Utilization Review RN - Remote, Mon-Fri, No Nights
Hines Associates Ltd.
- Remote job
Hines & Associates is seeking registered nurses for a Monday–Friday role focused on clinical decision reviews to determine eligibility for outpatient or inpatient services. This position emphasizes URAC guidelines, disability and workers compensation regulations, and collaboration with case managers. Experience in mental health or substance abuse is required; 3+ years of acute care practice is preferred. A remote setting is offered within a nationwide team, with a salary- and benefit-rich #J-18808-Ljbffr Hines Associates Ltd.
- ...seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with rotating weekends/holidays. #J...Remote work
$400 per month
RN & LPN - Nights - OPEN INTERVIEWS MON-FRI 10am-3pm Job Category : SNF Requisition Number : RNLPN006293 Posted : October 6, 2026 Full-Time On-site... ...federal employment laws.For further information, please review the Know Your Rights notice from the Department of...SuggestedDaily paidFull timeImmediate startFlexible hoursNight shift$35 - $40 per hour
...LLC, a leader in healthcare transformation, seeks an RN Utilization Management Reviewer for a fully remote role. You will perform timely clinical decision... ...judgment to determine medical necessity. Hours are Mon-Fri 9:00 AM-5:30 PM Eastern; compensation is hourly $35....Remote jobHourly pay$35 - $40 per hour
...experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior... .... Shift is 8 hrs/day Mon - Fri, 40 hrs/week Fully Remote Position Pay Range: $35 - $...Remote workHourly payLocal areaShift work$2,150 per week
...Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort... ...hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT – 13... ...or lounges, or just spend a quiet night enjoying the sound of the ocean...Remote workTemporary workZero hours contractImmediate startShift workNight shiftWeekend work- .... The role features a Monday through Friday schedule, 8:00 am to 4:30 pm, with no nights, weekends, or holidays, and includes an occasional remote opportunity after 4 months. A MO/ KS RN license and BLS are required, and ambulatory care experience is preferred. In this...Remote jobMonday to FridayWeekend work
$33 - $37 per hour
...and rewarding career! Job Description Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious... ...Behavioral Health and Long Term Care. Hours for this Position: Mon‑Fri: 8:30am - 5pm Advantages of this Opportunity: Great salary...Private practiceWork at office- ...change? Want to work no nights, no weekends, and no... ...HolidaysWork-life balance.Remote settingRole Description:This individual will utilize clinical knowledge and... ...decision to a second level reviewer. This individual... ...but is not limited to RN, LMSW, LMHC.Must have Mental...Remote workTemporary workWork at officeMonday to FridayFlexible hours
$23 per hour
Hospice Telephone Triage RN- FT 6:30a-4p Mon-Fri/no wknds (REMOTE) Hospice Telephone Triage RN- FT 6:30a-4p Mon-Fri/no wknds (REMOTE) 2 weeks ago Be... ...triage for hospice and home health providers since 2008. Utilizing best-in-class technology, IntellaTriage provides round...Remote jobHourly payFull timePart timeLive inWork from homeMonday to FridayShift workNight shiftWeekend workDay shiftAfternoon shiftWeekday work- CorVel Corporation is seeking a Utilization Review Case Manager for a fully remote role in the United States. The position requires current nursing licensure and 4+ years of clinical experience with preferred exposure to utilization review. Responsibilities include data...Remote job
- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials... ...appropriate levels of care and timely approvals. This remote role requires PA RN licensure (or multi-state eNLC), a care-...Remote work
- CorVel in the United States is seeking a Utilization Review Case Manager to gather demographic and clinical information, certify medical necessity... ...length of stay for inpatient and outpatient treatment. This remote role requires strong CPT/ICD coding knowledge, meticulous...Remote job
- Centene Management Company LLC is seeking a remote Nurse Reviewer to perform concurrent reviews, determine the member’s health status, and oversee... ...and discharge planning teams while educating providers on utilization processes. The ideal candidate holds a nursing degree with...Remote job
- Centene Corporation is hiring a nurse reviewer to perform concurrent reviews for Medicaid and... ...Marketplace post-acute care from a fully remote role. Ideal candidates reside in Central,... .../IPR/SNF settings. Typical schedule is Mon-Fri, 8am-5pm based on your time zone with rotating...Remote job
- ...TEEMA is seeking a Registered Nurse for a remote role with Arizona hours (1st shift). You will review medical records for quality, safety, and utilization issues, identify PQIs, and support QA... ...Directors. Must hold an active RN license, have 3+ years of clinical experience...Remote workDay shift
$30 - $38 per hour
A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote jobHourly payPart time- ...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
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization...Remote workWork at office
- ...RN Utilization Review Location: Torrance, CA Job Type: Travel Discipline: RN Specialty: Utilization Review Facility Setting: Short Term Acute Care (STAC) Accepting Locals per Radius Rule?: Yes Contract Length: 13 weeks Shifts: Days Shift Details...Remote workContract workTemporary workLocal areaShift work
- CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary... ...license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote jobWork from homeMonday to FridayWeekend work
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend work$63.1k - $94.65k
...all applications and next steps. Our partner is looking for a Utilization Review RN based in the United States. Join a healthcare team... ...financial integrity of hospital operations. In this part-time, remote role, you will apply your clinical expertise to evaluate medical...Remote workTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift- ...Job TitleIn this remote role, you will perform utilization reviews, ensuring compliance with clinical guidelines and patient care standards. Collaborate with interdisciplinary teams to assess patient needs and facilitate care coordination. Your expertise in medical necessity...Remote work
$33.28k - $35.36k
...and uploading medical records and files to the corresponding Utilization Review or Medical Case Management case. Concurrently, this position... ...(8) hour workday, Monday-Friday 8:30 AM - 5:30 PM PST. Remote . Responsibilities may include, but are not limited to:...Remote workFull timeHome officeMonday to Friday- Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care... ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...Telecommuting Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday 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 Summary and Responsibilities As our Utilization Review RN, you will meticulously review medical records to confirm appropriate admission status and continued hospitalization, utilizing established criteria and critical thinking. You'll work hand-in-hand with Concurrent...Remote work
- ...seeking a Pre-Authorization Nurse to review and approve prior authorization... ...adherence to guidelines in a remote environment. Candidates should hold an active RN license in Virginia or a compact... ...experience and familiarity with utilization management and discharge...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
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