Remote RN - Clinical Utilization Reviewer (Alabama)
Comagine Health
- Remote job
Comagine Health is seeking a Clinical Utilization Review Nurse (RN) licensed in Alabama to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position supports compliant, cost-effective care aligned with Alabama contract requirements. Education required includes a BA/BS in Nursing with an active Alabama RN license and at least 3 years of direct patient care experience. #J-18808-Ljbffr Comagine Health
- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care... ...care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role...Remote workFull timeContract work
$45 - $50 per hour
...looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr...Remote jobHourly pay- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time remote role supports compliant, cost-effective care under Alabama...Remote jobFull timeContract work
$38.2 - $57.3 per hour
...Lukes Medical Center - Clinical Documentation... ...on site, two days remote. Pay Range:... ...Documentation Specialist (RN) Aurora St. Luke... ...You Will Do Review inpatient medical records... ...assignments. Utilize the physician query... ..., Georgia and Alabama; and Aurora Health...Remote workDaily paidFull timeTemporary workPart timeFlexible hoursShift work2 days per week3 days per week- Enlyte is seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers’ compensation... ...retrospective treatment referrals. The role requires clinical judgment to ensure medical necessity, collaboration...Remote jobWork from home
$32 - $33 per hour
...RN - Clinical Field Reviewer (Remote in Montana) Mountain Pacific is looking for a Registered Nurse (RN) to join our team who lives in Missoula or... ...Mountain Pacific is an equal opportunity employer and utilizes Simpliverified. We welcome applications from all qualified...Remote workHourly payFull timeTemporary work- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration:... ...Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $...Remote workContract work
$32 - $33 per hour
...situation fit into our culture. We have an opening for a: RN - Clinical Field Reviewer (Remote in Montana) The RN Clinical Field Reviewer is a remote... ..., practice cultural humility with each client, and utilize evidence-based practice as a foundation for our interventions...Remote workFull timeTemporary workLocal area$88k - $93k
Profile Remote work opportunities are available in the following states: AK, AR... ...encouraged to apply. Job Summary The Utilization Management Clinical Review nurse reviews and makes decisions... ...Experience Required: Active, unrestricted RN license U.S. Citizen Ability to...Remote workContract workTemporary workInterim roleWork at officeLocal areaShift work- ...To enhance clinical documentation accuracy, the full-time Remote RN Clinical Documentation Specialist will perform documentation improvement activities, collaborate... ...on documentation best practices and compliance Utilize CDI software to track activities and maintain...Remote workFull time
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :... ...eligibility regarding benefits and clinical criteria and assess and monitor...Remote workFull timeContract workLocal areaShift work
$50k
...Department Overview The Clinical Documentation Specialist will... ...concurrent and retrospective review of provider documentation, query... ...of patient records in a remote setting. The Registered Nurse... ...physicians and nursing as needed. Utilizes software systems (including...Remote workFull timePart time- 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
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role... ...and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include reviewing medical necessity, coordinating with providers...Remote jobWork from home
- ...seeking an experienced Utilization Management Nurse 2 to support... ...medical necessity reviews, care coordination, and... ...members. You will use clinical judgment to decide on level... ...members. The role is remote/work-from-home with... ...annually; requires Kentucky RN license, 2+ years...Remote jobWork at officeWork from homeShift work
- ...telephonic and e-Referral case review and authorization of services utilizing established mental health... ...care appropriate to clinical needs. Responsible for... ...position is full-time, fully remote (work from home) and... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources... ...). These will be completely remote positions, working entirely... ...'s home. The Nurse will be reviewing cases, educating patients on... ...the HCWs must have pertinent clinical experience within the past two...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$85k - $92k
TEEMA Solutions Group is seeking a Clinical Quality Reviewer to support a federal healthcare program. This... .... Candidates must have a valid RN or LCSW license with at least three years... ...clinical experience. The position may be remote or onsite based on business requirements...Remote jobWork at officeHome office$50 per hour
...RN Clinical Reviewer / IDR - Remote Location: Remote Employment Type: Full-time Hourly Rate: $50/hr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals...Remote workHourly payFull timePrivate practice- ...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
$90k - $105k
...RN Clinical Documentation Reviewer (NYC, NY / Remote) FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry since 2016. We support our patients by ensuring they have the power to choose a caregiver who will care for them...Remote job- 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
- ...guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review of professional (or facility) claims vs. medical...Remote jobContract workWork at officeLocal areaMonday to Friday
- ...management organization is seeking a Utilization Management Nurse to oversee... ...This role requires an active LPN/RN license, and candidates should have clinical experience and proficiency in electronic... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract pertinent details, and... ...-based literature and coding guidelines. This remote role supports telecommuting from anywhere in the...Remote jobFlexible hours
$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... ...You'll DoReview home health clinical documentation for accuracy and complianceAudit...Remote workMonday to FridayWeekend work- ...to coordinate and manage utilization management for behavioral health services across remote settings in the US. The role... ...medical necessity reviews, discharge planning, and care... ...coordination. The position requires RN license, 2+ years acute clinical experience, and...Remote job
- ...seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior... ...care programs. Required are an active CA RN license and at least five years in patient... ...substitute for experience. Hybrid work and remote- interview options are offered. #J-18808...Remote jobTemporary work
- ...help millions of people live healthier lives. The Utilization Management and Clinical Validation RN will review patient medical records, extract pertinent details... ...process instructions and guidelines. This role is remote from anywhere in the U.S. with an unrestricted RN...Remote job
- ...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
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