RN - Utilization Review
INFOJINI
Utilization Review Rn
Job type: Travel
Profession: RN
Specialty: Utilization Review
State: NY
INFOJINIVacancy posted 9 hours ago
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...for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby....SuggestedRemote jobHourly pay- UofL Health is seeking a Utilization Review RN in Louisville to support utilization management. The role includes admitting and concurrent reviews, interfacing with physicians and payors, and ensuring compliance with UM criteria and documentation standards. Ideal candidates...Suggested
- ...Job Summary and Responsibilities As our Utilization Management Nurse, you will be a critical... ...utilization. Every day, you will meticulously review medical records, authorize services, and... ...outcomes. Collaborates with facility RN Care Coordinators to ensure progression of...Suggested
- ...and Responsibilities Responsible for the review of medical records for appropriate admission... ...reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical... ...in lieu of 1 year experience. California RN license. AHA BLS Ability to pass annual Inter...SuggestedRemote work
- ...delivering patient-centered care to each and every patient each and every day. Job Description Position Summary and Purpose The Utilization Review RN performs activities which support the Utilization Management functions. They are responsible for the delivery of the...Work at officeShift work
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New York, NY11 days ago $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- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role... ...patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master...Remote work
Santa Barbara Cottage Hospital
New York, NY4 days ago - Enlyte is seeking a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers’ compensation related prospective, concurrent, and retrospective treatment referrals. The role requires clinical judgment to ensure...Remote workWork from home
Genex Services, LLC
New York, NY1 day ago - A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote jobFlexible hoursWeekend workDay shift
- ...Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit and medical...Remote job
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Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...- 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
- Molina Healthcare seeks a Registered Nurse with an Ohio or compact license to join the Care Review Clinician team. You will provide prior authorization for behavioral health services for the Ohio Medicaid population and bring strong behavioral health experience to a fast...
- ...seeking Nurses for a Monday-Friday role, 9:30 AM to 6:00 PM, with no nights, weekends, or holidays. The position emphasizes clinical reviews to determine if treatments meet criteria, with collaboration among case managers and disease management nurses. Qualified...Remote jobMonday to FridayWeekend workDay shift
- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications with...Remote jobWork at office
- Whitecap Search Healthcare Partners is seeking a dedicated RN for a Utilization Review & Quality Improvement role at a community hospital. This position focuses on utilization review responsibilities, working closely with physicians to analyze patient readiness for discharge...Hourly payRemote work
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...Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of... ...stakeholders regarding review outcomes. Collaborates with facility RN Care Coordinators to ensure progression of care. Engages the...Full timePart timeLive out- ...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
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...patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you’ll play a vital role in ensuring members receive... ...Required Qualifications Active, unrestricted RN license in your state of residence with...Remote jobHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$35 - $45 per hour
...message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources... ...Graduate of an accredited professional nursing program (RN, LPN, or LVN). Minimum of two years of general nursing experience...Contract workRemote workWeekend work- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote jobContract work
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract... ...Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This...Full timeContract workRemote work
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...$35.00/hr - $43.00/hr Job Title Clinical Review Nurse - Concurrent Review Location: Remote... ...- must reside in CA or hold an active CA RN license) Duration: 12 months (with... ...Review Nurse - Concurrent Review will perform utilization management functions to ensure members receive...Remote work- A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with...Remote job
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...services. You’ll use advanced clinical judgment to review medical records, validate care plans, and authorize services...Immediate startRemote workWeekend workDay shift
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