Remote Utilization Management Nurse Specialist
Ampcus, Inc
- Remote job
Ampcus, Inc is seeking a Utilization Management Specialist to perform medical necessity reviews and ensure appropriate care within the healthcare system. The role involves utilizing clinical expertise to analyze information and contribute to the authorization of clinical services. Candidates should have a Bachelor’s in Nursing, extensive clinical nursing experience, and strong communication skills. The position is remote and offers a dynamic work environment. #J-18808-Ljbffr Ampcus, Inc
- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- 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
$275k - $325k
...affiliate locations of care across five states and growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon FloridaThe Medical Director role provides clinical...Remote workWork from home- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate...Remote jobFull timeWork from home
- ...Job Description Job Description Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients...Remote workFull timeWork at office
- ...General Brigham Health Plan is seeking a Registered Nurse to provide clinical review and escalation support for Utilization Management, triaging inquiries and ensuring medical necessity and regulatory compliance. This remote role supports our national network while...Remote job
- Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote job
- ..., EV charging, and complete home energy management ecosystems. By leveraging world-class... ...leading the company’s sales efforts in the Utility scale and Community Solar segment of the... ...in North America. Location : Remote USA, preferred location in the East Coast...Remote workFull timeWork from home
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will leverage your...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$34 - $35 per hour
Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from... ...Global Talent Attraction and Branding Specialist Lead @ BroadPath | Employee... ...Review Nurse- Prior Authorization Remote Registered Nurse (Remote Patient Monitoring...Remote workFull timeWork at officeWork from homeNight shift$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support our 24/7 Utilization Management operations. In this role, you will...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with occasional...Remote jobWork from home$94.9k - $130.5k
Become a part of our caring community The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation... ...and resolve basic technical difficulties in a remote environment. Ability to work independently under general...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office$88.85k
RN Job Utilization Management Nurse Specialist RN II Shift: Full Time Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Job ID: 13208 Location: Los Angeles, 90017 Job Description The Utilization Management Nurse Specialist RN II facilitates, coordinates...Full timeShift work$88.85k
...‑income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures...Full time$29.1 - $62.32 per hour
...health care one person, one family and one community at a time.Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse ConsultantFully Remote- WFHSchedule : Tuesday-Saturday 9:30am-6:00pmPosition SummaryUtilization...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift- ...Consulting Group, LLC is seeking a Technical Project Manager (TPM) to lead complex transformation programs from a remote posture with work-from-home eligibility, based... ...enterprise platform rollouts, with a focus on utilities and energy sectors. You will partner with...Remote jobWork from home
- DescriptionSummary: Huntington’s Director, Portfolio Management -Power & Utilities will co-manage a growing $4.5 billion book of business in the bank... ..., maintain a strong community, and do their best work. Remote roles will also have the opportunity to come together in our...Remote workFull timeWork at officeWork from homeFlexible hours
$240.12k - $315.16k
...Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first health insurance company built... ...report into the Senior Medical Director.Work Location: This is a remote position, open to candidates holding an active medical...Remote workFull timeImmediate startWork from homeHome office$85.7k - $128.54k
...dedicated to transforming the lives of the seniors we serve while providing ample opportunities for growth and innovation. Utilization Management Nurse Lead Responsibilities Reviews reporting to assign tasks to UM Nurses for completion of time sensitive items. Works...Remote jobImmediate start- ...Seeking a California Licensed UM Nurse for a full-time remote position, who will review prior authorization... ...when additional expertise is needed Utilize CMS guidelines and Milliman Care... ...year of pre-service UM experience in a managed care environment Active, valid, and...Remote workFull time
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
$100k
...Type Contract Industry Health Care Work Experience 1-3 years Salary $100,000 Remote Job Job Description This is a remote position. The Utilization Management (UM) Nurse is responsible for conducting clinical reviews and assessing the medical necessity,...Remote workContract workWork experience placement$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... ...Florida. WellMed is a network of doctors, specialists and other medical professionals that...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established criteria. The role requires adept EMR review, strong clinical judgment, and collaboration with ED physicians...Remote job
- ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in... ...and a member’s benefit coverage while working remotely. Primary Responsibilities • Performs...Remote workContract workWork at office
- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while collaborating with external entities. This... ...a comprehensive benefits package including remote work options. #J-18808-Ljbffr Healthcare Management...Remote job
- Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments to...Remote job
- Vālenz Health® is seeking a Utilization Management Nurse for a fully remote role. You will oversee and manage UM processes to ensure appropriate, necessary, and cost-effective care for plan participants, reviewing prospective, concurrent, and retrospective reviews. You’...Remote job
- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract... ...using evidence-based literature and coding guidelines. This remote role supports telecommuting from anywhere in the U.S. with...Remote jobFlexible hours
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