care. Candidates must be transitioning military service members or...Remote workInternshipWork at officeWeekday work
- ...We are seeking an experienced Utilization Review Nurse to join our team in a... ...Nassau County (Hybrid: In Office/Remote) Schedule: Monday to Friday,... .... Participate in case management and care coordination meetings. Qualifications Active RN license in the state of New York...Remote workWork at officeMonday to FridayFlexible hours
$2,700 per week
...Lancesoft is seeking an experienced Utilization Review Registered Nurse for an exciting Travel Nursing... ...Pending License accepted: No Fully Remote Position Hospital Highlights Type... ...Required: 1 year Certs Required: BLS, WA RN License About Lancesoft:...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work- ...Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate... ...LPN) or Registered Nurse (RN) with strong critical... ..., and resolving patient care issues with providers. Candidates... ..., and the ability to manage multiple tasks...Remote work
$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$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- ...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 work
- ...in Nevada seeks a Supervisor, Clinical Review to supervise clinical staff conducting utilization reviews. Ideal candidates will have an active RN licensure in Alabama, with 3+ years of... ...skills are crucial. The position offers a remote work option along with comprehensive...Remote work
$68.4k
...: JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate... ...CERTIFICATIONS Required Current State of PA RN licensure OR Current multi-state licensure...Remote workFull timeFor contractorsWork at officeLocal areaFlexible hours$34 - $52.7 per hour
...facility. This job is REMOTE. FTE: 0.500000 Standard... ...status type and level of care. Refers cases to the physician... ..., for a second level review as needed. Facilitates communication... ...is required; Prior utilization management or case management experience...Remote workHourly payTemporary workShift work$75k
...WNS Global Services is seeking a fully remote Utilization Review Nurse to perform inpatient reviews and ensure compliance... ...with physicians. The ideal candidate has an RN license, at least two years of experience in acute care, and proficiency in critical thinking and...Remote workWork at office$30 - $34 per hour
...healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in... ...and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly pay$51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in...Remote workDaily paidLive inShift workDay shift
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