Remote Utilization Review RN - Discharge & Care Coordination
Centene Management Company LLC
- Remote job
Centene Management Company LLC is seeking a remote Nurse Reviewer to support Marketplace/Ambetter members across multiple states. The role involves concurrent reviews, determining appropriate level of care, discharge planning, and collaboration with Medical Affairs to ensure quality, cost-effective care. Ideal candidates hold RN or LPN licensure, have acute care experience (acute rehab/SNF/LTC), and are eligible for licensure in required states. #J-18808-Ljbffr Centene Management Company LLC
- ...Corp. is seeking a fully remote nurse reviewer to evaluate concurrent care plans and determine... ...prefers an active NY State RN license and requires availability... ...reviewing acuity and discharge planning, collaborating... ...educating providers on utilization processes. Pay ranges...Remote workMonday to Friday
- ...Centene Corporation seeks a remote RN for concurrent reviews to determine appropriate care levels and discharge plans. The role supports... ...experience and familiarity with utilization management are preferred.... ...documenting findings, coordinating with care teams, and...Remote work
- ...seeking a highly motivated Utilization Review RN to join our team. The... ...appropriate level of care across inpatient and outpatient... ...The position supports remote work in the US,... ...responsibilities around discharge planning, documentation, and coordination with providers and plans...Remote workContract work
- ...CoxHealth is seeking a Utilization Review Nurse (RN) to collaborate with physicians and a multidisciplinary team to ensure high-quality, cost-effective patient care. The role focuses on concurrent medical record reviews to assess medical necessity and level of care, determining...Remote work
- ...Ascension seeks an experienced RN for Utilization Management in a fully remote, day-shift role. You will review admissions to ensure medical necessity and... ...journeys through case management, coordinating care transitions and discharge planning. Responsibilities include...Remote workDay shift
- ...UnitedHealth Group seeks an Inpatient Care Management Nurse RN for a remote role across the U.S. The position focuses on reviewing inpatient cases, coordinating plans of care, and... ...directors to ensure appropriate utilization and discharge planning. Strong nursing experience...Remote work
- ...Inc. is seeking a highly motivated Utilization Review RN to join our team. The RN will perform... ...length of stay, and level of care, including appeals initiated by providers... ...include authorizing services, coordinating discharge planning, and documenting outcomes while...Remote workContract work
- ...Health Partners is seeking a Lead Utilization Review RN to drive medical necessity reviews, discharge planning, and appeals coordination while collaborating with physicians... ...revenue cycle integrity and patient care quality in a remote US-based environment. You will evaluate...Remote work
- ...Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case... ...for conducting and coordinating medical necessity reviews... ...for determining level of care. Assures medical documentation... ...sending admitting and discharge clinicals on all...Remote workWork at officeFlexible hours
- ...Travel RN - Case Management/Utilization Review - Case ManagementAmerican TravelerSan Francisco... ...case management and discharge planning experience for... ...days onsite and 3 days remote per weekFloats between Emeryville... ...with care coordination, concurrent review, continued...Remote workWeekly payContract workLocal areaShift workNight shift
$47.03 - $63.48 per hour
...in healthcare. The RN, Senior Utilization Review Quality will play an... ...management denials. Coordinate with service line leaders... ...in an acute care environment required Utilization review/discharge planning experience... ...experiences This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area$63.1k - $94.65k
...current compact RN license, or be willing... ...seeking Virtual Utilization Review Specialist with... ...of health care resources and assists... ...Denial Management Coordinates the P2P process with... ...review/discharge planning experience... ...Required: This is a remote role which requires...Remote workTemporary workWork at officeLocal areaMonday to FridayShift work- HonorHealth is seeking an RN Utilization Review Specialist to review and monitor health care service utilization, ensuring appropriate... ...and payer types. You will coordinate medical necessity reviews for... ...payers from admission through discharge. You will work with the Care...Remote jobDaily paid
$2,627 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler... ...an RN Case Manager with discharge planning experience, requiring... ...who have been remote for the past 6 months must... ...Responsibilities include care coordination, discharge planning, needs...Remote workWeekly payPermanent employmentShift workWeekend workDay shift$81.95k - $110.24k
...healthcare. The Lead Utilization Review RN is a key contributor... ...-oriented, patient care delivery system, which... ...MANAGEMENT: Coordinates the appeal process with... ...readmissions to the liaison. DISCHARGE PLANNING: Through... ...#LI-LS1 #LI-REMOTE Join an award-winning...Remote workFull timeWork at officeLocal area$66.83k - $111.38k
...Days)Overview:Sentara Health Plans is hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote!Status: Full-time, permanent position (40... ...Conduct pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment...Remote workPermanent employmentFull timeTemporary workShift workDay shift$39.4 - $53 per hour
...Position Overview The Lead Utilization Review RN is a key contributor... ...-oriented, patient care delivery system,... .... DENIAL MANAGEMENT: Coordinates the appeal process with... ...readmissions to the liaison. DISCHARGE PLANNING: Through the... ...Top Workplace for Remote Work 2024 Great Place...Remote workWork at officeLocal area- ...Join our team as a remote (Oklahoma City) full... ...every other weekend RN Case Manager -Utilization Review at INTEGRIS Health,... ...resources. Recommends and coordinates timely transfers to... ...levels of care as indicated by clinical... ...necessary, a plan for discharge, including referrals...Remote workFull timeWork at officeWeekend work
- ...integrated health care plans and... ...LTSS department. RN will be responsible... ...and concurrent review. Provides... ...treatment setting by utilizing the applicable... ...for care coordination. Works with medical... ...proactive planning for discharge planning.... ...: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
- ...Ensemble Health Partners is seeking a remote Utilization Review RN to assess and optimize patient care utilization across services. This role requires an active... ...experience, with experience in utilization review or discharge planning preferred. Competitive pay with...Remote workFlexible hoursShift work
- ...ensuring the right care at the right time... ...in alignment with utilization management guidelines... ...to support timely discharge planning. Analyzes... ...to enhance care coordination, ensure accurate... ...Registered Nurse (RN) with a current Florida... ...of utilization review, case management,...Full timeMonday to Friday
- ...in New Jersey is seeking a Utilization Review Case Manager to validate patient... ...most appropriate level of care using InterQual or MCG... ...reviews. The UR Case Manager coordinates with payers to secure timely... ...monitor medical necessity, discharge planning, resource management...
- ...LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews... ...and fully covered by insurance. You will coordinate with Care Managers, payors, and external reviewers to minimize...Remote workFull time
- ...Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient... ...to ensure medically necessary care across the continuum. This role... ...inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote jobWork from homeMonday to FridayWeekend work
- ...Highmark Health is seeking a remote Care Manager RN to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) plus three weekdays, focusing on reviewing services, applying criteria, and improving member outcomes...Remote workWeekend workWeekday work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical... ...determinations for post-acute care services including SNF, home... ...established medical criteria, review information from clinicians,...Remote work
- ...experienced inpatient review nurse to join our remote utilization management team.... ...patients through the care continuum,... ...admission through discharge.The role emphasizes... ...and multispecialty coordination, with a Pacific Time... ...Candidates must hold LVN/RN licensure and pursue...Remote work
- ...CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management. This full-time, remote role supports a 24/7 team, reviews cases, and coordinates care to improve outcomes within your state. Requires active RN license, ADN, and 2+ years in adult...Remote workFull time
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...with physicians to ensure timely reviews and appropriate care settings. The role requires an RN license, 1+ year of clinical RN...Remote work
- ...Molina Healthcare seeks a Remote RN Care Review Clinician for UM/Discharge Planning in California. You will verify medical necessity, review services against guidelines, and coordinate care across the delivery continuum to achieve quality outcomes. The role requires...Remote workWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review RN - Discharge & Care Coordination. Be the first to apply!


