Remote Utilization Review Nurse: Medicare & Home Health
Medix
A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with healthcare teams. Qualifications include an accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
- ...Join a stable work from home team. This is a great... ...for a local remote position. Schedule... ...commercial, behavioral health, inpatient, etc). Requirements... ...: ~2 years of staff nurse experience performing... .... ~2 years of utilization review (UR) experience reviewing...Remote workWork from homeReliefLocal areaMonday to FridayFlexible hoursShift work
- ...professionals, the full-time remote Medicare Sales Agent will... ...while working from home in Maine, New Hampshire... ...questions and product reviews, assisting with enrollment... ...Current and active Health Insurance license in the... ...sales experience utilizing a health insurance license...Remote workWork from homeFull timeShift work
$20 per hour
A healthcare transformation company is seeking Licensed Health Insurance Agents for a remote role. In this position, you will provide consultative support... .... Join us to make a meaningful impact while enjoying flexible work-from-home conditions. #J-18808-Ljbffr View MoreiconsRemote jobWork from homeHourly payFlexible hours- ...Description \n Alignment Health is breaking the mold in conventional... ...Advanced Practice Provider (Nurse Practitioner or Physician... ...collaborative, highly coordinated home-based setting. The provider... ...history, physical exam, medication review, and appropriate cognitive/...Remote jobWork from home3 days per week1 day per week
- A clinician-led behavioral health company is seeking a Psychiatric Nurse Practitioner (PMHNP-BC) in Weymouth, MA. This position offers competitive salary, flexibility to work from home, and a focus on patient-centered care. Responsibilities include medication management...Remote workWork from home
- ...a friendly, detail-oriented Entry‑Level Home Health Intake Coordinator to join New Paradigm... ..., supporting home health agencies with remote patient intake. What You’ll Do Collect referral... ...insurance and demographic details Review clinical documents for accuracy Prepare...Remote workWork from home
$65k - $88.6k
...is looking for a Utilization Management Behavioral Health Professional 2... ...Bachelor's degree in nursing OR a master's... ...utilization review process. Experience... ...: This is a remote position.... ...needs. Work at Home Requirements: To... ...for people with Medicare and Medicaid, families...Remote workWork from homeFull timeTemporary workApprenticeshipPrivate practiceWork at officeHome officeMonday to Friday- ...Overview Title: Clinical Review Nurse – Prior Authorization... ...Location: Fully Remote (PST Time Zone - WA/... ...Authorization Review to join our Utilization Management team. In... ...information in health management systems to... ...Familiarity with Medicare and Medicaid Job Details...Remote workContract work
- ...Management Location: 100% Remote Schedule: M-F 9:00... ...Works with the Utilization Management team... ...necessity/utilization review and other utilization... ...unrestricted IL State Registered Nursing (RN) license in good... ...Job function Health Care Provider Industries...Remote workContract work
$120k - $170k
...a licensed Physician Assistant (PA‑C) or Nurse Practitioner (PMHNP) for a hybrid position supporting mental health patients in Texas. This role requires a minimum... ...off, and retirement plans, along with options for remote work or work-from-home flexibility. #J-18808-Ljbffr...Remote workWork from home- ...Nurses Are you looking for a change? Want to work... ...medical and behavioral health and/or substance use disorder... ...Work-life balance. ~ Remote setting Role... ...This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual...Remote workTemporary workWork at officeMonday to FridayFlexible hours
$125k
...Work From Home Nurse Practitioner – Telehealth Women’s Health | $125K+ 2 days ago Be among the first 25 applicants This range is provided by NPHire. Your actual... ...care for patients across the U.S. This fully remote position offers flexibility, autonomy, and competitive...Remote workWork from homeFull time- ...applicants This is full-time remote, but candidates must reside in... ...accurate and timely medical review of claims suspended for medical... ...URAC , NCQA standards and health insurance legislation . ~... ...prioritization skills. ~ Registered Nurse (RN) with unrestricted license...Remote workFull timeContract work
- ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
$70 - $100 per hour
...Psychiatric Mental Health Nurse Practitioner (PMHNP) Gibsonville, North Carolina We are a clinician-led, patient-centered, collaborative... ...cases or clinical topics. Clinical work is performed from home, days and hours are per the clinician's choosing (this includes...Remote workWork from homeDay shiftAfternoon shift- ...tuition assistance, 403(b), remote work United States,... ...: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Nursing Schedule: Day Shift... ...0 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns... ..., JHHP is the place to call home. #J-18808-LjbffrRemote workFull timeMonday to FridayDay shift
$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating... ..., and compliant delivery of home health care. This role monitors... ...ongoing care to ensure adherence to Medicare and regulatory guidelines while...Remote workContract workFlexible hoursWeekend work- Ahhmgt is looking for a dedicated Registered Nurse in Louisiana to manage patient care and... ...responsibilities include coordinating with health care teams, maintaining detailed reports,... ...A hybrid work environment with occasional home visits is required. #J-18808-Ljbffr AhhmgtRemote jobWork from home
$55 - $60 per hour
...seeking an experienced Utilization Management (UM) Registered Nurse to support outpatient utilization review and prior... ...clinical guidelines and health plan policies. Evaluate... ...Care, Health Plan, Medicare, Medicaid, or... ...independently in a remote environment. Comfortable...Remote workHourly payContract work- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours... ...combination of in person and remote considered) General... ...facilitates safe transition to home or extended care facility.... ...referral for home health, hospice, durable medical...Remote workFull timeShift work
- ...MCI is looking for a Licensed Life and Health Insurance Specialist in a remote, work-from-home capacity. This role involves educating customers about various insurance policies to meet their needs while ensuring compliance with regulations and achieving sales targets....Remote workWork from home
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley... ...Peterson AFB, Colorado Military Health System Compensation: $1,600... ...no holidays, no telehealth/remote work Minimum Qualifications... ...Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to Friday- ...Overview Home Health Visits with Growth Potential Job Summary:... ...includes opportunities to offer Remote Therapeutic Monitoring (RTM)... ...care while adhering to Medicare and Medicaid standards. Responsibilities... ...services such as: RTM Utilize RTM technology to monitor and...Remote workWork from homeFull timePart time
$8 - $65 per unit
Prolific is seeking Mental Health Professionals to help train AI models by reviewing AI-generated responses and providing expertise. Participants will complete... ...influence the future of AI while enjoying flexible hours and the ability to work from home. #J-18808-LjbffrRemote workWork from homeFlexible hours$14 per hour
...Morley is seeking a work-from-home customer service representative in Columbus, Ohio, to manage health insurance questions from customers and providers. You will be providing vital information regarding benefits, eligibility, and payments. The ideal candidate will...Remote workWork from homeHourly pay$35 - $43 per hour
...hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must reside in... ...– Concurrent Review will perform utilization management functions to ensure... ...plans, and medical determinations in health management systems. Educate...Remote work$120 per hour
...Join our network of remote Psychiatric Mental Health Nurse Practitioners (PMHNPs) and enjoy the freedom and flexibility of working from home. Benefits Guaranteed pay: You are fully compensated for cancellations and no‑shows. Set your schedule: You can work as...Remote workWork from homeContract work- ...Utilization Review Nurse- Remote American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates... ...care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by...Remote workFull timeTemporary workLocal area
- ...A large health care organization in Atlanta is seeking a clinical nurse to perform medical necessity reviews for Home Care and DME services. The ideal candidate will have a B.S. in Nursing... ...healthcare teams. Knowledge of Medicare and experience in home health coordination...
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