Nurse Manager, Utilization & Clinical Documentation (Remote)
Case Management Society of America Inc
The Case Management Society of America (CMSA) ® in San Antonio, Texas is seeking an experienced RN-Nurse Manager for Utilization Management & Clinical Documentation Integrity. This position will oversee health care operations, coordinate patient care, and ensure adherence to standards for quality and safety. The ideal candidate will require a valid RN license and has experience in utilization management and clinical documentation improvement. The role involves direct leadership interactions and improving patient outcomes through effective healthcare management. #J-18808-Ljbffr
- ...Summary The RN-Nurse Manager-Utilization Management & Clinical Documentation Integrity will be an experienced nurse leader who ensures that Veteran-centered health care is provided and delivered in a quality - timely - accessible and respectful manner - consistent with...Remote workPermanent employmentFull timeTemporary workWork at officeImmediate startRelocation packageMonday to Friday
- ...Clinical Nurse, Medical Management/Utilization Management Saratoga Medical is hiring for a Clinical Nurse, Medical Management/Utilization Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit options. This is a great...Remote workFull time
- ...Description The Office of Clinical Documentation Improvement (CDI) at... ...for a full-time CDI Manager . The CDI Manager... ...Accountable for CDI nursing and department level... ...in partial remote work (working 2 - 3 days... ...software applications utilized within the CDI programs...Remote workFull timeWork experience placementWork at officeMonday to Friday2 days per week3 days per week
$101.74k - $163.8k
...Manager, Clinical Utilization Management & Transitions of Care Requisition Number... ...April 28, 2026 Full‑Time Remote Salary range: $101,740 USD... ...Have a bachelor’s degree in nursing or an advanced clinical degree... .... Ensure processes and documentation meet NCQA and all...Remote workFull timeTemporary workPart timeWork experience placementWork at officeTrial periodFlexible hours- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-... ...Graduate from an accredited Registered Nursing Program; RN preferred. 2. Minimum...Remote workPermanent employmentFull timeTemporary workFlexible hours
$75 - $85 per hour
...Description Job Title: Manager, Clinical Resource/Case Management Location: Remote Type: Contract |... ...Case Management, Utilization Review, and Social Work... ...Support Clinical Documentation Integrity initiatives... ...trainees, physicians, nurses, and allied health professionals...Remote workContract workTraineeshipMonday to FridayShift workRotating shiftDay shift$250k
...solutions provider is seeking a Utilization Review Medical Director to conduct clinical reviews of Durable Medical Equipment... ...include evaluating clinical documentation and ensuring compliance with Medicare... ...and various benefits, with remote work opportunities available in...Remote workFull time- ...The Medical Director is a key clinical leader responsible for driving excellence in documentation integrity and coding accuracy across... ...quality outcomes. Innovation: Utilize advanced technology and EMR... ...insurance Paid time off Location Remote with limited travel to client...Remote workWork at office
$250k
...is seeking a full-time Utilization Review Medical Director to conduct clinical reviews of Durable Medical... ...in utilization management. Responsibilities include evaluating documentation, ensuring compliance with... ...productivity standards in a remote setting. The position offers...Remote workFull time- ...Now Hiring: Medical Director – Utilization Management 100% Remote | Must work PST hours Medicare Advantage... ...Management) to help lead clinical integrity and medical necessity decision... ...protocols Maintain accurate clinical documentation per regulatory standards You’ll Be...Remote workImmediate start
- ...outpatient behavioral health utilization management clinicians: One... ...This role serves as a key clinical decision-maker, exercising... ...timely, and well-reasoned documentation of clinical decisions in accordance... ...Demands: • Primarily remote role with periodic travel...Remote workWork at office
- ...the operational areas of the Utilization Management (UM) program including... ...policies, procedures, and clinical guidelines aligned with contractual... ...Work Arrangement ~ Fully remote; must be willing to work... ...as needed Thoroughly documents all care coordination activity...Remote workContract workLocal areaFlexible hoursWeekend work
$275k
...Remote Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time | Remote (Post-Onboarding) | U.S. Licensed... ...clear, timely, and well-documented medical review... ...consultation and support to nursing and interdisciplinary teams...Remote workFull timeRelocation packageMonday to Friday$250k
...The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...Integra’s Utilization Management (UM) operations.... ...Evaluate clinical documentation, identify missing elements... ...: Full-time remote role requiring consistent...Remote workFull timeTemporary workLocal area- CVS Health Corporation is looking for a Manager for Screening and Diagnoses Excellence. The role involves driving initiatives aimed at improving clinical documentation using data analytics and strategic thinking. The ideal candidate will possess over 5 years of relevant...Remote job
- ...overseeing and performing utilization reviews, prior... ...serve as a key clinical expert, ensuring... .... This is a remote position requiring... ...comprehensive and well-documented rationales in... ...teams, including Nurse Practitioners,... ...optimize utilization management processes and...Remote workFull timeFlexible hours
$240.12k - $315.16k
...Medical Director to join the Utilization Management Team. This role determines... ...services by reviewing clinical information and applying evidence... .... Work Location This is a remote position, open to... ...while using clinical acumen. Document all communication and decision...Remote workImmediate startWork from home$25k
...caring community As a Clinical Manager at CenterWell Home... ...City, MO This is NOT a remote or work-from-home position... .... As a Registered Nurse Clinical Manager ,... ...delivery, staff management, documentation quality, and... ...documentation review, utilization review findings, and...Remote workWeekly payFull timeTemporary workApprenticeshipWork at office$223.8k - $313.1k
...may include national clinical guidelines, CMS policies... ...in care management. The clinical scenarios... ...practices and clinical documentation, grievance and appeals... ...requirements in daily utilization management and coverage... ...Travel: While this is a remote position, occasional...Remote jobBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome office- ...Behavioral Health Case Manager II Job Location- Remote - MI Duration: 4... ...Description The Case Manager utilizes a collaborative process... ...Through the use of clinical tools and information/data... ...written and computer generated documents as well as a PC monitor....Remote workContract workWork at officeShift work
$128.5k - $298.1k
...Angeles, CA, USA Onsite or Remote Fully On-Site... ...supervision of the Clinical Director, the Clinical Nurse Manager independently coordinates... ...complete and accurate charge documents and charge capture and... ...and report weekly utilizing Microsoft Office and EMR...Remote workWork at officeMonday to Friday$92.6k - $127.4k
...experienced, motivated Clinical Managers to join our growing... ...Riverhead This is NOT a remote or work-from-home... ...Monitor cases to ensure documentation is in compliance with... ...recommendations by Utilization Review staff. Upon completion... ...accredited School of Nursing. Current state...Remote workWeekly payFull timeTemporary workApprenticeshipImmediate startRelocation package$57.56 - $92.1 per hour
...Description Manager IT - Epic Inpatient Clinical Documentation (ClinDoc) Location: UCHealth UCHlth Admin 2450 Peoria, US:CO:Aurora Department: UCHlth... ...dependent on applicant's relevant experience This is a remote position but you must reside in Colorado. Some...Remote workFull timeTemporary workLocal areaFlexible hoursShift work$275k - $325k
...Medical Director - Utilization Management Astrana is seeking a California... ...Utilization (UM) to provide clinical oversight and strategic leadership... ...transparency by clearly documenting and communicating... ...This position is fully remote, with some travel to SoCal...Remote work$248.5k - $373k
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take... ..., render coverage determinations Document clinical review findings, actions, and outcomes... ...specialties will be considered) Experience in utilization and clinical coverage review Reside...Remote jobMinimum wageWork experience placementLocal area- ...outcomes. Our talented remote workforce spans... ...The Supervisor, Clinical Review plays a... ...staff who conduct utilization review and/or... ...Qualifications All nurse reviewers will be... ...year of medical management / utilization review... ...and clinical documentation standards. Preferred...Remote workContract work
- ...direction of the Regional Manager, Clinical Documentation Integrity (CDI), this position... ...skill sets and optimal utilization of the 3M CDI software.... ...team who work onsite and remotely. Communicates effectively... ...Healthcare related field or Nursing or equivalent in experience...Remote jobFull timeWork at officeLocal area
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from... ...determinations according to regulations Document due process and attempt to gather... ...Review Nurse- Prior Authorization Remote Registered Nurse (Remote Patient...Remote workFull timeWork at officeWork from homeNight shift- ...you're a registered nurse looking for a new... ...for medically managing assigned caseload and by applying clinical expertise ensure individuals... .... This is a remote position however,... ...case outcome. Utilizes the Nursing... ...catastrophic injuries. Documents all RN activities...Remote workWork at officeLocal area
- ...Medical Group) is seeking a Case Manager to evaluate the necessity and... .... The role offers hybrid or remote work options and an... ...candidate will be a Registered Nurse with acute care experience and... ...to quality patient care and utilization review processes. #J-18808-Ljbffr...Remote work
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