Remote Utilization Management RN - InterQual Expert
The Judge Group
- Remote job
A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating with providers, and managing discharge planning. Candidates must have an active PA RN license and a minimum of three years in Medical/Surgical experience, along with proficiency in Microsoft's applications and InterQual criteria. #J-18808-Ljbffr The Judge Group
$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 healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information... ...of Medical/Surgical experience and proficiency with InterQual criteria. This position offers a day shift workload with...Remote workFlexible hoursWeekend workDay shift
- 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
- ...Incorporated is seeking a Peer-to-Peer Utilization Review Nurse to join the central utilization management team. The role focuses on... ...-to-peer discussions through expert clinical analysis and standardized... ..., and care management, with remote work options and a 32-hour weekly...Remote job
- ...seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive salary, supportive work...Suggested
- ...integrity through compliance management. Here, you'll champion the needs... ...Registered Nurse (RN) license Strong clinical background... ...records Experience in utilization review, case management, quality... ...for vulnerable populations Remote work - enjoy the convenience...Remote workFull timeTemporary workWork at officeWork from home
$65k - $85k
Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) for a fully remote home health role in the US. Salary ranges from $65,000 to $85,000 annually, based on experience, with Florida RN license and OASIS/coding certifications required. The role...Remote jobFlexible hours- Mass General Brigham Incorporated is seeking a P2P Utilization Review Nurse to join the Central Utilization Management team. You will identify, prepare, and clinically... ...on concurrent level-of-care denials and using InterQual/MCG criteria with thorough documentation. You...Remote job
- Netsmart is seeking a Remote Utilization Review Nurse to evaluate ED admissions using InterQual/MCG criteria and apply evidence-based guidelines to ensure proper resource... ...authorization. Ideal candidates have an active RN license, 3+ years in acute care (ER/ICU/medical-...Remote job
$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one... ...Care Guidelines (MCG) or InterQual Criteria Strong... ...community knowledge in a new way. Experts add insights directly into...Remote workDaily paidContract workMonday to FridayShift workWeekend work- ...applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...days for first week. This role will be remote BUT regular meetings/trainings require... ...~ Previous experience with MCG and/or InterQual systems ~2 years of experience in hospital...Remote workReliefWeekend work3 days per week
$100 - $150 per hour
...Dorsey . Position: Utilisation Management / Case Management leader (RN/Physician-advisor) Type:... ...: $100–$150/hour Location: Remote Role Responsibilities Lead utilisation... ...oversee clinical reviews against InterQual , MCG , or Milliman care guidelines...Remote workContract workSummer workNight shift$239k - $350k
A management consulting firm is seeking a Vice President, Utility Return on Equity & Cost of Capital Expert Witness. This role involves leading complex engagements, advising on regulatory... ...Marlborough, MA office and two days remote, with a competitive salary between $239...Remote workWork at office- Bickham Services Unlimited, LLC is seeking an experienced Concurrent Review RN to join its Utilization Management team in California on a 6-month contract (with potential extension). You will perform concurrent reviews, prior authorizations, medical necessity reviews, discharge...Contract work
- Working Nurse in Los Angeles is seeking an experienced Utilization Management Nurse Specialist RN II for a full time role. You will coordinate and approve medically necessary referrals, ensure timely notification of determinations, and collaborate with clinical staff to...Full time
- Texas Children's Medical Center in Bellaire, TX seeks an experienced Utilization Management Clinical Registered Nurse to preauthorize inpatient and outpatient services and perform telephonic/concurrent reviews. You will analyze requests against guidelines, determine medical...
$35 - $37 per hour
...poster from The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $36-37/hr... ...national medical guidelines (MCG, Interqual, etc.), evaluating the clinical... ...No NPs, whether practicing or not. Utilization Review experience is helpful but not...Remote jobPermanent employmentFull timeTemporary workMonday to Friday- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include...Remote workWork from home
$60.2k - $107.4k
...Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...wpm Preferred Qualifications: Working knowledge of InterQual and MCG Prior experience with utilization management...Remote jobMinimum wageFull timeWork experience placementLocal areaMonday to FridayFlexible hoursWeekend workAfternoon shift- ...Utilization Manager Registered Nurse (UMRN)Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- ...seeking a Physician Reviewer to provide remote support for a healthcare organization.... ...necessity determinations and applying InterQual criteria. Candidates should have an MD... ...with opportunities to leverage clinical expertise in utilization management. #J-18808-LjbffrRemote work
- ...seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior... ...care programs. Required are an active CA RN license and at least five years in patient... ...substitute for experience. Hybrid work and remote- interview options are offered. #J-1880...Remote workTemporary work
- ...Performance Co. (HOPCo) in Phoenix, Arizona, is hiring a Case Manager/Utilization Review Nurse. This role involves collaborating with patients... ...have an Associate Degree in Nursing (ADN) and a current Arizona RN license, alongside experience in case management. The...
- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within...Remote workFull time
- Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews,... ...with providers and members. The role is remote/work-from-home with weekend shifts and... ...few times annually; requires Kentucky RN license, 2+ years clinical experience,...Remote jobWork at officeWork from homeShift work
- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...a Friend Back Remote Work from Home Share... ...Plans (JHHP) is the managed care and health services... ...AM - 5:00 PM As a Utilization Review Registered Nurse... ...various criteria sets (i.e. InterQual) Ability to... ...Unencumbered Registered Nurse (RN) license in Maryland (...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
$70k - $75k
...AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections... ...a better path!! Job Description The Utilization Management Registered Nurseis responsible for...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Utilization Management Specialist Shift: Monday through Friday 8:00 AM to 4:30 PM, with every fifth weekend rotation. Contract Length: 1... ...experience necessary. ~ Must be computer literate and have remote working experience. Compliance / Notes: Must provide...Remote workContract workWork experience placementLocal areaMonday to FridayShift workWeekend work
- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote job
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