Remote Utilization Review RN Specialist (Case Management)
70 HonorHealth Support Services
- Remote job
HonorHealth is seeking a Utilization Review RN Specialist to review and monitor health care utilization, ensuring medical necessity and appropriate levels of care across inpatient, observation, and ambulatory settings. The role involves coordinating reviews for Medicare and other payers, collaborating with care teams, and driving accurate documentation for data reporting. Remote work is available after training, with a day shift in a major Arizona healthcare system. #J-18808-Ljbffr 70 HonorHealth Support Services
$65k - $85k
...Utilization Review Specialist (RN) – Remote At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN)... ...integrity Collaborate with Branch Directors, Clinical Managers, and field clinicians Support quality assurance and...Remote workMonday to FridayWeekday work- Ensemble Health Partners is seeking a Remote Utilization Review Specialist to join our team, focusing on... ...reviews and collaboration with care management and billing teams. This role is remote... ...candidates must hold an active LPN or RN license, have a Bachelor's degree or...Remote job
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...Remote job
- ...and monitoring the utilization of behavioral health... ...Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member... ...degree and active NYS RN license required.... ...be opportunity for remote work within all jobs...Remote workContract workWork at office
- ...General Hospital is seeking an Utilization Management Nurse (UMN) to ensure... ...concurrent, and retrospective reviews, collaborate with physicians... ...compliance. Role requires Florida RN licensure and at least 3 years of nursing experience. Remote or hybrid work options may apply...Remote job
- Gateway Regional Medical Center, Inc. is seeking a full-time Utilization Review Specialist RN responsible for conducting admission and concurrent reviews to avoid payment denials, while managing appeals. This role requires collaboration with interdisciplinary teams to enhance...Full time
- UofL Health is seeking a Utilization Review RN in Louisville to support utilization management. The role includes admitting and concurrent reviews, interfacing with physicians... ...2 years of RN experience with preference for case management experience and CCM/ ACM certification...
- UofL Health is seeking an RN for Utilization Review in Louisville, KY. The role supports the Utilization Management process, reviews medical necessity, and coordinates care across... ...of RN experience, and Kentucky licensure. Case management experience is preferred and...
- ...seeking experienced nursing professionals to review medical records and ensure appropriate... .... Candidates must have a valid California RN license and at least two years of clinical... ...degree in a related field. The position offers remote work with emphasis on critical thinking...Remote work
- ...NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals... ...organizational determinations. The role requires collaboration with RN Case Managers and the Medical Director to support timely decisions and...Remote work
$63k - $65k
...RN Utilization Review By joining Sedgwick, you'll be part of something truly... ...experience to assist in the management of complex medical... ...and well-being of others in a remote work environment. Enjoy flexibility... ...preferred. Certification in case management, pharmacy,...Remote workWork experience placementLocal areaFlexible hours- ...Network Services is hiring a Registered Nurse for Utilization Management in a remote, full-time role. You will review admissions and service requests for medical... ...with the healthcare team. The role requires Texas RN licensure (Compact State preferred) and a nursing...Remote jobFull time
- ...of appropriate clinical review of all applicable... ...patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains... .... This role will be remote BUT regular meetings/trainings... ...Epic and escalating cases for status change where...Remote workReliefWeekend work3 days per week
$2,210 per week
...leader in personalized managed health care,... ...Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces with case managers and disease... ...is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...Responsibilities Responsible for the review of medical records for... ...Coordination staff utilizing evidence-based... .... Job Requirements Remote. Must reside within... ...or a Masters degree in Case Management or Nursing field in lieu... .... California RN license. AHA BLS Ability...Remote work
- 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
- Job Title Utilization Review/Case Management - Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly...Remote workFull timeShift work
- ...Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review... ...) to join our growing Utilization Management team. This fully remote position plays... ...experience in utilization review, case management, or behavioral health...Remote jobWork at office
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type... ...necessity. This position manages medical necessity process for... ...negotiation with a payer on a case-by-case basis. This position... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle...Remote workFull timeWork at officeFlexible hoursShift work
$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment... ...reviewers to support case review processes. Assist... ...required timelines. Support case management activities and identify... ...working independently in a remote or office-based setting. Working...Remote workWeekly payContract workWork at officeMonday to Friday$51.43 - $79.84 per hour
Overview Description - This is a remote role. You MUST live in the state... ...(WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical... ...certification upon hire. 1 year of Case Management experience. Why Join...Remote workDaily paidLive inShift workDay shift$84.56k - $126.84k
...: Regular Job Overview The Utilization Review RN participates as a member of... ...Department Name: Utilization Management Job Status: part time, 24 hours... ...position will be primarily remote but there may be occasions... ...care in conjunction with the Case Managers regarding the...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift$40.5 - $64.8 per hour
...future of medicine. Description **This is a remote casual position supporting Utilization Review at Catherine Gratz Griffin Lake Forest Hospital.... ...for this role is 6a to 6p or 6p to 6a. ** The Case Manager, RN (PT)reflects the mission, vision, and values of NM...Remote workHourly payTemporary workWork experience placementCasual workLocal areaRelocation packageFlexible hoursRotating shiftWeekend workWeekday work$16.74 - $26.92 per hour
...Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services... ...goals of the Utilization Review / Case Management department, and of CorVel. ESSENTIAL... ...workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours$77.96k - $120.37k
...Utilization Review Supervisor RN The Utilization Review Supervisor RN is responsible for directing... ...service, and limited sales management. This is a remote position. ESSENTIAL FUNCTIONS... ...activities May be required to oversee case management clinical activities (...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- ...Job Description Position Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management for participants enrolled in the Program for All... ...and interdisciplinary team to review clinical cases, manage utilization policies, and ensure regulatory...Work at office
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with...Remote work
- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care.... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are essential...Remote jobContract work
- ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and... ...caseload of 50-75 patients, authorizing 15-25 cases daily while ensuring timely utilization reviews...Remote workFull time
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