Remote Clinical Review Nurse — Utilization & Discharge
Centene Management Company LLC
- Remote job
Centene Management Company LLC in New York is seeking a Remote RN to perform concurrent reviews and support healthcare providers in delivering high-quality member care. The role requires an active New York State RN license and 2–4 years of nursing experience, preferably in acute care. The RN will evaluate member health, contribute to discharge planning, and conduct reviews while collaborating with Medical Affairs. Competitive pay and flexible work schedules are offered. #J-18808-Ljbffr Centene Management Company LLC
$27.02 - $48.55 per hour
...IntelliResume is seeking a Clinical Review Nurse for a remote position in New York. This role involves performing concurrent reviews to assess members' health and contribute to discharge planning. Ideal candidates will have a BSN and 2+ years of acute care experience....Remote workHourly payFlexible hours- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) to work remotely. This role involves assessing the necessity and quality of healthcare services through various review methods, ensuring compliance with clinical criteria. The ideal candidate must hold...Remote job
- Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full‑time position involves managing utilization reviews and ensuring compliance with clinical policies for quality...Remote jobFull time
- ...love your Mondays as the Nurse Director Utilization Review and Case Management at an... ...proven quality results; strong clinical excellence and safety... ...support, virtual nursing, and remote monitoring; clear... ...documentation integrity partnership, discharge planning, complex care...Remote workWeekend work
- ...Work Mode: Remote Duration: 3 months... ...medical necessity and clinical reviews of authorization requests... ...member's transfer or discharge plans to ensure a timely... ...teams on utilization processes to promote... ...Accredited School of Nursing OR Bachelor's degree...Remote workFull timeWork at officeMonday to Friday
- ...Summary Job Family: 08 Nursing Ambulatory/Admin -... ...3 months, then remote/hybrid Must have 3... ...setting doing utilization management. This job... ...from admission to discharge, collaborating with the assigned clinical team to identify patients... ...Physician Advisor review Care...Remote workWork at officeLocal area
$27.02 - $48.55 per hour
...The standard fully remote work schedule is... ...Perform concurrent reviews, including determining... ...contributing to discharge planning according... ...according to utilization management policies... ...necessity based on clinical policies and guidelines... ...school of nursing or a Bachelor’s degree...Remote workHourly payWork at officeMonday to FridayFlexible hours$27.02 - $48.55 per hour
...million members as a clinical professional on... ...This is a fully remote role. Candidates must... ...State Registered Nurse (RN) licensure strongly... ...and clinical reviews of authorization requests... ...'s transfer or discharge plans to ensure a... ...teams on utilization processes to promote...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...Nurses Are you looking for a change? Want to work... ...-life balance. ~ Remote setting ROLE DESCRIPTION... ...This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual... ...aftercare needs, implements discharge planning and/or case...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
- ...million members as a clinical professional on... ...flexibility. This is a remote role. This... ...Performs concurrent reviews, including determining... ...contributing to discharge planning according... ...according to utilization management policies... ...Accredited School of Nursing or Bachelor’s degree...Remote workFull timePart timeWork at officeFlexible hoursWeekend work
$2,250 per week
...Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort Myers... ...payers to ensure compliance with clinical guidelines, regulatory requirements... ...based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT –...Remote workTemporary workShift workNight shiftWeekend work- ...Department: Utilization Management Schedule: M-F 8am-5pm Work Location: Remote Benefits for eligible positions... ...admissions, case management, discharge planning and utilization review. Review admissions... ...Will Need ~ Registered Nurse credentialed from the...Remote work
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing... ...management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license in New...Remote workContract work
- ...A leading insurance provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments. This role does not require prior utilization review experience and is perfect for skilled nurses looking to transition...Remote workFull timeWork at officeWork from home
- ...Summary Utilization Review Nurse - Case Management Full-time, day shift (varies... ...0p or 8:00a-4:30p) Hybrid (remote with rotating in house coverage... ..., length of stay, discharge, and services ordered and provided... ...of education and clinical experience will be accepted...Remote workFull timeWeekend workDay shift
$40 per hour
...in TX Full time remote Candidates must be... ...initial, concurrent review activities; discharge care coordination for... ...divisions. Collects clinical and non-clinical... ...information regarding utilization management requirements... .... Registered Nurse (RN) with valid, current...Remote workFull timeContract workWork at office$35 - $43 per hour
...35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must reside... ...Concurrent Review will perform utilization management functions to ensure... ...right time. This role focuses on discharge planning, concurrent reviews, and...Remote work$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly pay$2,220 per week
...Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Hanover, Maryland... ...Utilization Review Nurse (Remote) Location: 100% Remote Schedule:... ...regarding approvals and denials • Initiate discharge planning and coordinate post-discharge...Remote workWeekly payContract workMonday to FridayShift work- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... ...from an accredited Registered Nursing Program; RN preferred. 2....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...Job Family: 08 Nursing - Ambulatory/Admin... ...for 3 months, then remote/hybrid Must have... ...hospital setting doing utilization management.... ...from admission to discharge, collaborating with the assigned clinical team to identify patients... ...Physician Advisor review o Care...Remote workWork at officeLocal area
- ...hospitals and eleven clinics provide excellence in... ...Applies approved utilization criteria to monitor appropriateness... ...and continued stay review. Communication to... ...and case manager/discharge planner when patient no... ...payer as determined by nursing judgment and/or collaboration...Remote workWork at officeShift workNight shiftRotating shift
$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating... ...support as needed. Review clinical documentation for compliance... ...status, visit utilization, and discharge planning. Identify and escalate...Remote workContract workFlexible hoursWeekend work- ...MedPOINT Management as a Medical Claims Clinical Review Nurse in Sherman Oaks, CA, where you'll play... ...and resolve discrepancies. Utilize clinical knowledge to assess the medical... ...a difference in the lives of patients every day. This is a remote position....Remote work
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active... ...with management and providing guidance on clinical questions. This is a unique opportunity to work from...Remote workFull timeWork from home
- ...COMMITMENT**JOB TITLE: UTILIZATION REVIEW/CASE MANAGEMENT –... ...combination of in person and remote considered)GENERAL... .../Case Management Nurse is directly responsible... ...stay and effective discharge planning is provided.... ...case-by-case basis with clinical staff.6. Demonstrates...Remote workFull timeSecond jobWork at officeRelocation packageShift work
- ...Summary: This position has a remote option for those living close... ...hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided... ...to address post-hospital discharge services, redirection to in-network...Remote workFull time
- ...join our talented Team. Job Title: Clinical Medical Review Nurse. Location: Owings Mills, MD. Summary... ...and population health data to support utilization review, adhoc requests, and client... ...professionalism and a collaborative mindset. Remote work environment with minimal...Remote work
$47.69 - $94.06 per hour
...Job Summary The Utilization Review (UR) Nurse supports the Utilization Management (UM) program by developing... ...management, quality management, or discharge planning. Compensation and Benefits... ...Providence St. Peter Hospital Location: Remote, Olympia, WA (work site Providence St...Remote workHourly payFull timeLocal areaShift workDay shift- ...This position will be remote only**... ...skill set related to utilization review, care coordination, performance... ...accredited school of Nursing. Experience ~... ...preferably in assigned clinical area. Equivalent... ...delays and obstacles to discharge. Ensures/maintains...Remote workTemporary workReliefShift work
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