Remote Utilization Review Nurse - Acute Care Expert
Insight Global
A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality policies. The ideal candidate has over 2 years of experience in utilization review and significant clinical experience in an acute setting. Strong written and verbal communication skills are essential. #J-18808-Ljbffr
- ...staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client... ...role involves evaluating patient care cases and ensuring requested services... ...clinical experience in an acute setting. Strong written and verbal...Remote work
- ...Company LLC is seeking a licensed nurse to perform concurrent reviews for appropriate care and setting, evaluating medical... ...supporting discharge planning in a fully remote role. You will work weekdays with... ...candidates have 2–4 years of acute care nursing experience,...Remote workWeekday work
$72.8k - $130k
...Coding Subject Matter Expert Optum Insight is improving... ...alignment between care providers and payers,... ...with prebill reviews, such as, HAC/PSIs. The... ...the flexibility to work remotely * from anywhere within... ...process standardization, utilization of best practices, work...Remote jobMinimum wageFull timeContract workWork experience placementLocal area- ...Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization... ...coordinating with Medical Directors. Remote options are available for eligible... .... The position demands 3+ years of acute care nursing and 1+ year in Utilization...Remote work
- ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization... ...requirements while working remotely. Key responsibilities:... ...degree is required 2+ years of Acute Hospital Care experience is required...Remote workFull time
- ...ensure appropriate resource utilization and minimize payment denials, the full-time remote Maryland Licensed Utilization Review Nurse will conduct initial,... ...actions taken to coordinate care, avoid denials, and... ...experience, preferably in an acute hospital setting Current...Remote workFull time
- ...driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity... ...records to ensure timely and compliant care determinations. Key responsibilities Conduct... ...years of recent clinical experience in acute care, med-surg, ICU/ED, or similar...Remote workFull time
$1,966 per week
...25 applicants Nurses – are you looking... ...managed health care, focused on... ...-life balance. Remote/hybrid setting... ...individual will utilize clinical knowledge... ...a second level reviewer. This individual... ...3 years recent acute clinical... ...in a new way. Experts add insights directly...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours$26.41 - $51.49 per hour
...This RN will act as a Care Review Clinician supporting our... ...discharge to either a nursing facility or back to... ...This is a telephonic remote position and productivity... ...will have previous utilization management, case management... ...in hospital acute care, inpatient review...Remote workHourly payWork experience placementWork at officeMonday to FridayWeekend work- ...Currently seeking a Utilization Management RN .... ...: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact... .... ** Previous Acute Hospital Utilization... ...medical record review to determine medical... ...appropriate care settings. Report...Remote workImmediate startDay shift
$39.64 - $61.45 per hour
...a Friend Back Remote Work from Home Share... ...MD 21076 Category: Nursing Schedule: Day Shift... ...(JHHP) is the managed care and health services... ...- 5:00 PM As a Utilization Review Registered Nurse for Johns... ...' experience as an acute care RN ~1+ years' experience...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift$40.12 - $62.19 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty... ...physician advisors, nurses, and support staff who... ...improving quality of care. Summary Conducts... ...Type This is a Full-time remote position. Responsibilities... ...; preferably in acute hospital setting Licensure...Remote workFull time- ...Utilization Review NurseWe are seeking a detail-oriented and experienced... ...Utilization Review Nurse to evaluate the... ...cost-effective patient care. The ideal candidate is... ...observation, and post-acute care services. Assess... ...management department. Remote, hybrid, or on-site...Remote workWork at office
$93.18k - $136.95k
...Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse . The Utilization Review Nurse... ...) Experience: • 3 years of acute care clinical experience (required... ...For positions that are available as remote work, Sentara Health employs associates...Remote workFull timeTemporary workShift work- ...Centene Management Company LLC is hiring for a remote RN/LPN utilization reviewer. You will evaluate patient care, determine appropriate level of care, and contribute... ...with Medical Affairs. Role requires 2+ years acute care and UM knowledge. Licensure as LPN and/or RN...Remote workMonday to Friday
$68k - $165k
...Regulatory Affairs Subject Matter Expert 2 acts alongside RA SME 1 to... ...and submission of acute care medical products.***Contingent... ...medical solutions.Develop and review regulatory strategies, submission... ...Detrick, MD 21702Travel: 10%Remote, Onsite, or Hybrid: Onsite.#LI...Remote workFull timeContract workTemporary workWork experience placementLive outFlexible hours$35 - $45.94 per hour
...we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review... ...records and speak with care providers regarding treatment... ...Work Location: This is a remote position, open to candidates... ...year clinical practice in an acute care setting, i.e., ER or hospital...Remote workHourly payFull timeWork from homeHome officeWeekend work- ...about helping people get care, stay well, and build... ..., the Clinical Care Reviewer - Utilization Management evaluates medical... ...Associate's Degree in Nursing (ASN) required;... ...Rehabilitation, or Long-Term Acute Care (LTAC), home... ...solutions include remote options, hybrid work schedules...Remote workFull timeWork at officeMonday to FridayFlexible hours
- ...Minnesota, United StatesCompany: UnitedHealth GroupPosted: 2026-09-12UnitedHealth Group seeks a Certified Sr. (IP) Acute Edits Medical Coder to work remotely from anywhere in the U.S. You will determine and record correct codes for treatments, ensuring documentation...Remote work
- ...Adult-Gero Acute Care NP Subject-Matter Expert - Contractor (Remote) Hours: 5–15 hours per week Location: Remote Type:... ...as an Adult-Gerontology Acute Care Nurse Practitioner. Contracted writers will write, edit, review and/or categorize nurse practitioner...Remote workHourly payContract workTemporary workFor contractors
- ...Mass Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure...
- ...experience and at least 1 year in auditing/DRG validation, with strong accuracy in diagnostic and procedure coding.Candidates should have acute-care inpatient and trauma coding experience, preferably from Academic Medical Centers or Trauma Centers, and will#J-18808-Ljbffr
$90k - $92k
...looking to get away from bedside nursing or transition out of the... ...clinical knowledge in a Utilization Review role while gaining a more predictable... ...necessity and quality of care. What You'll Do Conduct... ...in a more structured office/remote environment . #J-18808-Ljbffr...Remote workWork at officeWork from homeMonday to Friday- ...healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include... ...degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
- ...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
- ...Plan is seeking an Inpatient Utilization Management Clinician for a fully remote role in the United States.... ...discharge planning with care management and medical directors... ...an active RN license, nursing degree, and 2 years of utilization review experience with InterQual....Remote work
$78k - $88k
...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for... ...believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone....Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...Job TitleThis position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness...Remote workContract work
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) for a fully remote role. You will review home health documentation, audit OASIS and care plans, and ensure coding accuracy to protect reimbursement integrity. Qualified candidates hold an...Remote work
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