Remote Utilization Review RN - OASIS & Coding Expert
$65k - $85kCovenant Care, Corp.
- Remote job
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 focuses on reviewing clinical documentation, auditing OASIS and care plans, and ensuring accurate coding for reimbursement while supporting QA and regulatory initiatives. Flexible schedule options and full benefits are included. #J-18808-Ljbffr Covenant Care, Corp.
- Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This role emphasizes OASIS review, coding accuracy, QA, and remote documentation audits. The ideal candidate holds an active Florida RN license, OASIS certification...Remote job
- ...Clinical Documentation Specialist RN to ensure CMS program compliance through meticulous review of OASIS admission documents and Plans... ...full-time, day shift role is remote for eligible states and... ...Preferred: BSN and Home Care Coding Specialist credentials. #J-18...Remote jobFull timeDay shift
$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced... ...Review Specialist (RN) to join our remote home health team.This role is ideal... ...an RN with strong experience in OASIS, coding, QA, and home health documentation...Remote workMonday to FridayWeekend work$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 jobWeekend work- Netsmart is seeking a Remote Utilization Review Nurse to evaluate ED admissions using InterQual/MCG criteria and apply evidence-based guidelines to... ...insurance authorization. Ideal candidates have an active RN license, 3+ years in acute care (ER/ICU/medical-surgical), and...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
$40 - $52 per hour
...Clinical Data Coordinator/OASIS Review VNA Health Group is seeking an experienced Registered Nurse to join our Coding Review team as a Clinical Data Coordinator/OASIS Review. In... ...initiatives Qualifications • Current NJ RN License required • BSN preferred •...Remote workWork experience placementWork at officeLocal area$92.71k - $125.72k
...medical and surgical experts are among the... ...Lippincott Drive Remote Type: On-Site... ...Preferred Experience: Coding experience; Oasis experience.... ...Job Summary : Review of Home Health OASIS... ..., resource utilization, quality of care... ...Experience: 3 years of RN Coding...Remote workHourly payFull timeTemporary workPart timeWork at officeLocal areaFlexible hoursShift workWeekend workDay shift- ...and monitoring the utilization of behavioral... ...Medical Director for review and works closely... ...responsible for pricing, coding, researching... ...to the functions. Expert and resource for escalations... ...and active NYS RN license required.... ...opportunity for remote work within all...Remote workContract workWork at office
- 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
- ...seeking a Clinical Documentation Specialist RN to perform OASIS and Plan of Care reviews for CMS compliance, working remotely with day shifts and weekdays. The role reports... ...to Home Health leadership and acts as Oasis expert and consultant across the region. The RN must...Remote jobDay shiftWeekday work
- ...seeking a Clinical Documentation Specialist, RN for the Oregon Home Services team. This role focuses on quality review of OASIS admission documents and Plans of Care to ensure... ...Home Health leadership, acting as an Oasis expert and consultant to staff across the region, while...Remote job
- Working Nurse in Los Angeles is seeking an experienced Utilization Management Nurse Specialist RN II for a full time role. You will coordinate and... ...handling complex calls, provider communications, and data transfer for medical reviews, in a #J-18808-Ljbffr Working NurseFull time
- A healthcare staffing firm is 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...
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on... ...schedule of 8 hours per day, requiring an RN with a Bachelor's degree, state licensure...Remote jobWork from homeMonday to Friday
- ...Responsibilities As our UM RN (Utilization Management Registered Nurse),... ...compliant denial notices, to review medical records, authorize... ...organizational resources. As a remote employee, we will provide you... ...of ICD-10, CPT, HCPCS coding, medical terminology and insurance...Remote workLocal areaWork from homeShift workWeekend work
- ...analytical guidance across segments. This role requires reviewing Medicare/Medicaid documentation, ensuring accuracy in MDS coding, and training staff on reimbursement processes.... ...and MDS experience. This is a full-time remote position in Wisconsin offering competitive pay...Remote workFull time
- ...providing telephonic and e-Referral case review and authorization of services utilizing established mental health and... ...This position is full-time, fully remote (work from home) and requires some... ...State of Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required.Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...Job Description Job Description Remote OASIS Reviewer Join Custom Home Health’s Quality... ...with experience in OASIS review, ICD-10 coding, and home health compliance . ✔... ...patient diagnoses and comorbidities Utilize OASIS validation and alert reports to...Remote workFlexible hours
- CorVel Corporation is seeking an Itemization Review Nurse to assess charges on UBIB submissions for accuracy. This remote role requires meticulous data review and documentation... ...designated system. The ideal candidate holds RN licensure in the employment state, with 5+...Remote job
- UnitedHealth Group is seeking a Clinical Review Clinician in Plymouth, Minnesota. This role involves conducting forensic reviews of hospital... .... Candidates should have an Associate's degree, an active RN or LPN license, and at least 2 years of clinical experience. Benefits...Remote job
- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
- WPS Health Solutions is hiring an Appeals Nurse to review medical records and claims for first-level Medicare appeal cases to determine medical... ...are medically reviewed. Qualifications include an active RN license (state of practice), 1+ years clinical experience, and strong...Remote job
- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis of hospital facility bills. You will document, research, and identify adjustments as part of a team preparing Forensic Reviews for clients....Remote job
- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established criteria. The role requires adept EMR review, strong clinical judgment, and collaboration with ED physicians...Remote job
$40 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Harrisburg, PA Agency: 22nd Century Healthcare, Inc. Pay: $40 to $45 per hour... ...of five (5) or more years of experience with claims review/coding or processing; be familiar with HCPCS II, CPT, or Dental...Hourly payFull timeContract workWork at officeImmediate startShift work- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract pertinent details... ...using evidence-based literature and coding guidelines. This remote role supports telecommuting from anywhere...Remote jobFlexible hours
- ...Healthcare seeks an experienced RN to support Arizona Plan clinical member services review processes. The role requires an... ...RN license and experience with utilization management, prior authorization,... ...inpatient and outpatient settings. Remote position, must reside in Arizona...Remote job
- Johns Hopkins Health Plans (JHHP) is seeking a Utilization Review Registered Nurse to assess care appropriateness, authorize services, and coordinate discharge planning for plan members. This remote role prioritizes candidates in MD, DC, VA, PA, DE, and FL with strong clinical...Remote job
$63k - $65k
...RN Utilization Review By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your...Remote workWork experience placementLocal areaFlexible hours
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