Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review RN - Insurance Care Quality in New York, NY vacancy
  •  ...clinical member services review assessment...  ...clinical guidelines, insurance policies, and...  ...integrated delivery of care across the...  ...strategy to provide quality and cost-effective...  ...model. Adheres to utilization management (UM) policies...  ...Registered Nurse (RN). License must be... 
    Remote work
    Quality
    Work at office

    Molina Healthcare

    United States
    4 days ago
  • $35 - $45 per hour

     ...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX...  ...and will include 80% travel. Remote role. Will require a driver’...  ..., and need for services for care plan development. Monitor...  ...travelers be an infectious agent of quality care wherever they go.... 
    Remote work
    Quality
    Hourly pay
    Full time
    Contract work
    Immediate start
    Shift work
    3 days per week

    TravelNurseSource

    Corpus Christi, TX
    13 days ago
  •  ...organization is searching for Clinical Utilization Review Nurses (RN) based in Alabama. This full-time, remote position involves assessing the medical necessity and quality of healthcare services....  ...ensuring compliance with quality care. The organization values work-life... 
    Remote work
    Quality
    Full time

    Comagine Health

    El Paso, TX
    1 day ago
  •  ...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...  ...benefits including health insurance, retirement contributions,... 
    Remote work
    Quality

    BJC HealthCare

    Saint Louis, MO
    2 days ago
  •  ...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 work
    Quality

    Guidehealth

    Chicago, IL
    2 days ago
  •  ...healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating...  ...based on necessity and promoting quality care outcomes. The candidate must have a...  ...with care management and insurance payers. This position offers flexible... 
    Remote work
    Quality
    Flexible hours

    Harris Health

    Houston, TX
    2 days ago
  •  ...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...  ...for assessing member needs and ensuring high-quality health care services. Key qualifications include... 
    Remote work
    Quality
    Full time

    Village Center for Care, Inc.

    New York, NY
    1 day ago
  •  ...Humana is offering a remote internship for a Utilization Management Behavioral Health Registered Nurse (RN) Intern. This role supports...  ...team, focusing on clinical reviews and patient care. Candidates must be transitioning...  ..., documentation, and quality assurance. The position... 
    Remote work
    Quality
    Internship
    Work at office
    Weekday work

    Humana

    New York, NY
    1 day ago
  •  ...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 work
    Quality

    Council Of State and Territorial Epidemiologists

    Albany, NY
    1 day ago
  •  ...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
    Quality

    MVP Health Care

    New York, NY
    8 days ago
  •  ...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 work
    Quality

    Alumni Ventures

    Florida, NY
    2 days ago
  • $30.37 - $59.21 per hour

     ...clinical member services review assessment...  ...clinical guidelines, insurance policies, and...  ...integrated delivery of care across the...  ...strategy to provide quality and cost-effective...  ...model. Adheres to utilization management (UM) policies...  ...Registered Nurse (RN). License must be... 
    Remote work
    Quality
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    United States
    4 days ago
  •  ...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 work
    Quality
    Full time
    Work from home
    Shift work
    Weekend work
    Afternoon shift

    MRINetwork

    United States
    5 days ago
  •  ...engaged in health care quality consulting and quality...  .... Our talented remote workforce spans...  ...dental and vision insurance Paid time off for...  ...employee is an active RN and based in...  ...Supervisor, Clinical Review plays a critical role...  ...staff who conduct utilization review and/or... 
    Remote work
    Quality
    Contract work

    Council Of State and Territorial Epidemiologists

    Sacramento, CA
    1 day ago
  •  ...appropriate clinical review of all applicable...  ...stated in system utilization management plan....  ...This role will be remote but regular meetings...  ...in hospital or insurance related utilization...  ...including critical care, for appropriateness...  ..., and reporting quality issues. Reviews concurrently... 
    Remote work
    Quality
    Relief
    Shift work
    Weekend work
    3 days per week

    Children's Healthcare of Atlanta

    Morgantown, WV
    1 day ago
  • $35 - $45 per hour

     ...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE)...  ...timely, accurate, and compliant care decisions in accordance with...  ...working independently in a remote or office-based setting....  ...same enthusiasm, we devote to quality and competency and using the... 
    Remote work
    Quality
    Weekly pay
    Contract work
    Work at office
    Monday to Friday

    Canon Recruiting Group

    Sacramento, CA
    4 days ago
  • $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 work
    Quality
    Full time
    Temporary work
    Part time
    Casual work
    Work at office
    Work from home
    All shifts
    Monday to Friday
    Flexible hours

    Hines

    Freeport, IL
    2 days ago
  •  ...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 work
    Quality
    Work at office

    Nexus Health Systems

    Houston, TX
    6 days ago
  • $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 work
    Quality
    Hourly pay
    Full time
    Work at office
    Relocation package
    Shift work

    Gibson Area Hospital

    Gibson City, IL
    6 days ago
  •  ...OverviewDescription – 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...  ..., vision), life insurance, disability insurance...  ...expanding access to quality health care for all.Providence... 
    Remote work
    Quality
    Daily paid
    Live in
    Shift work
    Day shift

    Providence Swedish Medical Center

    Seattle, WA
    2 days ago
  • $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 work
    Quality
    Hourly pay
    Full time
    Part time
    Work at office
    Monday to Friday
    Weekend work

    Santa Barbara Cottage Hospital

    New York, NY
    5 days ago
  •  ...Registered Nurse (RN) – Case Manager & Utilization Review Nurse Wichita, United...  ...setting while supporting quality member outcomes,...  ...services, and effective care coordination. The...  ...stop-loss carriers, insurance brokers, and health...  ...however, this isnota remote position. Applicant... 
    Remote work
    Quality
    Monday to Friday
    Flexible hours

    ProviDRs Care

    Wichita, KS
    1 day ago
  •  ...or behavioral health care services. Assesses...  ...professionals regarding utilization management and quality requirements. Makes...  .... Medical necessity reviews for designated...  ...~ Registered Nurse (RN) - State of Michigan...  ...protection, home and auto insurance Traditional and... 
    Remote work
    Quality
    Full time
    Monday to Friday
    Shift work
    Weekend work

    Corewell Health

    United States
    4 days ago
  • $49.14 per hour

     ...Dignity Health is seeking a Utilization Review Nurse to supervise clinical decision-making and ensure resource utilization compliance. Responsibilities...  ...utilization review principles, and liaising with care coordinators and physicians. Ideal candidates will have a nursing... 
    Remote work
    Quality
    Hourly pay

    Dignity Health

    Chandler, AZ
    2 days ago
  • $77.91k

     ...USA, LLC is seeking an Inpatient Review Nurse to join its remote Utilization Management team. This position...  ...inpatient admissions, coordinating care, and ensuring quality and cost-effective patient...  ...management and licensing as an LVN or RN in California. The role offers a... 
    Remote work
    Quality

    E2E Alignment Healthcare USA, LLC

    California, MO
    1 day ago
  •  ...Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and...  ...utilizes clinical expertise to ensure care aligns with industry standards, works...  ...resolve denials, and participates in quality improvement activities. Qualified... 
    Remote work
    Quality
    Flexible hours

    Case Management Society of America Inc

    United States
    5 days ago
  •  ...Martin's Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong...  ...and utilization management to ensure quality, cost‑efficient medical outcomes. Responsibilities...  .... Candidates must have a Compact RN License and at least 3 years of... 
    Remote work
    Quality

    Martins Point Health Care

    New York, NY
    1 day ago
  •  ...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 work
    Quality
    Internship

    Humana

    Augusta, ME
    1 day ago
  •  ...Quantum Corporation is seeking a Pre-Cert Pharmacy Review Nurse, RN for their healthcare navigation team. The role...  ...with multidisciplinary teams to ensure quality care for members, either on-site in Dublin, OH, or remotely within the United States. The ideal candidate... 
    Remote work
    Quality

    Quantum

    New York, NY
    3 days ago
  •  ...Advanced Health Coordinated Care Organization is hiring a part-time remote Utilization Review Nurse. The ideal candidate will be a licensed RN with experience in acute care and utilization...  ...prior authorizations, ensuring quality care, and applying medical necessity... 
    Remote work
    Quality
    Part time

    Advanced Health Coordinated Care Organization

    Oregon, WI
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Review RN - Insurance Care Quality. Be the first to apply!