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

Remote Utilization Management RN - InterQual Expert

The Judge Group

New York, NY
  • 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

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN - InterQual Expert in New York, NY vacancy
  •  ...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 work
    Flexible hours
    Weekend work
    Day shift

    The Judge Group, LLC

    New York, NY
    3 days ago
  • 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

    TEXAS INDEPENDENCE HEALTH PLAN INC

    Austin, TX
    1 day ago
  • 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 work
    Work at office
    Relocation package

    TEXASCONNECT INC

    Dallas, TX
    5 days ago
  •  ...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

    BJC HealthCare

    Kansas City, MO
    3 days ago
  • $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

    Providence Health & Service

    Portland, OR
    2 days ago
  •  ...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

    NeuroPsychiatric Hospitals

    Indiana, PA
    3 days ago
  •  ...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 job
    Full time
    Temporary work
    Work at office
    Work from home

    HealthSkil

    Harrisburg, PA
    13 days ago
  •  ...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 work
    Flexible hours
    Weekend work
    Weekday work

    Santa Barbara Cottage Hospital

    New York, NY
    8 hours ago
  •  ...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 work
    Full time
    Temporary work
    Work at office

    The CKHobbie Group

    Harrisburg, PA
    4 days ago
  • $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 work
    Full time

    Gainwell Technologies LLC

    Orange Beach, AL
    1 day ago
  • $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 work
    Daily paid
    Contract work
    Monday to Friday
    Shift work
    Weekend work

    The Judge Group

    Chicago, IL
    1 day ago
  •  ...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 work
    Full time
    Contract work
    Work at office

    Morgan Stephens

    United States
    2 days ago
  •  ...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 work
    Relief
    Weekend work
    3 days per week

    Children's Healthcare of Atlanta

    United States
    8 hours ago
  • $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 work
    Work at office

    Concentric Energy Advisors, Inc.

    Marlborough, MA
    3 days ago
  • $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 work
    Hourly pay
    Work at office

    Clever Care Health Plan

    Huntington Beach, CA
    1 day ago
  • 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 job
    Full time

    Industrial Asset Management Council, Inc

    Florissant, MO
    1 day ago
  • 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... 

    L.A. Care Health Plan

    Los Angeles, CA
    5 days ago
  •  ...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... 

    CharterCARE Health of Rhode Island, Inc

    Providence, RI
    3 days ago
  • $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 work
    Part time
    Work from home
    Shift work

    Mass General Brigham

    United States
    2 days ago
  •  ...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 work
    Full time
    Contract work
    Work at office
    Work from home
    Monday to Friday

    Spectrum Healthcare Resources

    Phoenix, AZ
    2 days ago
  •  ...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

    Insight Global

    Raleigh, NC
    8 hours ago
  •  ...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... 

    Valley Health System

    Paramus, NJ
    3 days ago
  •  ...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... 

    Universal Hospital Services Inc.

    Las Vegas, NV
    2 days ago
  • $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 work
    Hourly pay

    Oscar Health

    New York, NY
    8 hours ago
  •  ...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 work
    Hourly pay
    Daily paid
    Day shift

    Providence Swedish Medical Center

    Seattle, WA
    2 days ago
  •  ...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

    Santa Barbara Cottage Hospital

    New York, NY
    8 hours ago
  •  ...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 work
    Contract work

    The Judge Group

    Chicago, IL
    3 days ago
  • $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 work
    Full time
    Monday to Friday

    Broadway Ventures LLC

    New York, NY
    8 hours ago
  •  ...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 work
    Full time

    BlueCross BlueShield of South Carolina

    Columbia, SC
    3 days ago
  • $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 work
    Work at office
    Flexible hours
    2 days per week
    3 days per week

    Concentric Energy Advisors, Inc.

    Marlborough, MA
    21 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management RN - InterQual Expert. Be the first to apply!