Remote Utilization Management Clinician I
Community Health Plan of Washington
- Remote job
Community Health Plan of Washington is hiring a Level I Utilization Management Clinician. You will perform utilization reviews for medical and behavioral health requests, collaborate with health care teams, and support patients through transitions between levels of care. The role requires a clinical background, RN or LPN license, and at least two years of relevant experience. Travel to local facilities 1–3 times weekly is expected, with a remote work option within Washington state. #J-18808-Ljbffr Community Health Plan of Washington
- ...in service, compliance, and adherence to regulations. With a focus on utilization management, candidates should have experience in clinical fields or health insurance. The position allows for remote work within Arizona, requiring effective communication and organizational...Remote job
- ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers... ...payer rules for authorizations, and collaborate with clinicians to optimize resource use and care quality....Remote jobPart timeWork from home
- ...A healthcare provider in California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-Authorization team. This role requires 5+ years of clinical experience and 3+ years in utilization management. You'll manage staffing, coordinate referrals...Remote work
$75.3k - $135.4k
...Centene Corporation is seeking a Clinical Supervisor to oversee the utilization management team ensuring appropriate care for members. The ideal candidate will supervise day-to-day activities, collaborate on complex member care issues, and maintain compliance with healthcare...Remote work- ...A leading healthcare company is seeking a Utilization Management Registered Nurse to leverage clinical nursing skills in supporting medical service... ...and over a year of clinical experience. Position offers remote work and occasional travel. The role includes utilizing established...Remote work
- ...A leading healthcare organization is seeking a Utilization Management Registered Nurse to ensure appropriate levels of care for members through... ...RN license and have over a year of clinical experience. This remote position requires strong interpersonal skills and commitment...Remote work
- ...A major healthcare organization is seeking a Utilization Management Registered Nurse to join their team in Richmond, Virginia. This remote role requires an RN license and a minimum of one year of clinical experience in an acute care setting. Responsibilities include coordinating...Remote work
- ...A healthcare company is seeking a Utilization Management Registered Nurse to coordinate medical services and benefit determinations. The role... ...clinical experience, preferably in acute care settings. This is a remote position with occasional travel requirements and offers a...Remote work
- ...Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote workFlexible hours
$71.1k - $97.8k
...A national health services provider is looking for a Utilization Management Registered Nurse to coordinate medical services and benefit administration determinations. Positioned remotely, the successful candidate will leverage clinical nursing skills, communicate with...Remote work- ...mission of Building Healthier Communities Together. This is a remote position in which we are able to employ in the following... ...candidate will have the following experience: ~ ~ Health plan utilization management ~ Medicare and Medicaid rules and regulations and health...Remote work
$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 workWeekend work- ...A leading health services organization is seeking a Utilization Management Registered Nurse to support the coordination and documentation of medical... ...license and have clinical experience. The position offers a remote or hybrid work arrangement, providing competitive pay and...Remote work
- ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN... ...Medicare Advantage regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
$71.1k - $97.8k
...A leading healthcare organization is seeking a Utilization Management Registered Nurse to use clinical skills for coordinating medical services... ...and over a year of relevant clinical experience. This is a remote position, with occasional travel to the office. The pay range...Remote workWork at office$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $... ...Monday–Friday, 0730–1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications U.S. Citizenship (...Remote workContract workImmediate startMonday to Friday$29.1 - $62.32 per hour
...UM Nurse Consultant Fully Remote- WFH Schedule: Monday-Friday 8a-5p EST/9a-6p CST... ...with 1 hour lunch Position Summary Utilizes clinical experience and skills in a... ...administration of the utilization/benefit management function. Required Qualifications...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to Friday- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while collaborating with external entities... ...offers a comprehensive benefits package including remote work options. #J-18808-Ljbffr Healthcare Management...Remote job
- Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote job
- WPS Health Solutions in Georgia seeks a Utilization Management RN to evaluate medical necessity and authorize services using evidence-based criteria... ...care, and strong coordination with health care teams. Remote work options are available in several states, including Georgia...Remote job
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote job
- WPS Health Solutions seeks a Utilization Management RN to assess medical necessity and authorize services using evidence-based criteria. You will... ...Care, and strong analytical and communication skills. Remote work options available within approved states, with comprehensive...Remote job
- 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 jobContract work
- ...Health Solutions in the United States is seeking an experienced Utilization Management RN to evaluate medical necessity and authorize services for... ...criteria to support quality care while controlling costs. Remote work is available in many states; expect collaboration with...Remote job
- ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity... ...requirements, and a member’s benefit coverage while working remotely. Primary Responsibilities • Performs clinical utilization...Remote workContract workWork at office
- ...Full Time Days 7am-4:30pm 40 Hours/Week Utilization management and pediatric nursing experience preferred Summary: The Utilization... ...experience: 3 years is required. 4. Years of experience supervising: None. Full Time FTE: 1.000000 Status: Remote...Remote workFull timePart timeImmediate start
- Truman Medical Centers is seeking an experienced Utilization Management RN to join the Care Continuity team in Missouri. You will partner with interdisciplinary teams to optimize resource use, monitor care delivery, and guide discharge planning. This full-time role requires...Remote jobFull time
- WPS Health Solutions is seeking an Utilization Management RN to evaluate medical necessity and efficiency for health plan services. The role involves... ...directors when criteria are not met. The position supports remote work in approved states, including Michigan, with a focus on...Remote job
$45k - $70k
A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote job
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