Remote RN Utilization Management Reviewer
$35 - $40 per hourSagility LLC
- Remote job
Sagility LLC, a leader in healthcare transformation, seeks an RN Utilization Management Reviewer for a fully remote role. You will perform timely clinical decision reviews for services requiring prior authorization across various clinical areas, applying criteria like InterQual and clinical judgment to determine medical necessity. Hours are Mon-Fri 9:00 AM–5:30 PM Eastern; compensation is hourly $35.00–$40.00, with standard benefits including medical, dental, vision, and 401(k). #J-18808-Ljbffr Sagility LLC
$35 - $40 per hour
...service offerings for clinical, case management, member engagement, provider... ...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely clinical... ...may require weekends. Location: Fully remote work at home role. Secure, private...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend work$35 - $40 per hour
...service offerings for clinical, case management, member engagement, provider... ...employees across 5 countries. Job title: RN Utilization Management Reviewer Job Description: We are currently hiring... ...require weekends This is a fully remote work at home role. You must have a...Remote workHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- ...power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And Quality Assur-Weston Hospital Job Code 000446 Shift...Remote workFull timeWork at officeShift workWeekend work
- Coastal Care Services, Inc. is seeking an LPN licensed Utilization Management Nurse Reviewer for a work-from-home opportunity serving the Miami, FL area. Work schedule is 10am to 7pm, with every other Sunday and a weekday off for a total of five days per week. The role...Remote jobWeekday work
- ...Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...business background required Experience in Utilization Management with criteria review utilizing standard practice guidelines...Remote work
- ...Location: Remote - TX Department: Utilization Shift: First Shift (United States of America) Standard... .... Works with the Department Manager and Team Lead to assure the timely... ...Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate...Remote workFull timeShift workDay shift
- A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote jobFull timeWork from home
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient... ...and applying evidence-based guidelines. This remote role in the United States offers work from home with occasional...Remote jobWork from home$219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend work- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure...Remote jobFull time
- A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote jobFull timeCasual workMonday to Friday
$230k
...health care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: Full-Time, Monday - Friday, 8am -5pm CST Salary: $230k per year Role Description...Remote workHourly payFull timeLocal areaMonday to Friday- ...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...Remote workWork from home
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and... ...post-acute care. You will work remotely, reporting to the Manager of... ...include an active RN license in your state and 1+... ...candidates have UM/utilization review experience, knowledge of Milliman...Remote work
- Elevance Health is seeking a Wound Care Utilization Management RN to work primarily virtually with periodic in-person training sessions. The role... ...health care settings. The RN will coordinate care plans, review home-based services, and discuss plans of care with providers...Remote jobWork from home
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations... ...ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in...Remote work
- ...Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
- ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...5 pm with one hour for lunch This is an in-office, no remote work capability position Travel ~ Some travel may be...Remote workWork at office
- ...Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to ensure timely, compliant...Remote workFull time
- ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary... ...fully remote in EST hours. This position will be reviewing prior authorization requests, assessing medical necessity...Remote workContract workTemporary workMonday to FridayShift work
- Elevance Health is seeking a Psychologist Reviewer - ABA to join our behavioral health team in a virtual, full‑time capacity. You will... ...clinical/counseling psychology, an active license, and experience in managed care. Travel is not required, training sessions are in-person...Remote jobFull time
- ...seeking a Pre-Authorization Registered Nurse for a remote, full-time role based in Virginia. The RN will review prior authorization requests, determine... ...appropriate care settings, and educate providers on utilization and management processes. Requirements include an active RN...Remote jobFull time
- ...in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity reviews across inpatient, outpatient, and... ...Behavioral Health/utilization management; remote work across time zones as #J-18808-Ljbffr...Remote job
- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
- Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho... ...prospective, concurrent and retrospective reviews to ensure medical necessity and promote cost-effective...Remote job
- Optum is seeking a Registered Nurse with managed care experience to evaluate outpatient... ...services and determine appropriate care in a remote role within the United States. You will... ...cross-functional teams, and supporting utilization management and case management...Remote job
- ...is seeking an experienced Registered Nurse to support 24/7 Utilization Management, reviewing cases, assessing medical necessity, and coordinating care from a remote home office. Candidates must hold an active RN license and have at least 2 years of acute or critical...Remote jobHome office
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote jobWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Utilization Management Reviewer. Be the first to apply!



