Remote Utilization Management Nurse - LVN/LPN
NeueHealth
NeueHealth is hiring a Utilization Management Nurse (LVN/LPN) based in California for a remote, full-time role. The PA Nurse reviews prior authorizations, verifies coverage, and ensures medical necessity under state and plan policies.
You will collaborate with Medical Directors, providers, and plans to resolve denials and improve processes. The position requires 2–3 years of clinical nursing experience, with 1 year in utilization review or case management, and an active CA license.
#J-18808-Ljbffr$65k - $85k
...Description: Position Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is responsible for... ...skills, and the ability to work independently in a fully remote environment. Budgeted Compensation: $65,000 - $85,...Remote workWork at office$27.1 - $40.65 per hour
...better care experience for all. JOB SUMMARY The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to... ...: Licensed Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California nursing license...Remote workHourly payFull timeContract workWork at officeWork from home- ...NeueHealth is seeking a Utilization Management Nurse (LVN/LPN) for a remote role based in California. The position focuses on reviewing prior authorizations, ensuring alignment with coverage policies and medical necessity, and collaborating with providers, patients, and...Remote work
$60k
...Integra is looking for a LPN/LVN experienced in the managed care payor environment to... ...-service and post-service utilization reviews and appeals for DMEPOS... ..., Licensed Vocational Nurse, or Licensed Practical Nurse... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal area- 100% Remote | Contract-to-Hire | Monday-Friday 8-5pm | California License Required We are seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) with a strong background in Inpatient Utilization Management to join a growing healthcare organization...Remote workContract workWork at officeMonday to Friday
- ...Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...to optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote work
$60k
...Integra Partners seeks an LPN/LVN experienced in managed care UM to perform pre- and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director on benefit and medical necessity reviews within an NCQA-compliant UM program....Remote work- Alignment Health seeks an inpatient review nurse to join its remote utilization management team. You will assess inpatient stays, collaborate with PCPs, discharge... ...and cost-effective care. The role requires LVN or RN licensure (CA) with willingness to obtain licenses...Remote job
- ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a... ...competitive compensation with benefits, remote opportunities across multiple... ...with UM experience in managed care are encouraged to apply. #J...Remote job
- Integra Partners is seeking a Licensed Practical Nurse to perform pre-service and post-service utilization management reviews and appeals within a NCQA-compliant UM... ...payor environments. The role requires an active LPN/LVN license, at least 3 years of nursing in acute or...Remote job
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate care for members. The role requires a registered nurse with at least 3 years of experience and an active license in the resident state.The position operates...Remote workWork from home
$30 - $35 per hour
...Department: Enhanced Care Management (ECM) Reports To: Registered Nurse Clinical Case Consultant... ...Licensed Vocational Nurse (LVN) serves as a vital member... ...a combination of remote work, field-based member... ...Pacific Health Group utilizes AI-assisted tools to support...Remote workHourly payTemporary workWork at officeLocal areaMonday to FridayFlexible hoursAfternoon shift- ...Blue Zones Health seeks a Licensed Vocational Nurse (LVN) for Utilization Management & Inpatient Case Management in a fully remote role based in California. You will monitor inpatient services, perform concurrent reviews, and coordinate transitions of care while collaborating...Remote work
- ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS within a... ...LPN/LVN license, with at least 3 years of nursing experience and 2 years in managed care UM, and have knowledge of InterQual and...Remote work
- ...Cambia Health Solutions, Inc. is hiring a Utilization Management Nurse who will conduct reviews to ensure medical necessity and cost-effective outcomes. Working from home within the states of Oregon, Washington, Idaho or Utah, you will assess patient needs and collaborate...Remote workWork from home
- ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote workWork from home
- ...Partners is seeking a licensed LPN/LVN with managed care UM experience to... ...pre-service and post-service utilization reviews and appeals for DMEPOS... ...with NCQA standards. The UM Nurse will review requests using... ...others to the Medical Director. Remote opportunities are available...Remote work
- ...CVS Health in Florida is seeking a Utilization Management Nurse Consultant. This full-time remote (work from home in Florida) role requires an active Florida RN license and at least 3 years of inpatient nursing experience. You will review medical necessity, coordinate...Remote workFull timeWork from homeWeekend workAfternoon shift
- Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required...Remote jobContract work
- Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote jobWork from home
$29 - $62 per hour
...About This Role The Utilization Management Nurse Consultant role at CVS Health involves utilizing clinical experience to assess, plan, implement... .... Highlights Pay: $29 - $62/hour Location: Remote, TX Residency: Must reside in EST or CST Schedule: 2...Remote workWork at officeWork from homeAfternoon shift$77.91k - $116.86k
...Together. Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist... ...have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately...Remote jobImmediate startMonday to Friday- Astrana Health is seeking a CA-licensed Utilization Review Nurse to support the Health Services Department. You will review outpatient services... ...and refer cases to Medical Directors as needed. This is a remote role for CA-licensed RNs/LVNs, with candidates living in California...Remote jobCasual workWork at office
- Astrana Health is seeking a Utilization Review Nurse with a Texas LVN license to support our Health Services Department in reviewing a high volume of outpatient... ...weekend and holiday rotation. The position is fully remote and will align with PST hours during probation,...Remote jobTrial periodWeekend work
$29.1 - $62.32 per hour
...CVS Health Remote Clinical Position We're building a world of health... ...in collaboration with management to ensure adequate weekend coverage. Position Summary: Utilize your clinical experience and skills... ...: Registered Nurse Education: Diploma RN acceptable...Remote workFull timeWork at officeWork from homeShift workWeekend work$30 - $40 per hour
Astrana Health, Inc. is seeking a Utilization Review Nurse with a Texas LVN license to support the Health Services Department. The position is fully remote with open availability from 8:00 AM to 8:00 PM PST, Monday through Sunday, and weekend/holiday rotation. The target...Remote jobHourly payTrial periodWeekend work- ...Licensed Vocational Nurse /LVN – Utilization Review (HEDIS Abstractor) HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading... ...to review charts • Coordinate, complete, and update management on clinical quality • Establish and maintain an action plan...Private practiceWork at officeMonday to Friday
- ...Day (United States of America) Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the clinical floor and administrative compliance. Unlike remote roles, this position relies heavily on real-time, face-to-face...Remote workFull timeImmediate startShift work
- ...NeueHealth is seeking a Utilization Management PA Nurse in California. The role reviews prior authorizations to ensure medical necessity and contract... ...with providers and health plans. Licensing as LVN/LPN in CA is required; prior authorization or case management...Contract work
$45 per hour
Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh'smanaged care health plan client based out of Fairfield & Redding, CA. Anticipating to betemporary for at least 6 months with potential for temp-to-hire...Remote workContract workTemporary workMonday to FridayWeekend work
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