Remote Preservice Review Nurse - Utilization & Case Review
ISHE
- Remote job
UnitedHealthcare is seeking a Preservice Review RN to review provider requests using Milliman Care Guidelines or Healthcare Operations Protocols. The RN approves those requests meeting medical necessity, benefit level, and provider/facility status for self-funded lines. This role also precepts new staff. Candidates must be available to work Monday–Friday 8:00 am–5:00 pm PST. You’ll enjoy remote work from anywhere in the U.S. while tackling challenging cases and supporting high-quality care. #J-18808-Ljbffr ISHE
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization... ...-based clinical guidelines. Identify and present cases of possible quality of care deviations, questionable...Remote workFull time
$65k - $75k
Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to make high-quality care decisions...Remote job- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull 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 appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- UnitedHealthcare is seeking a Preservice Review RN to review provider requests for medical necessity... ...-5:00 pm PST, with the option to work remotely from anywhere in the U.S. You will... ...eligibility, determine benefits, and route cases for review, maintaining high accuracy...Remote jobMonday to Friday
$29 - $52 per hour
...Growing together The Preservice Review RN is responsible for... ...the flexibility to work remotely * from anywhere within... ...based on site of service Utilize written criteria to... ...approve, pend or send the case to the medical... ...of and comply with the Nurse Practice Act for each...Remote jobHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- Optum is seeking a Registered Nurse for Preservice Review/Prior Authorization to support cross-functional care... ...into PA, PACM, ICM, and DCM functions, with remote work available anywhere in the United States. You will review cases, collaborate with Medical Directors, and...Remote job
- Northwestern Medicine is seeking a remote RN Case Manager (PT) to support Utilization Review at Catherine Gratz Griffin Lake Forest Hospital. This role provides staffing coverage with no set schedule and requires availability on weekdays and weekends; shifts are 6a-6p or...Remote jobShift workWeekend workWeekday work
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...Utilization Management, Utilization Review, or Case Management Preferred Certifications...Remote workContract workImmediate startMonday to Friday$30 - $40 per hour
...RN Clinical Review Nurse (Utilization Review Nurse)The Clinical Review Clinician... ...standards.Responsibilities:Prepare case reviews for Medical... ...complete clinical reviews for preservice authorization denials and... ...Type:This is a fully remote position.Application Deadline...Remote workContract workTemporary work$30 - $40 per hour
...Job Title: RN Clinical Review Nurse (Utilization Review Nurse) Job Description... ...Responsibilities Prepare case reviews for Medical... ...complete clinical reviews for preservice authorization denials and retrospective... ...Type This is a fully remote position. Application...Remote workContract workTemporary work- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote jobContract work
- ...Hospital Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations*... ...Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge* # 1...Remote work
$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges... ...clinical criteria for decision-making, referring complex cases to Medical Directors when needed. Engage with providers...Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...Job Description Job Description Remote Registered Nurse – Utilization Review Location: Fort Myers, FL 33916 Work Arrangement: Remote Duration:... ...decisions. Collaborate with providers, physicians, case management teams, and other healthcare professionals....Remote jobContract workMonday to FridayWeekend work
$35 - $45.94 per hour
...Utilization Review Nurse Remote Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the Role You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed...Remote workHourly payWork from homeHome officeWeekend work- ...Job Type Full-time Description The Case Manager / Utilization Review Nurse (RN) is responsible for coordinating patient care progression, discharge planning, and utilization review activities. This integrated role ensures appropriate levels of care, regulatory...Full timeWork at office
- ...RN Case Manager - Utilization Review Join our team as a day shift/variable, full time, RN Case Manager - Utilization Review, at INTEGRIS Baptist... ...Heart Association within 30 days of hire ~ RN (Registered Nurse) Current licensure as a Registered Nurse (RN) in the...Full timeWork at officeShift workDay shift
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type:Full Time The individual... ...negotiation with a payer on a case-by-case basis. This position integrates... ...Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
- ...Case Manager/Utilization Review NurseAt The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits... ...Responsibilities:A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and the...Part time
$81.12k - $115.94k
...Location: Partially remote, with onsite coverage required... ...Department: Utilization Management Schedule:... ...for appropriate care by reviewing admissions and service... ...journeys through expert case management and consultation... ...Registration: ~ Registered Nurse credentialed from the...Remote workFull timeLocal areaMonday to FridayWeekend workDay shift$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $... ...-homecare services, and durable medical equipment Refer cases to Medical Directors as needed/appropriate Maintain knowledge...Remote jobHourly payMonday to Friday- ...Utilization Review Medical Appeals Nurse - USRN NTT DATA Services is currently seeking a Utilization Review... ...and Responsibilities: Prepares case reviews for Medical Directors by... ...analytic skills ~ Required shift timings - US daytime ~ Can work remotely...Remote workShift work
$1,900 - $2,000 per week
...Registered Nurse (RN) | Utilization Review Location: Cape Coral, FL Agency: Lifelink Healthtech LLC Pay: $1,900 to $2,000 per week... ...Weeks Start Date: 9/14/2026 About the Position REMOTE POSITION Utilization Management: Shift: Monday through Friday...Remote workFull timeContract workMonday to FridayShift workWeekend work- NeueHealth is seeking a Concurrent Utilization Review (UR) Nurse to perform real-time clinical reviews ensuring medical necessity and appropriate... ...with payers, providers, and the Medical Director for complex cases. Responsibilities include authorizations for inpatient,...Remote job
- ...Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional... ...services against the clinical data provided Certify cases that meet clinical review criteria, guidelines and/or...Remote jobFull timeTemporary workLocal area
- ...discharge and providing proficient timely utilization management services to ensure that... ...of an accredited school of nursing. Experience: A minimum three years... ...Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant...Full timeLocal area
$1,900 - $2,000 per week
...Registered Nurse (RN) | Utilization Review Location: Cape Coral, FL Agency: Lifelink Healthtech LLC Pay: $1,900 to $2,000 per week... ...qualified Utilization Review RN in Cape Coral, Florida, 33904! REMOTE POSITION Utilization Management: Shift: Monday through...Remote workFull timeContract workMonday to FridayFlexible hoursShift workWeekend work- ...discharge and providing proficient timely utilization management services to ensure that... ...of an accredited school of nursing. Experience: A minimum three years... ...Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must...Full timeLocal area
$30 - $40 per hour
...life-changing decisions, one review at a time? Why This Role... ...on a clean, well-documented case. Your reviews are the front line... ...~ Graduate of an accredited nursing program (ADN or diploma required... .../ED, or similar setting) ~ Utilization review/utilization management...Remote workHourly payImmediate startMonday to FridayFlexible hours
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