Fully Remote Utilization Review Nurse (RN)
Tristar
TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers’ compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to determine medical necessity and appropriateness of care.
The position requires a nursing degree and an active RN/LPN license, with CCM/CMCN/CPHUR/CPDM/CDMS certifications preferred.
#J-18808-Ljbffr$40.12 - $62.94 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty... ...physician advisors, nurses, and support staff who... ...appropriate and fully covered by the patient... ...This is a Full-time remote position. Responsibilities... ...Utilization Review RN reviews the medical record...Remote workFull time$89.07k - $162.8k
...and retrospective case reviews to ensure appropriate admit... ...and level of care by utilizing the nationally approved... ...way. This position is remote but must be willing to... ...Associate's degree in Nursing required Bachelor's... ...Certifications: RN - Registered Nurse - State...Remote work- ...Utilization Review Nurse, RN Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our... ...opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and...SuggestedWork at officeLocal area
- ...Utilization Review Nurse (RN) A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its...SuggestedWork experience placement
- ...Healthcare Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying out utilization... ...opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion...SuggestedFull timeWork at officeLocal areaWeekend work
- ...current Arkansas licensure as a RN. Preferably experienced in the... ...with the Medical Staff, review organizations, administration... ...Must be able to apply current nursing knowledge to determine appropriate... ...control system to assure effective utilization of hospital facilities and...Work at office
$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13266 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142...Full time- ...Hospital in Springville, New York is seeking an experienced Utilization Review Nurse to review patient care plans for cost-effectiveness and clinical... ...required; strong knowledge of utilization review principles, BLS/ACLS and NY RN licensure are essential. #J-18808-Ljbffr...Weekend work
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract to full... ...Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team....Remote workFull timeContract work
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration... ...Review to join our Utilization Management team. In this role,... ...assigned Qualifications Active RN license (WA; must be in good standing...Remote workContract work
- ...Management Location: 100% Remote Schedule: M-F 9:0... ...This position is fully remote, but... ...an Illinois state RN license Assess and... ...Works with the Utilization Management team primarily... .../utilization review and other utilization... ...State Registered Nursing (RN) license in...Remote workContract work
$35 - $40 per hour
...seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior... ...8 hrs/day Mon - Fri, 40 hrs/week Fully Remote Position Pay Range: $35 - $40 per...Remote workHourly payLocal areaShift work$35 - $40 per hour
Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services... ...nursing. Current, active nursing license (RN, LPN, or LVN) in good standing with the Arizona Board...Remote workContract workFlexible hoursWeekend work$65k - $78k
...development. Your Role In Our Mission Review admissions, procedures, services, and... ...management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements...Remote workFull timeWork at officeWork from homeFlexible hours$33 - $37 per hour
...today to see how a conversation can turn into a long‑lasting and rewarding career! Job Description Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the...Private practiceWork at office- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient’s PCP,... ...maintaining safety and quality. The role requires a CA LVN/RN license, 3+ years in case management, and experience...Remote work
$43 - $63 per hour
...Job Description Job Description The Utilization Review Nurse plays a key role in evaluating patient admissions to ensure appropriate levels... ...Management, or Clinical Documentation Improvement Active Nevada RN license required Minimum 3 years of Utilization...Relocation package$42 - $65 per hour
...Job Description Job Description Utilization Review Nurse Location: Las Vegas, NV Job Type: Full-Time Pay: $42–$65/hr + Sign-On Bonus... ...~ Graduate of an accredited School of Nursing. ~ Current RN license in the applicable state. ~5+ years of acute care...Full timeRelocation package- ...Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our growing team. Lighthouse Care Center of... ...equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and...Work at officeLocal area
- Alignment Health is seeking an experienced inpatient review nurse to join the remote utilization management team. You will review inpatients with complex medical needs and coordinate care across physicians, facilities, and community providers, ensuring appropriate and cost...Remote job
- ...Virtual Medical seeks a qualified Registered Nurse to join its 24-hour, fully remote triage center serving clients in need of immediate medical attention. The RN will assess calls, provide disposition guidance, and route to the appropriate level of care, working with...Remote workImmediate start
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatients and collaborate with physicians... .... Qualified candidates will hold an active LVN or RN license, have at least 3 years in case management, and...Remote work
- ...Job Summary: The RN Remote, WMG is a member of an... ...care. This position is fully remote, practicing in a... ...This position is led by a nurse supervisor, nurse manager... ...Collects, updates, and reviews patient health... ...guide decision-making. Utilizes the electronic health record...Remote workShift work
- ...Plans, a division of American Health Partners Inc., seeks a Utilization Review Nurse to assess medical necessity and quality of care. You will support... ...while coordinating care for plan members. The role requires RN licensure with UR experience; CCM is a plus. The position...
$53 per hour
...Job Description Job Description REMOTE RN OPPORTUNITY – GRIEVANCE & APPEALS / UTILIZATION REVIEW $53/hour | 100% Remote | Long-Term... ...We're hiring experienced Registered Nurses to join a leading healthcare organization in a fully remote role! Position Details...Remote jobLong term contractWork from homeMonday to FridayShift workWeekday work$2,000 per month
...Find your calling at Mercy! Utilizes the nursing process to provide patient care under the supervision of person(s) licensed by a State regulatory... ..., or under the direction of a Registered Professional Nurse (RN). Maintains professional accountability for provision of...Full timeContract workPart timeImmediate startFlexible hoursShift workNight shiftWeekend workAfternoon shift$33 - $37 per hour
A national healthcare staffing firm seeks an experienced RN Utilization Review Nurse in Troy, MI. Responsibilities include utilization review for Medicaid and Medicare, managing authorization processes, and collaborating with healthcare teams to ensure quality care. Ideal...Hourly payMonday to Friday- ...term care facilities. In partnership with nursing home operators, these Medicare Advantage... ...Bonus Program JOB SUMMARY The Utilization Review Nurse is to assess the medical necessity... ...active and unrestricted Registered Nurse (RN) license EQUAL OPPORTUNITY EMPLOYER...Remote workFull timeTemporary workLocal area
$35 - $48 per hour
...innovate and grow. Grow with us by joining our team of over 18,000 nurses. Our workplace culture focuses on treating patients and co-... ...looking for positive, compassionate, hardworking registered nurses (RN) who can provide the high-quality care patients and families have...Full timePart timeWork from homeRelocation packageShift workNight shift$60.52k - $129.62k
...This Case Manager - Registered Nurse (RN) position is with Aetna’s... ...Excellence (NME) team and is a fully remote position. Candidates from... ...doing both Case Management and Utilization Management. The RN Case... ...tools and information/data review, conducts an evaluation of member...Remote workFull timeTemporary workWork experience placementWork at officeLocal areaWork from homeMonday to FridayWeekend work
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