Remote Utilization Review RN - Insurance Care Quality
IntePros
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-based criteria for patient treatment, and collaborating with healthcare providers. Strong clinical judgment and familiarity with review tools are essential for this role. The ideal candidate will have 2-5+ years of experience in the field. #J-18808-Ljbffr
- ...vision insurance, paid time off, paid holidays... ...assistance, 403(b), remote work United... ...- 5:00 PM As a Utilization Review Registered Nurse for... ...clinical, managed care, utilization review... ...Registered Nurse (RN) license in... ...to drive improved quality and better health...Remote workQualityFull timeMonday to FridayDay shift
- ...staff position, please review this tip sheet ( .... ...The Case Manager RN (U) coordinates the... ...plan of care for patients, from... ...healthcare personnel, and insurers. Evaluates the needs... ...pathways to improve quality of care.Care facilitation... ...Ancillary notes utilizing the templates for...Remote workQualityFull timeTemporary workWorldwide
- ...Case Manager RN (U) The Case Manager... ...interdisciplinary plan of care for patients, from... ...personnel, and insurers. Evaluates the needs... ...to improve quality of care. Care facilitation... ...Enter Ancillary notes utilizing the templates for... ...care plans and review medical needs for continued...Remote workQuality
- ...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... ...position offers the flexibility of remote work while supporting professional...Remote workQuality
- ...Healthcare 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... ...reviews, assisting in quality improvement, and resolving patient care issues with providers. Candidates...Remote workQuality
- ...is seeking a Clinical Review Supervisor to provide... ...clinical staff conducting utilization review activities. This fully remote position requires an RN license and relevant experience in patient care and medical management. The role focuses on quality oversight and staff...Remote workQuality
- ...HEALTH is seeking a Clinical Utilization Review Nurse (RN) to conduct utilization... ...full-time role supports high-quality care delivery while ensuring... ...experience. The position is remote, allowing work from any... ...benefits including medical insurance and paid time off. #J-1880...Remote workQualityFull time
- ...Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services.... ...and ensuring compliance with clinical policies for quality care. Candidates should possess a BA/BS in Nursing, hold...Remote workQualityFull time
- ...and e-referral case review and authorization of services utilizing established mental... ...criteria to provide quality care appropriate to... ...is full-time, fully remote (work from home) and... ...One (1) year health insurance plan experience or... ...clinical license (RN, LMSW, LP, LPC, or...Remote workQualityFull timeWork from homeShift workWeekend workAfternoon shift
- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key... ...-effective patient care. Working collaboratively... ...policies on Health Insurance Portability and... ...levels of care. • Quality Assurance and Compliance... ...based staff; optional for remote staff.Remote workQualityWork at office
$47.69 - $94.06 per hour
...Job Summary The Utilization Review (UR) Nurse supports the Utilization... ...experience in utilization review, care management, quality management, or discharge... ..., medical/dental/vision insurance, life and disability... ...Peter Hospital Location: Remote, Olympia, WA (work site Providence...Remote workQualityHourly payFull timeLocal areaShift workDay shift- ...POSITION SUMMARY - RN Utilization Review POSITION DUTIES... ...~ Skilled experience with remote work LENGTH OF ASSIGNMENT... ...Short-term disability, life insurance, paid jury duty ~ Access... ...organizations provide quality patient care that continually evolves to...Remote workQualityTemporary workShift workWeekend work
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 6... ...DEPARTMENT: CASE MANAGEMENT (QUALITY) HOURS & SHIFT REQUIREMENTS... ...of in person and remote considered) GENERAL SUMMARY... ...ensures safe transitions of care. GIBSON AREA HOSPITAL & HEALTH...Remote workQualityHourly payFull timeWork at officeRelocation packageShift work$2,210 per week
...managed health care, focused on what... ...while ensuring quality care through... ...voluntary life insurance. Critical Illness... ...-life balance. Remote/hybrid setting... ...individual will utilize clinical knowledge... ...a second level reviewer. This... ...not limited to RN, LMSW, LMHC. Successful...Remote workQualityFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...non-profit managed care organization (MCO)... ...Department of Insurance. Through its network... ...access to the high-quality health care they need... ...Behavioral Health Utilization Manager will... ...concurrent and discharge reviews on assigned... ...systems. Work Schedule: Remote Other Requirements...Remote workQualityContract workWork experience placement
$51.43 - $79.84 per hour
...Description – This is a remote role. You MUST live... ...) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a... ...dental, vision), life insurance, disability insurance... ...expanding access to quality health care for all....Remote workQualityDaily paidLive inShift workDay shift$30 - $38 per hour
...solutions, and comprehensive care navigation together in one... ...Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑... ...to meet productivity, quality, and turnaround times daily... ...successfully perform in a remote healthcare environment. Ability...Remote workQualityHourly payFull timePart timeWork at officeMonday to FridayWeekend work$2,250 per week
...seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job... ...Skilled experience with remote work LENGTH OF ASSIGNMENT... ...-term disability, life insurance, paid jury duty ~... ...organizations provide quality patient care that continually evolves...Remote workQualityTemporary workShift workNight shiftWeekend work- ...internship for a Registered Nurse (RN) in Kentucky, aimed at... ...involve conducting clinical reviews, communicating with... ...health experience. The role is remote, focusing on healthcare quality assurance and compliance within the managed care industry. #J-18808-Ljbffr...Remote workQualityInternship
- ...Utilization Review Specialist The Utilization Review Specialist is responsible for the assessment... ...on tasks that promote cost-effective quality care and cost containment in accordance... ...state mandated regulations Analyzes insurance, governmental and accrediting...Remote jobQualityWeekly payContract workWork at officeLocal area
- ...seeking a Registered Nurse (RN) Intern to conduct clinical reviews and support healthcare... ...providing key training in a remote work setting. Key responsibilities... ..., documentation, and quality assurance. Applicants must... ..., and a keen interest in managed care. #J-18808-Ljbffr...Remote workQualityInternship
$85k - $105.34k
...Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure quality care. This role includes conducting prior authorizations, collaborating... ...regulations. The ideal candidate will have an RN license, 5 years of experience, and skills in...Remote workQuality- ...Houston Methodist, the Utilization Review Nurse (URN) position... ...licensed registered nurse (RN) who comprehensively... ...and level of care using nationally recognized... ...medical guidelines, and insurance benefits and communicates... ...medical channels. QUALITY/SAFETY ESSENTIAL...QualityPermanent employmentWork experience placementLocal area
$45k - $70k
...the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical... ...Applicants must have an active LVN/RN license, with a preference for candidates... ...benefits package including health insurance, retirement plans, and paid time off...Remote workQuality- ...) provides health insurance options to Samaritan... ...Coordinated Care Organization (CCO)... ...Together. This is a remote position in which... ...~ ~ Health plan utilization management ~ Medicare... ...plans ~ Quality Management experience... ...unencumbered Oregon RN License required within...Remote workQuality
- ...States is hiring for a Concurrent Review Nurse responsible for performing utilization management activities remotely. The role involves conducting... ...ensure appropriate patient care. The ideal candidate will be... ...regulatory standards and quality improvement initiatives. #J-1...Remote workQuality
- ...Comagine Health is seeking a Clinical Utilization Review Nurse (RN) to work remotely. This role involves assessing the necessity and quality of healthcare services through various... ...extensive benefits, including medical insurance, paid time off, and a retirement savings...Remote workQuality
$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions... ...FL - On-site - No Remote Salary: $55K - $70... ...health, and autism care fields of... ...burden of billing and insurance administration on... ...external stakeholders. Quality Improvement Participate... ..., PT, OT, SLP, RN). Proven...Remote workQualityWork at officeFlexible hours$41 - $45.5 per hour
...Senior Analyst Location: Remote (within plan states:... ...Active, unrestricted RN License Must have MCG/... ...cost-effective, high-quality care and supports members through... ...health education, and utilization management. Key... ...concurrent, and retrospective reviews for inpatient, rehab,...Remote workQuality$45 - $50 per hour
...Registered Nurse Clinical Reviewer for a fully remote position in New York.... ...role involves conducting utilization and quality reviews and contributing... ...paid vacation and health insurance, this position offers a great... ...with an active New York RN license. #J-18808-Ljbffr...Remote workQualityHourly pay
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