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
- ...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
- TEXAS INDEPENDENCE HEALTH PLAN INC is seeking a Utilization Management Nurse to evaluate the appropriateness of services for members. This role... ...collaborating with healthcare teams. The position is hybrid remote, requiring residence in Texas areas such as Austin, DFW, or...Remote job
- About this position Department: Managed Services This position will be... ...positions for this role. The Utilization Management (UM) LVN performs... ...addition, the UM LVN delegates to UM RN initial reviews and determines... ...position will be hybrid with remote and in-office assignment....Remote workWork at officeRelocation package
- ...A major healthcare organization is seeking a registered nurse for a remote position focused on utilization review. Candidates should have 2 years of experience in a hospital setting and expertise in evaluating medical necessity. Responsibilities include assessing care...Remote work
$49.34 - $76.59 per hour
...A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse... ...particularly in collaboration with physicians. This position manages medical management programs to optimize patient care....Remote work- ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
- ...integrity through compliance management. Here, you’ll champion the needs... ...Registered Nurse (RN) license Strong clinical... ...medical records Experience in utilization review, case management, quality... ...vulnerable populations Remote work – enjoy the convenience...Remote jobFull timeTemporary workWork at officeWork from home
- ...Concierge Home Care is seeking a Utilization Review Specialist (RN) for a remote opportunity. This position requires a Florida RN License, OASIS Certification, and Home Health Coding Certification. You will be responsible for reviewing home health clinical documentation...Remote workFlexible hoursWeekend workWeekday work
- ...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 office
$65k - $75k
Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include... ...license, 5+ years of clinical experience, and 2+ years in utilization review or claims auditing. This full-time position offers...Remote workFull time$39 - $40 per hour
...Judge GroupUtilization Management Registered Nurse (RN)Type: 6-Month Contract W2Location: Remote - but MUST reside in... ...: We are seeking a Utilization Management RN to... ...Guidelines (MCG) or InterQual CriteriaStrong computer... ...in a new way. Experts add insights directly...Remote workDaily paidContract workMonday to FridayShift workWeekend work- ...Utilization Management RN - Pediatrics (Remote) | New York RN License Required | 110K+ • Fully remote opportunity • Pediatric Utilization Management... ...established clinical guidelines including MCG or InterQual criteria • Collaborate with providers, care...Remote workFull timeContract workWork at office
- ...Utilization Review Nurse Participates as a member of a multidisciplinary... ...in system utilization management plan. Oversees Clinical... ...as well. This role will be remote but regular meetings/trainings... ...experience with MCG and/or InterQual systems Education...Remote workReliefWeekend work3 days per week
$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$34.98 - $42.85 per hour
...Remote in California only Are you ready to make... ...The UM Nurse I - RN performs clinical review... ...policies. This role conducts utilization review activities... ...criteria (e.g., MCG, InterQual). • Review outpatient... ...) year in utilization management or case management preferred...Remote workHourly payWork at office- Industrial Asset Management Council, Inc is seeking a remote RN to support various units, requiring at least 2 years... ...experience in patient care and Utilization Review. Candidates must live... ...care appropriateness and utilizing Interqual Criteria. Benefits include comprehensive...Remote jobFull time
- L.A. Care Health Plan in Los Angeles is hiring a Utilization Management Claims Review Nurse RN II responsible for conducting clinical reviews of medical claims. The position requires a minimum of 5 years in clinical nursing, with experience in Medi-Cal and Medicare managed...
- ...role demands a BSN graduate with an active RN license in Rhode Island and a minimum of... ...experience, particularly in case management or discharge planning. Strong interpersonal... ...familiarity with care management criteria such as InterQual® / MCG. The position also emphasizes...
$58.66k - $142.45k
...business people, tech experts, researchers, and... ...-to-Peer (P2P) Utilization Review Nurse is an... ...Central Utilization Management team, specializing... ...criteria (InterQual and/or MCG) and organizational... ...processes through RN-to-RN... ...Schedule and Work Model Remote / Work from Home....Remote workPart timeWork from homeShift work- ...Job Description Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- ...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 work
- ...Registered Nurse to coordinate and facilitate patient care while utilizing resources effectively. Candidates must have a Bachelor's... ...experience. Preferred qualifications include experience in case management and ANCC certification. The position requires strong communication...
- ...seeks an experienced Registered Nurse to manage patient discharges and ensure optimal healthcare... ...healthcare teams and mandates a valid RN license in Nevada. Applicants should have... ...settings, with preferred experience in utilization review. Benefits include competitive...
$35 - $45.94 per hour
...Oscar Health is looking for a Utilization Review Nurse to join their team. The role involves... ...patient care. Candidates must hold an active RN license and have at least one year of... ...utilization review or acute care settings. This remote position offers a competitive pay range...Remote workHourly pay- ...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
- ...Santa Barbara Cottage Hospital seeks a Utilization Management RN – Pediatrics to ensure quality and cost-efficient healthcare services for pediatric patients. This fully remote role requires an active New York RN license and a minimum of 2 years of pediatric nursing experience...Remote work
- ...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
$67.7k
...consulting firm is seeking a Medical Claims Reviewer to conduct medical reviews and provide guidance on claims. This remote role requires an active RN license, a bachelor's degree in nursing, and at least five years of clinical experience. Ideal candidates will work full...Remote workFull timeMonday to Friday- ...involves reviewing complex claims and documenting decisions based on established clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical experience. The position is full-time and includes a six-week training, partially onsite...Remote workFull time
$239k - $350k
...Concentric”) is an employee-owned management consulting and financial... ...North American energy and utility industries. Since 2002, Concentric... ...on Equity & Cost of Capital Expert Witness to lead complex... ...and two days per week working remotely.* What You Will Do As a...Remote workWork at officeFlexible hours2 days per week3 days per week
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