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

Remote Utilization Management Nurse: Appeals & Reviews

Registered Nurse

Brooklyn, NY
  • Remote job

Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role requires an RN license, 3+ years bedside experience, and strong data extraction skills. You will work per diem with flexible start times and may telecommute from anywhere in the United States. Responsibilities include HIPAA compliance, collaboration with OPAS/Optum teams, and maintaining high quality reviews. Microsoft Office proficiency and 45 wpm typing are required. #J-18808-Ljbffr Registered Nurse

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse: Appeals & Reviews in Brooklyn, NY vacancy
  •  ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization...  ...regulatory requirements while working remotely. Key responsibilities:...  ...Previous Utilization Management, Appeals, or Denials Management... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    4 days ago
  • $29 - $52 per hour

    Optum is seeking an Utilization Management Nurse to review patient records, extract essential details, and craft defensible appeal letters following process guidance. The role emphasizes HIPAA compliance and timely, high-quality reviews. The position offers Per Diem scheduling... 
    Remote job
    Hourly pay
    Daily paid
    Full time
    Flexible hours

    Texas Health Institute

    Brooklyn, NY
    3 days ago
  •  ...Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply...  ...and 3+ years in a clinical setting plus 1 year in managed care or utilization management. This is a 7-month contract with potential... 
    Remote job
    Contract work

    Santa Barbara Cottage Hospital

    New York, NY
    1 day ago
  • $65.8k - $130.8k

    Onsite or Remote Flexible Hybrid Work Schedule Monday...  ...The UM Denial Nurse Reviewer supports high-quality, cost...  ...required Two or more years of utilization review/utilization management experience in an HMO,...  ...scoring Knowledge of the appeals process Experience with... 
    Remote work
    Monday to Friday
    Flexible hours

    UCLA Health

    Los Angeles, CA
    3 days ago
  •  ...Job TitleRegistered Nurse (RN) for Critical Incident Management TeamLocationHarrisburg...  ...will be responsible for reviewing and evaluating...  ...participate in hearings, appeals, and stakeholder discussions...  ...environment while utilizing technology to support remote and hybrid work... 
    Remote work
    Work from home

    The CKHobbie Group

    Harrisburg, PA
    1 day ago
  •  ...States is seeking an Inpatient Utilization Management Clinician to evaluate...  ...across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual...  ...management to ensure timely reviews, document outcomes, and... 
    Remote work
    Full time

    Well Sense Health Plan

    United States
    1 day ago
  •  ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization... 
    Remote work

    TriWest Healthcare Alliance

    Phoenix, AZ
    3 hours ago
  •  ...Description Job Description The utilization review and management (UM) component program ensures that external...  .... Qualifications ~ Registered nurse with active, unincumbered nursing...  ...lunch This is an in-office, no remote work capability position Travel... 
    Remote work
    Work at office

    MedTrust LLC

    Oklahoma City, OK
    17 days ago
  •  ...organization dedicated to improving health outcomes through care and technology. The Utilization Management Nurse will extract details from patient records and craft persuasive appeal letters per guidelines, within required timeframes. The role offers Monday-Friday, 40... 
    Remote job
    Monday to Friday
    Flexible hours

    ISHE

    Brooklyn, NY
    3 days ago
  • $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 job
    Weekend work

    kozmetickesluzby.vecnakraska.sk - Jobboard

    Phoenix, AZ
    5 days ago
  • $60.2k - $107.4k

     ...services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company policies. The role offers a... 
    Remote job
    Full time
    Monday to Friday

    NHSHP

    Brooklyn, NY
    4 days ago
  • $72.8k - $130k

     ...occasional opportunity for remote work based on business needs.   As a Sr Utilization Management Nurse in the Boston MA Regional Area...  ...to discuss care details, reviewing clinical information for appropriateness...  ..., and/or clinical appeal and guidance reviews ~ Must... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Casual work
    Live in
    Work at office
    Local area

    Optum

    Boston, MA
    2 hours ago
  • UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases. The position offers a 40-hour... 
    Remote job
    Monday to Friday

    Anacalifornia

    Brooklyn, NY
    4 days ago
  • UnitedHealth Group is seeking a Utilization Management Nurse to review medical records and craft defensible appeal letters. The role supports telecommuting from anywhere in the U.S. and requires a state RN license, 3+ years bedside nursing, and strong data extraction skills... 
    Remote job

    University of Minnesota School of Nursing

    Brooklyn, NY
    4 days ago
  • $60k

     ...LPN/LVN Utilization Management Nurse Integra is looking for a LPN/LVN experienced in the managed...  ...service and post-service utilization reviews and appeals for DMEPOS. This individual will...  ...Career development opportunities Remote Opportunities We are actively... 
    Remote work
    Temporary work
    Local area

    Integra Partners

    United States
    3 days ago
  • $95k - $110k

    Select how often (in days) to receive an alert: DRG Nurse Reviewer Appeals and Hearings- Remote Date: Aug 30, 2026 Location: Any city, FL, US, 99999...  ...hearings in conjunction with the Medical Director. Assists management with training new reviewers to include daily... 
    Remote job
    Full time
    Work from home
    Relocation package
    Flexible hours

    Gainwell Technologies

    Brooklyn, NY
    4 days ago
  • A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license... 
    Remote job
    Contract work

    Rangam

    Pennington, NJ
    4 days ago
  •  ...Job Description Join our team as a remote full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to...  ...Association within 30 days of hire RN (Registered Nurse) Current licensure as a Registered Nurse (RN)... 
    Remote work
    Full time
    Work at office
    Weekend work

    INTEGRIS Health

    United States
    4 days ago
  • Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in the tri...  ...an active PA license or a Nurse Licensure Compact to include...  ...conditions through medical record review to determine medical... 
    Remote work
    Immediate start
    Day shift

    The Judge Group

    New York, NY
    3 days ago
  •  ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the...  ...appropriate care and timely approvals. You will review clinical documents, collaborate with providers,... 
    Remote work
    Work from home

    Santa Barbara Cottage Hospital

    United States
    3 days ago
  • $45 - $50 per hour

    Join Our Team as a Utilization Management RN - Make an Impact in Healthcare Are...  ...you a dedicated Registered Nurse passionate about optimizing...  ...outcomes. Whether working remotely or in a flexible hybrid...  ...you'll play a key role in reviewing authorization requests, evaluating... 
    Remote work
    Hourly pay
    Work at office
    Flexible hours

    The Hollister Group

    Oklahoma City, OK
    1 day ago
  •  ...Registered Nurse (RN) | Utilization Review Location: Pennsylvania Agency: Pyramid Consulting,...  ...Position Key Responsibilities ~100% REMOTE role but candidate has to be in (PA,...  ...be provided ~ Perform utilization management reviews for inpatient admissions... 
    Remote work
    Weekly pay
    Full time
    Immediate start

    Pyramid Consulting, Inc.

    Pennsylvania
    10 days ago
  •  ...Hopkins Health Plans (JHHP) is the managed care and health services business of...  ...hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you...  ...~ Work-life balance - This is a remote role! Candidates in the following approved... 
    Remote work
    Full time
    Monday to Friday

    Johns Hopkins Medicine

    Hopkins, MN
    17 days ago
  •  ...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 work
    Full time
    Work from home

    ExamWorks

    United States
    4 days ago
  • $38 - $45 per hour

     ...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc...  ...Registered Nurse – Utilization Review (Remote) Location: Fort Myers, Florida...  ...Center Department: Utilization Management Contract: 13 weeks with possible... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Work experience placement
    Monday to Friday
    Shift work
    Weekend work

    Lancesoft Inc

    Fort Myers, FL
    3 days ago
  • $34 - $47 per hour

     ...Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department...  ...various Health Plans. This is a remote position for CA-licensed nurses. Candidates...  ...one year of outpatient Utilization Management experience in a fast-paced setting.... 
    Remote work
    Hourly pay
    Live in
    Work at office
    Monday to Friday
    Shift work

    Astrana Health, Inc.

    Monterey Park, CA
    12 days ago
  •  ...primary care, wellness, disease management and population health...  ...the U.S. achieving Magnet nursing excellence designation for...  ...mission. Job Summary The Utilization Management Review Nurse (UMRN) performs...  ...reconsiderations, assist with appeals as needed and arrange peer... 
    Remote work
    Work experience placement
    Work at office
    Flexible hours
    Weekend work

    Harris Health System, Inc.

    Bellaire, TX
    2 days ago
  • $50k

     ...Industry: Behavioral Healthcare Management Why consider this job...  ..., concurrent reviews, and internal utilization review assessments Consult...  ...coordinate urgent/expedited appeals Staff individual cases...  ...license (e.g., Registered Nurse, Licensed Practical Nurse,... 
    Remote work

    NurseRemotely

    United States
    2 days ago
  • $2,065 per week

     ...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description...  ...Extension (UR EXT) specialist for a remote position. This role involves conducting utilization management activities, requiring collaboration... 
    Remote work
    Temporary work
    For contractors
    Zero hours contract
    Monday to Friday
    Shift work
    Weekend work

    Cross Country Nurses

    Fort Myers, FL
    2 days ago
  •  ...Description Job Description: Manager of Clinical Utilization Management - Denial...  ...Type: Hybrid (85% remote, 15% onsite in...  ...tasks, performance reviews, and any necessary disciplinary...  ...Registered Nursing Program; RN...  ...prior-authorization, appeals & grievance, or health... 
    Remote work
    Permanent employment
    Full time
    Temporary work
    Flexible hours

    Vivo HealthStaff

    Burbank, CA
    16 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management Nurse: Appeals & Reviews. Be the first to apply!