Remote Utilization Review RN — Prior Authorization Expert
$49.34 - $76.59 per hourProvidence Health & Services
- Remote job
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This position manages medical management programs to optimize patient care. Competitive salary range for Portland is $49.34 - $76.59. Comprehensive benefits including health care and retirement plans are offered. #J-18808-Ljbffr Providence Health & Services
- 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 jobFlexible hoursWeekend workWeekday work
- Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience...Remote job
- 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
$35 - $45.94 per hour
Oscar Health is looking for a Utilization Review Nurse to join their team. The role involves performing... ...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 jobHourly pay$67.7k
A specialized 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...Remote jobFull timeMonday to Friday$45.9 - $71.4 per hour
Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development...Remote jobHourly payLocal area$45.9 - $71.4 per hour
Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health... ...administration of medical management programs for prior authorization. These programs are developed to manage medical expense...Remote jobMinimum wageLocal areaShift work- 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
$28.37 - $36 per hour
Acentra Health, LLC is seeking a Clinical Reviewer - RN - PRN (Remote U.S.) to interpret patient records, ensuring medical necessity and appropriateness of care. Ideal candidates will possess an RN license and relevant clinical experience. This position offers flexible...Remote jobReliefFlexible hours- ...Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires... .... Responsibilities include reviewing prior authorization requests, collaborating with healthcare... .... Candidates must have a Compact RN License and at least 3 years of clinical...Remote job
- Kelsey-Seybold Clinic is seeking a Utilization Review Specialist (LVN) to conduct medical reviews... ...necessity for services requiring prior authorization. This role involves liaising with providers... ...utilization review. Flexibility for remote work is provided for Texas residents....Remote jobHourly pay
$20.38 - $36.44 per hour
...Psychiatric Association Inc seeks a Utilization Review Specialist (LVN) who will... ...for services requiring prior authorization and serving as a liaison for surgery... ...review experience and an active RN license. The position offers flexible remote work options adhering to...Remote jobHourly payFlexible hours- ...Utilization Review Nurse Join Martin's Point Health Care - an innovative, not... ...need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific... ...nursing experience as an RN, preferably in a hospital setting...Remote workWork at office
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration... ...Review to join our Utilization Management team. In this role,... ...assigned Qualifications Active RN license (WA; must be in good standing...Remote workContract work
$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG... ...care for members. This role conducts prior authorizations, facilitates care coordination, and... ...QUALIFICATIONS Active, unrestricted RN license (BSN or MSN) in Oregon or a...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- 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...
- UofL Health in Louisville, KY, is seeking a Utilization Review RN to support utilization management functions. The RN will be responsible for clinical recommendations regarding medical necessity, working collaboratively with healthcare professionals. Ideal candidates must...
$26.41 - $61.79 per hour
...involves assessing service requests and ensuring compliance with clinical guidelines. The ideal candidate will have a Registered Nurse (RN) license and at least two years of relevant experience. You will collaborate with various teams to maximize member outcomes....Hourly pay- A healthcare provider is hiring a Utilization Review Nurse for an on-site position in Las Vegas, Nevada. This role involves reviewing patient admissions... ...with payer guidelines. Candidates should have an active RN license in Nevada, over 5 years of acute care nursing...
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...visits and telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.... ...Innovative Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions,...Remote jobHourly payMonday to Friday$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical... ...Essential Functions Process patient prior authorization and reauthorization requests in accordance... ...professional nursing program (RN, LPN, or LVN). Minimum of two years...Remote workContract workWeekend work$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...visits and telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week$55 per hour
Women Veterans Interactive is seeking a dedicated Clinical Pharmacist for a fully remote position. This role involves reviewing utilization management requests, making informed clinical decisions based on specific criteria, and collaborating with healthcare providers. The...Remote jobHourly pay- ...: Manager of Clinical Utilization Management - Denial Compliance... ...Type: Hybrid (85% remote, 15% onsite in... ...daily tasks, performance reviews, and any necessary disciplinary... ...Nursing Program; RN preferred. 2. Minimum of five years in prior-authorization, appeals & grievance,...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position... ...Responsibilities: Evaluate and process prior authorization requests/referrals submitted from...Remote workWork at officeLocal areaWork from homeHome officeMonday to Friday
- ...provider in the United States is seeking a Physician to provide utilization review services. The successful candidate will utilize clinical... ...compliance with guidelines. This role includes reviewing prior authorizations and appeals, maintaining proper licensure, and tackling...
- ...To Apply for this Job Click Here Position: UTILIZATION REVIEW RN- Case Management (IN PERSON) - SIGN ON BONUS Location:... ..., Leader of Others, or Leader of Leaders. Conducts prior authorization reviews to assess whether proposed services are covered and...Work at officeRelocation package
$69.38k - $92.28k
MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum... ...candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent...Remote job- CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote job
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