Remote Utilization Review RN - Insurance/URAC Expertise
Innovative Systems Group
A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and knowledge of accreditation standards. Candidates must reside in IL or TX and possess strong communication skills to interact with providers and members. #J-18808-Ljbffr
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review RN - Insurance/URAC Expertise in United States vacancy
$2,210 per week
...and voluntary life insurance. Critical Illness,... ...Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces... ...knowledge of URAC guidelines, Hines... ...is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hoursHines
Freeport, IL2 days ago- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
TurningPoint Healthcare Solutions
Florida, NY4 days ago $40 per hour
Insurance Or Managed Care Industry Registered Nurse (RN)$40/hour - Contract for 6 months Must reside in TXFull time remote Candidates must be based in TX. RN working... ...initial, concurrent review activities; discharge... ...information regarding utilization management requirements...Remote workContract workWork at officeHireOps Staffing LLC
Dallas, TX2 hours ago$84.06k - $118.67k
...A Glance Location: Remote Facility: Ascension... ...Services Department: Utilization Management Schedule... ...their skills and expertise every day to reimagining... ..., disability and life insurance Time to recharge:... ...Impact In This Role Review admissions and service...Remote workPart timeLocal area- The Utilization Review Nurse gathers demographic and clinical information on... ...and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS... ...state of operation required;RN is required unless local state... ...Account Options Life Insurance Accident Insurance Critical...Remote workMinimum wageWork at officeLocal areaFlexible hours
- Position Summary: The RN Integrated Care... ...are required to address utilization review cases. Roles and Responsibilities... ...of medical and insurance industry terminology... ...health programs, NCQA/URAC standards. You have 3... ...Requirements This is a remote position. Our whole...Remote workLive inFlexible hoursWeekday work
$67.2k - $85k
...80127, Job Title: BH Utilization Manager RN, Salary: $67,200.00 -... ...Texas Department of Insurance. Through its network... ...Community is accredited by URAC for its health plan... ...and discharge reviews on assigned patients.... ...systems Work Schedule: Remote Other Requirements...Remote workContract workWork experience placementHarris Health
Houston, TXa month ago- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
3B Healthcare, Inc.
Torrance, CA1 day ago - ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
Virtual Vocations Inc
United States5 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 workHourly payPart timeSanta Barbara Cottage Hospital
New York, NY5 days ago- ...Utilization Review ManagerIn this role, you will manage utilization review processes, ensuring quality patient care while optimizing resource... ...fifth weekend, contributing to a collaborative and supportive remote work environment.Benefits include:Weekly PayReferral...Remote workMonday to FridayWeekend work
Slate Healthcare
Fort Myers, FL5 days ago - ...Utilization Management – Care ManagementScheduleShift: 8:00–16:30 or 9:00–17:30 PST. Weekend... ..., New Year's Day.Assignment Details100% remote position supporting a centralized UM team... ...is required.Experience with utilization review, prior authorization, and pre-...Remote workWeekend work
TLC
Torrance, CA5 days ago $65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30)... ...No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend workPacer Group
United States4 days ago- ...Utilization Management Nurse 2Become a part of our caring... ...QualificationsLicensed Registered Nurse (RN) in an Enhanced Nurse... ...authorization, claims review, utilization management... ...healthcare/health insurance environments involving... ...: While this is a remote position, occasional...Remote workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday
Minnesota Jobs
Saint Paul, MN1 day ago - ...Fully Remote Utilization Review Position Setting: Fully Remote – Utilization Review Schedule: Full... ...N/A Job Requirements: Active RN license with Multi-State/Compact... ...Collaborate with physicians, case managers, and insurance payers Support denial prevention,...Remote workFull timeMonday to Friday
HealthPlus Staffing
United States5 days ago - ...Fully Remote Utilization Review Position Setting: Fully Remote – Utilization Review Schedule: Full... ...Job Requirements: Active RN license with Multi-State/Compact License... ...system (provider-side required) Payer/insurance-only Utilization Management experience...Remote workFull timeMonday to Friday
HealthPlus Staffing
United States4 days ago - ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs. You will review cases, coordinate with providers, and ensure timely decisions in line with policy and regulatory requirements. Ideal...Remote workWork at office
HealthHelp
Houston, TX4 days ago $30 - $34 per hour
...A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...Remote workHourly payAstrana Health
California, MO3 days ago- ...Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC2 days ago $35 - $43 per hour
...0/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must... ...CA or hold an active CA RN license) Duration: 12 months... ...Review will perform utilization management functions to... ...Provide subject matter expertise and guidance to utilization...Remote workIMCS Group
New York, NY5 days ago- ...Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type:Full Time The individual... ...of accurate patient demographic and insurance information. Identification and... ...time Job Shift Day Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr...Remote workFull timeWork at officeFlexible hoursShift work
Oracle
El Paso, TX2 days ago $84.09k - $120.12k
...Utilization Management Nurse Location: Partially Remote, with onsite coverage required in Baltimore... ...bring their skills and expertise every day to reimagining... ..., disability and life insurance Time to recharge:... ...for appropriate care by reviewing admissions and service...Remote workFull timeLocal areaMonday to FridayWeekend workDay shiftAscension
United States2 days ago$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.00 – $4... ...-paced environment. Comfortable working independently in a remote or office-based setting. Working Conditions May be exposed...Remote workWeekly payContract workWork at officeMonday to FridayNeier Inc
Sacramento, CA1 day ago$42 per hour
...Ascension Texas Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning and utilization review. Reviews admissions and service requests within assigned unit for prospective, concurrent...Remote job$35 - $40 per hour
...- $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating... ...Current, active nursing license (RN, LPN, or LVN) in good standing... ...community resources. NCQA and URAC experience is a plus....Remote workContract workFlexible hoursWeekend workIntePros
Phoenix, AZ2 days ago$34 - $40 per hour
...$34.00/hr - $40.00/hr Remote (Compact Licensure Required... ...) - Open to LPN's & RN's About the Role Medix... ...an experienced Utilization Review Nurse to support our mission... ..., managed care, NCQA/URAC standards, and... ...for this job Medical insurance Vision insurance Disability...Remote workFull timeMedix
New York, NY4 days ago- Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote job
- ...Utilization Review Nurse, LPNAcrisure is seeking a Utilization Review Nurse... ...in the office and three days remote. Candidates must also have... ...applicable state-mandated and URAC turnaround... ...Wellness: Comprehensive medical insurance, dental insurance, and vision...Remote workWork at officeImmediate startFlexible hours2 days per week
Acrisure LLC
Bradenton, FL3 days ago - Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective...Remote jobFull timeContract work
- ...Utilization Review And Management (Um) Component Program The utilization review and management... ...Familiarity with healthcare regulations, insurance policies, and quality improvement... ...for lunch This is an in-office, no remote work capability position Travel ~...Remote workWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review RN - Insurance/URAC Expertise. Be the first to apply!
Related searches
- cath lab registered nurse United States
- full-time registered nurse rn United States
- rn urgent care United States
- rn bsn United States
- davita rn United States
- rn risk management United States
- occupational health nurse rn United States
- rn strike nurse United States
- surgery rn United States
- oncology rn United States