Remote Utilization Management RN
Guidehealth
- Remote job
Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments, and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings, and are proficient with Microsoft 365. #J-18808-Ljbffr Guidehealth
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote work
- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
$72.8k - $130k
...scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional Area, the... ...Qualifications: ~ Must be a Registered Nurse (RN) with a current, active, unrestricted RN License...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation... ..., communication and EMR proficiency, with a four-day work week and remote options for Montana residents. #J-18808-LjbffrRemote work
$101.72k - $198.36k
...Location: California - Ability to work remote, but selected candidate must reside in... .... This position requires California RN Licensure. Candidates must have significant... ...or all of the following functions: utilization management, care management, behavioral health and...Remote workContract workWork experience placementWork at officeLocal area- ...Arkansas Blue Cross and Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions... ...to guide cost-effective care. Candidates should have an RN license in good standing, a Bachelor's degree in Nursing preferred...Remote workHome office
- ...CVS Health is seeking a Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) to support treatment decisions remotely. You will collaborate with providers and apply clinical judgment for the right care at the right time. An active RN license...Remote workWork at office
- ...is seeking an experienced Registered Nurse to join the Utilization Management team in a remote, full-time role focused on Medicare joint procedures. You... ...appropriate services. Ideal candidates have an active RN license in their state, 3+ years of RN experience, and...Remote workFull timeWork at office
- ...experienced Registered Nurse for the Medicare Utilisation Management Nurse Consultant role (Remote, Full-Time). You will help ensure members receive the... ...to improve care quality while supporting care integration and utilization management. #J-18808-Ljbffr CVS HealthRemote jobFull time
- Humana Inc. is seeking a remote Utilization Management Registered Nurse to interpret clinical data and coordinate medical service determinations for home solutions and post‑acute care. You will review, document, and communicate with providers to ensure appropriate care...Remote job
- Guidehealth, a fully remote healthcare company, is seeking a Utilization Management Registered Nurse to perform reviews, apply medical necessity criteria, and document findings in support of determinations. You will collaborate with the Medical Director and peers to ensure...Remote job
$63.1k - $94.65k
...technology-enabled revenue cycle management solutions for health systems,... ...*Must have current compact RN license, or be willing to... ...Schedule Information: Our Utilization Review team provides coverage... ...Abilities Required: This is a remote role which requires access to...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$70k - $75k
...AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections... ...room for all patients. Job Description The Utilization Management Registered Nurse is responsible for performing...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$100k - $130k
...value to those who need it most. The Utilization Management (UM) team plays a vital role in supporting... ...with CMS guidelines. As the Lead RN, Utilization Management, you will coach... ...off policy. Additionally, we embrace a remote-first culture that supports...Remote workFull timeWork experience placementWork at officeFlexible hours$39.4 - $53 per hour
...provider of technology-enabled revenue cycle management solutions for health systems,... ...the possible in healthcare. The Lead Utilization Review RN is a key contributor to the overall financial... ...degree Nursing required #LI-LS1 #LI-REMOTE Join an award-winning company...Remote workWork at officeLocal area- Highmark Health is seeking a remote Care Manager RN to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) plus three weekdays, focusing on reviewing services, applying criteria, and improving member outcomes...Remote jobWeekend workWeekday work
- Ensemble Health Partners is seeking an RN Utilization Review quality professional to lead QA efforts within the VUR team. You will mentor staff... ..., and knowledge of medical necessity review criteria. Remote work with travel to client sites is expected, and opportunities...Remote job
- CVS Health in the United States seeks an RN Utilisation Management Nurse Consultant to support Medicare joint procedures in a remote, full-time role. Remote work with some evenings... ...care with providers, and help optimise utilization while upholding safety and quality. #J-1...Remote jobFull timeAfternoon shift
- Highmark Inc. is seeking a full-time REMOTE Care Management professional with weekend availability to coordinate utilization management and health coaching. You will review services... ...3 years of progressive clinical experience; RN licensure in PA or multi-state licensure,...Remote jobFull timeWeekend work
- Highmark Inc. is seeking a full-time remote Care Management professional available on weekends and... ...appropriateness of health care services, applying utilization criteria, and identifying referrals to... .../case management. The job requires RN licensure and clinical experience,...Remote jobFull timeWeekend workWeekday work
$47.03 - $63.48 per hour
...provider of technology-enabled revenue cycle management solutions for health systems,... ...redefining the possible in healthcare. RN, Senior Utilization Review Quality will play an essential... ...patient and client experiences This is a remote position; however, candidates must be...Remote workTemporary workWork at officeLocal area- ...please click here . Job Summary Utilization Management Nurse performs clinical review of prior... .../CERTIFICATION ~ Registered Nurse (RN) with active, current, unrestricted and... ...normally works in an office setting or remotely, periodically has lifting and carrying...Remote workFull timeWork at officeWork from home
$29.1 - $62.32 per hour
...helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare Home Care) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$26.01 - $62.32 per hour
...bigger – helping to simplify health care one person, one family and one community at a time. RN Utilization Management Nurse Consultant (Medicare – Joint Procedures) Remote | Full-Time | Monday–Friday (9:00 am to 5:30 pm in your time zone, with occasional evenings/holidays...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$29.1 - $62.32 per hour
...bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know Your Team: INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking a...Remote workFull timeWork at officeWeekend work
$71.1k - $97.8k
...a part of our caring community The Utilization Management Registered Nurse uses clinical nursing... ...Must hold Compact Registered Nurse (RN) license in your state of residence... ...Interqual. Experience working in a fully remote, metrics-focused role Experience as...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$60.53k - $129.63k
...bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) Remote | Full-Time | Monday-Friday Are you a Registered Nurse looking to leverage your...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- ...CVS Health is seeking an RN Utilisation Management Nurse Consultant (Medicare – Joint Procedures) for a remote, full-time role. You will review clinical data, apply criteria, and coordinate plans to ensure members receive appropriate care in a timely manner. Ideal candidates...Remote workFull time
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