Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Utilization Management Nurse (RN/LPN)

Integrated HomeCare Services

Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency, and compliance. You will review treatment files, verify medical necessity, and collaborate with a multidisciplinary team to optimize patient outcomes.

State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are required. Proficiency with word processing and spreadsheet programs is essential; UM/Case Management

#J-18808-Ljbffr
Vacancy posted 21 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse (RN/LPN) in Florida vacancy
  • 100% Remote | Contract-to-Hire | Monday-Friday 8-5pm | California License Required We are seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) with a strong background in Inpatient Utilization Management to join a growing healthcare organization... 
    Remote work
    Contract work
    Work at office
    Monday to Friday

    Medix™

    Sacramento, CA
    4 days ago
  •  ...Description Job Description Position Summary: The Utilization Management Nurse (UMN) works under general supervision of the Director and...  ...stay.  Qualifications:  Current unrestricted Florida RN or LPN License. Minimum of two years of utilization review experience... 
    Remote work
    Work at office
    Weekend work

    South Florida Community Care Network LLC

    Fort Lauderdale, FL
    16 days ago
  • Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will oversee inpatient case reviews, coordinate referrals, and collaborate with physicians, discharge planners, and ancillary services to ensure safe, cost-effective... 
    Remote job

    Alignment Health

    New York, NY
    2 days ago
  • Alignment Health seeks an inpatient review nurse to join its remote utilization management team. You will assess inpatient stays, collaborate with PCPs, discharge...  ...and cost-effective care. The role requires LVN or RN licensure (CA) with willingness to obtain licenses in... 
    Remote job

    Alignment Health

    Phoenix, AZ
    5 days ago
  • Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and...  ...inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least... 
    Remote job
    Work from home

    Arkansas Blue Cross Blue Shield

    Bismarck, ND
    5 days ago
  •  ...Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the...  ...administrative compliance. Unlike remote roles, this position relies heavily on...  ...site UM Nurse is a Registered Nurse (RN) responsible for performing admission... 
    Remote work
    Full time
    Immediate start
    Shift work

    Wellstar Health Systems, Inc.

    Augusta, GA
    18 days ago
  • $65k - $85k

     ...Position Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is...  ...ability to work independently in a fully remote environment. Budgeted...  ...additional clinical review and escalate to an RN, Medical Director, or other... 
    Remote work
    Work at office

    Blue Zones Health

    La Crescenta, CA
    18 days ago
  •  ...Wound Care Nurse (RN or LPN)Location: Middleton Oaks Health and RehabilitationJob Type: Full time...  ...team and provide high-quality wound management and support to our residents. If you have...  ...adults. From telemedicine services and remote health monitoring to advanced... 
    Remote work
    Full time
    Local area
    Shift work
    Night shift
    Day shift
    Afternoon shift

    Avardis Health

    Winona, MS
    2 days ago
  •  ...CVS Health is seeking a Utilization Management Nurse Consultant (Remote) to support Florida Medicare home-care requests. You will review cases, determine coverage...  ..., full-time setting. The position requires an active RN license, 2+ years of experience (including 1+ year in... 
    Remote work
    Full time

    CVS Health

    United States
    4 days ago
  • $70k - $75k

     ...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies... 
    Remote work
    Bi-weekly pay
    Full time
    Temporary work
    For contractors
    Local area
    Work from home

    Guidehealth

    United States
    21 hours ago
  • $27.1 - $40.65 per hour

     ...better care experience for all. JOB SUMMARY The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to...  ...: Licensed Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California nursing license... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Work at office
    Work from home

    NeueHealth

    United States
    1 day ago
  •  ...Wound Nurse (LPN/RN) - Philadelphia, Pennsylvania At Accela Rehab and Care Center at Somerton, we are committed to providing exceptional...  ...who deliver high-quality care to patients with complex wound management needs. Job Summary: We are seeking a Wound Nurse (LPN/... 
    Remote work

    Accela Rehab and Care Center at Somerton

    Philadelphia, PA
    21 hours ago
  •  ...NeueHealth is seeking a Utilization Management Nurse (LVN/LPN) for a remote role based in California. The position focuses on reviewing prior authorizations, ensuring alignment with coverage policies and medical necessity, and collaborating with providers, patients, and... 
    Remote work

    NeueHealth

    California
    21 hours ago
  •  ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate... 
    Remote work
    Work from home

    Cambia Health Solutions, Inc.

    Provo, UT
    5 hours ago
  • $60k

     ...Integra is looking for a LPN/LVN experienced in the managed care payor environment to...  ...-service and post-service utilization reviews and appeals for DMEPOS...  ..., Licensed Vocational Nurse, or Licensed Practical Nurse...  ...development opportunities Remote Opportunities We are... 
    Remote work
    Temporary work
    Local area

    Integra Partners

    Crystal Bay, NV
    21 hours ago
  • Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required... 
    Remote job
    Contract work

    Medix™

    Sacramento, CA
    4 days ago
  • Integra Partners is seeking a Licensed Practical Nurse to perform pre-service and post-service utilization management reviews and appeals within a NCQA-compliant UM program...  ...payor environments. The role requires an active LPN/LVN license, at least 3 years of nursing in acute... 
    Remote job

    Integra Partners

    Milton, MA
    5 days ago
  • $77.91k - $116.86k

     ...Together. Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist...  ...maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately upon... 
    Remote job
    Immediate start
    Monday to Friday

    Alignment Health

    New York, NY
    5 days ago
  • $45 per hour

    Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh'smanaged care health plan client based out of Fairfield & Redding, CA. Anticipating to betemporary for at least 6 months with potential for temp-to-hire... 
    Remote work
    Contract work
    Temporary work
    Monday to Friday
    Weekend work

    Yoh

    Columbus, OH
    4 days ago
  •  ...role of Precertification Nurse is to perform Pre-...  ...Precertification Nurse - LPN/RN Full time:  Monday to Friday Location:  Remote. Will need to be in...  ...Preferred # InterQual/Review Manager/CERME # CPT and ICD-9...  ...-Surg – Required # Utilization Review – Preferred #... 
    Remote job
    Full time
    Work at office
    Monday to Friday

    MEDLOGIX, LLC

    Trenton, NJ
    16 days ago
  •  ...Find your calling at Mercy! Position Details: Primary Care Nurse RN or LPN Mercy Clinic Primary Care - Edmond I-35 South Monday-Friday, 40 hours per week *This is a hybrid remote position. The person hired for this role will complete at least 90 days of... 
    Remote work
    Full time
    Monday to Friday
    2 days per week
    3 days per week

    Mercy

    Edmond, OK
    19 days ago
  •  ...Job Description Looking for qualified Nursing Supervisor (RN or LPN) to join our team!   Location:...  ...Lead & Supervise Nursing Staff - Manage daily staffing needs, ensuring adequate...  ...adults. From telemedicine services and remote health monitoring to advanced diagnostic... 
    Remote work
    Full time
    Local area
    Shift work
    Night shift
    Weekend work
    Day shift
    Afternoon shift

    Avardis Health

    Arden, NC
    4 days ago
  •  ...About the role We're looking for an RN who has personally owned grievance and...  ...hospital-based role. The best fit has a utilization management or case management foundation and has...  ...time-sensitive cases at once in a fully remote setting. Nice to haves BSN or MSN... 
    Remote job

    Phaxis LLC

    New York, NY
    12 days ago
  •  ...considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply. Utilization Management Nurse RN - Utilization Management - UH Truman Medical Center (7:00a-4:00p, varied days per week)101 Truman Medical Center Job... 
    Full time
    Work from home

    University Health

    Remote
    10 days ago
  •  ...This role is ideal for an RN or LPN who enjoys patient...  ...Summary The Physician Nurse serves as a key clinical...  ...office-based and utilizes the electronic medical...  ...skills. Ability to manage multiple priorities in...  ...afternoons off! Hybrid remote work may be available following... 
    Remote work
    Full time
    Private practice
    Work at office
    Monday to Friday
    Flexible hours
    Weekend work

    GASTROENTEROLOGY SPECIALTIES PC

    Lincoln, NE
    9 days ago
  • $60.2k - $107.4k

     ...Inpatient Care Management NurseOptum is a global organization...  ...Care Management Nurse, you will be responsible...  ...for ensuring proper utilization of our health services...  ...the flexibility to work remotely from the Pacific,...  ...Current, unrestricted RN license in state of Residence... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Local area

    UMR

    Phoenix, AZ
    1 day ago
  •  ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a... 
    Remote work
    Work from home
    Weekend work
    Afternoon shift

    Native American Talent

    Arizona
    21 hours ago
  •  ...CVS Health in Florida is seeking a Utilization Management Nurse Consultant. This full-time remote (work from home in Florida) role requires an active Florida RN license and at least 3 years of inpatient nursing experience. You will review medical necessity, coordinate... 
    Remote work
    Full time
    Work from home
    Weekend work
    Afternoon shift

    CVS Health

    Fort Lauderdale, FL
    21 hours ago
  •  ...Job Title Registered Nurse (RN) for Critical Incident Management Team Job Location Harrisburg, Pennsylvania, United States, 17...  ...responsibilities in a structured environment while utilizing technology to support remote and hybrid work functions. Your ability to... 
    Remote work
    Work from home

    The CKHobbie Group

    United States
    3 days ago
  •  ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a...  ...competitive compensation with benefits, remote opportunities across multiple...  ...with UM experience in managed care are encouraged to apply. #J... 
    Remote job

    Integra Partners

    New York, NY
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management Nurse (RN/LPN). Be the first to apply!