Remote Utilization Management Nurse | Denials & Appeals
Brigham Womens Hospital Radiology
- Remote job
Brigham and Women's Hospital in Boston is seeking a Staff Nurse - Per Diem Rotating Day in Utilization Management. The role reviews denials, appeals, and ensures appropriate care levels with care coordination and finance teams. A BSN is required with RN licensure in Massachusetts and prior utilization review experience. Responsibilities include applying Milliman/InterQual criteria, collaborating with physicians and staff, and supporting quality and financial outcomes. #J-18808-Ljbffr Brigham and Women's Hospital
$36 - $40 per hour
...Norwood we’re forging our own path. We’re a remote-first staffing and consulting company specializing in mid-Revenue Cycle management within the healthcare industry. Our... ...in your coding career. If you are an Appeals and Denials Nurse looking for a new opportunity to...Remote workPermanent employmentFull timeWork visa- ...Description Job Description: Manager of Clinical Utilization Management - Denial ComplianceLocation:... ...Type: Hybrid (85% remote, 15% onsite in Northridge... ...an accredited Registered Nursing Program; RN preferred.2.... ...in prior-authorization, appeals & grievance, or health plan...Remote workPermanent employmentFull timeTemporary workFlexible hours
- UnitedHealth Group is seeking an Utilization Management & Clinical Validation RN to accurately review medical records and extract case details, crafting defensible appeal letters using evidence-based literature and coding knowledge. You will work from anywhere in the U....Remote jobFlexible hours
$41.71 - $105.65 per hour
...Staff Nurse - Per Diem Rotating Day - BWH Utilization Management The Insurance Support Nurse participates... ...timely management of denials that are received in... ...medical and nursing staff to appeal denied claims and... ...Details (if applicable) Remote Type Remote Work...Remote workHourly payDaily paidShift work$41.71 - $105.65 per hour
..., including doctors, nurses, business people, tech... ...Rotating Day - BWH Utilization Management The Insurance Support... ...timely management of denials that are received in... ...and nursing staff to appeal denied claims and... ...Details (if applicable) Remote Type Remote Work...Remote workHourly payDaily paidShift work$60k
...LVN experienced in the managed care payor... ...service and post-service utilization reviews and appeals for DMEPOS. This individual... .../ABILITIES The UM Nurse’s responsibilities... ...Experience writing denial letters is preferred... ...opportunities Remote Opportunities We...Remote workFull timeTemporary workLocal area- ...United States is seeking a Denials Management Specialist to join our remote team. This role focuses... ...necessity reviews, and appeals for insurance payers.... ...Qualified candidates will have nursing experience, RN license,... ...2–5 years in case/un utilization management with exposure...Remote work
$71.1k - $97.8k
...independently in their communities? As a Utilization Management (UM) Nurse, you will play a vital role in... ...HCBS). Make decisions related to denials for HCBS-covered services in accordance... ...Illinois. Workstyle: This is a remote position supporting members and...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$56.2k - $100.98k
...professional on our Medical Management/Health Services team.... ...necessity grievance, appeals and denials including disposition... ...3+ years of clinical nursing experience or RN with... .... Experience with utilization or appeals review... ...Location: Position is remote. Will work PST hours....Remote workHourly payFull timePart timeWork at officeFlexible hours- ...Medical Center in Dallas, TX invites applications for a Clinical Denial Management Specialist III in the Revenue Cycle Department. This is a 100... ...complex surgical E/M denials, coordinate with payers, and submit timely appeals. #J-18808-Ljbffr UT Southwestern Medical CenterRemote jobWork from homeMonday to FridayShift work
$62.5k - $79.8k
...enabled revenue cycle management solutions for... ...experience The Denials RN Coordinator prepares appeals for clinical and technical... ...: Registered Nurse RN Job Experience... ...years of denials, utilization review, or case management... ...AI. This is a remote position; however,...Remote workFull timeContract workTemporary workWork at officeLocal area- ...Medical Center is seeking a Clinical Finance Case Manager - RN to secure complex pre-authorizations and prevent denials. You will apply clinical knowledge to... ...assigned payers, with responsibilities spanning Appeals, Utilization Management, and collaboration with Legal and...Remote job
- ...Utilization Management Registered NurseDuration: 6 Month Contract... ...Management (UM) Registered Nurse to support outpatient... ...for complex cases, denial recommendations, and clinical... ....Participate in appeal reviews and provide clinical... ...independently in a remote environment....Remote workContract work
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical... ...timely processing of all denial determinations according to... ...and communicating appeal processes Distributed denial... ...Nurse- Prior Authorization Remote Registered Nurse (Remote...Remote workFull timeWork at officeWork from homeNight shift- Providence California Regional Services is seeking an Appeals RN in Case Management for a remote per diem position. This 8-hour day shift role focuses on managing clinically-based appeals and coordinating reimbursement conversations with external payers. The Care Management...Remote jobDaily paidDay shift
$42 per hour
...adjustment, population health, and utilization management. IntusCare empowers teams to... ...Utilization Management Nurse plays a critical role in... ...patient related interactions Appeal Management - In cases of claim... ...location : This is a fully remote role based in the United...Remote workContract work- UT Southwestern Medical Center seeks a Clinical Denial Management Specialist III to perform advanced medical billing/denial duties under supervision... ...and EPIC familiarity. CPC certification is a plus. 100% remote work with a shift Mon-Fri; benefits include comprehensive...Remote jobShift work
- ...as stated in system utilization management plan. Oversees Clinical... .... This role will be remote BUT regular meetings/... ...Bachelor of Science in Nursing ~ Previous... ...clinical support to aid in appeal process. Serves as... ...review process, aids in denial prevention, and...Remote workReliefWeekend work3 days per week
$40 per hour
100% Remote - Utilization Management Nurse We are seeking a dedicated Utilization Management Nurse to provide timely and appropriate prior approval... ...review documentation system. Communicate approval and denial decisions to members and providers according to...Remote jobContract workTemporary workWork at office$84.56k - $126.84k
...Job Overview The Utilization Review RN participates... ...participate in denial mitigation. It is... ...Name: Utilization Management Job Status: part time... ...will be primarily remote but there may be... ...staff to assist with appeals. 7. Maintains and... ...of Science in Nursing (BSN) Experience:...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology... ...is an occasional opportunity for remote work based on business needs. As a... ...concurrent authorization, and/or clinical appeal and guidance reviews ~ Must live in...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area$67.2k - $85k
...80127, Job Title: BH Utilization Manager RN, Salary: $67,200.0... ...adhering to BH UM and Appeals policies and... ...appeals standards for denials. Review any requests... ...Bachelor's degree in nursing. Current state Registered... ...systems Work Schedule: Remote Other Requirements...Remote workContract workWork experience placement$26.35 - $39.53 per hour
...Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for... ...provided to members under a managed care health plan. This role... ...leadership for complex cases, denials, and escalated reviews. Key... ...Corporate office preferred / remote may be considered Collaborative...Remote workHourly payWork at office- ...East is looking for a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start... ...writing, medical record/chart review, and utilization review; Strong clinical foundation with...Remote workFull timeMonday to FridayFlexible hours
$66.58k - $142.58k
...something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Utilization Management | Work from Home Are you an experienced RN looking to leverage your clinical...Remote workHourly payFull timeTemporary workLocal areaWork from homeAfternoon shift- ...Clinical Appeals Nurse - Full Time Remote - Jefferson Health Reviews payor denials and audits for potential lost revenue. Writes... ...and reports payor trends to management team. This is not intended... ...clinical or case management/utilization review experience Knowledge...Remote jobFull time
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports utilization management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities...Remote jobWork from home
- ...organization is seeking a RCS-Physician Advisor to join their Denial Management team. This full-time remote position requires a medical degree and board... ...leadership abilities to help optimize hospital services and resource utilization. #J-18808-Ljbffr Indiana University HealthRemote jobFull time
- Mercor is seeking a Denials Management & Appeals Manager to lead operations focused on managing claim denials and appeals processes. This role requires... ...effective appeal strategies. This position is fully remote and offers competitive compensation. #J-18808-Ljbffr MercorRemote job
$60.53k - $129.63k
...care one person, one family and one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home | Full-Time | EST or CST... ...(UM) Nurse Consultant to join our team. This is a fully remote role available to candidates in any U.S. state in the...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeShift work
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