Remote Inpatient Utilization RN - Care Coordination & Review
Registered Nurse
- Remote job
Optum is seeking a Utilization Review Nurse (RN) to perform inpatient utilization management, applying evidence-based guidelines to admissions and preauthorization requests. The role requires clinical judgment, documentation in the care management system, and collaboration with physician leadership. We offer a Monday–Friday schedule with potential remote work for those in PST or MST and weekend coverage. Candidates must have an active RN license and the ability to obtain California licensure #J-18808-Ljbffr Registered Nurse
- Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization... ...necessity criteria, and coordinating with Medical Directors. Remote options are available for eligible... ...demands 3+ years of acute care nursing and 1+ year in...Remote job
- Optum is seeking a Utilization Review Nurse, RN to perform inpatient utilization management, applying evidence-based guidelines and medical necessity... ...familiarity with Medicare/Medicaid guidelines, MCg/InterQual, and care coordination processes. #J-18808-Ljbffr NHSHPRemote job
- Optum is seeking a Utilization Review Nurse (RN) to perform inpatient utilization management, applying evidence-based guidelines... ...judgment, documentation in care management systems, and collaboration with physician leadership. Remote work is available for those in PST/...Remote workWeekend work
- UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient... ...Directors for complex cases. The position may offer remote work options and requires working a Monday-Friday schedule...Remote jobMonday to FridayWeekend work
- ...Utilization Review Nurse Position at Vassar Brothers... .... Northwell cares for more than three... ...patient status (inpatient, observation, outpatient... ...leadership. Coordinates with the care... ...the Nuvance Health Remote Work Program... ...nursing Current NYS RN License. CCM/ACM...Remote workNight shift
- ...Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services... ...assessing member needs and coordinating care. Based in... ..., AZ with a fully remote work style, the... ...settings and an active RN license. You will perform reviews using criteria (MCG...Remote job
- Sentara Health Plans is seeking an experienced Utilization Review Nurse (RN) for Imaging/Commercial with remote work eligibility. The role covers prior authorization, inpatient and concurrent review, and coordination of care across benefits and contracts. A Virginia-...Remote jobFlexible hoursWeekend work
$29 - $52 per hour
UnitedHealth Group's Optum unit is seeking a Utilization Review Nurse, RN to perform inpatient utilization management with evidence-based... ...with physician leadership to coordinate patient care. The position offers remote work options for those in Pacific or Mountain...Remote jobHourly payWeekend work- ...Group is seeking an Inpatient Care Management Nurse to... ...ensure appropriate utilization of health services and coordinate plans of care. This role offers remote work and requires... ...experience and an RN license. You will collaborate... ...Directors, perform reviews, and support...Remote job
- ...Most of the training will be remote however you will be... ...required to start onsite A Utilization Review (UR) Nurse is a registered... ...guidelines like Milliman Care Guidelines (MCG) or InterQual... ...care (e.g., observation vs. inpatient) and help coordinate discharges to lower levels...Remote workWork experience placementFlexible hoursShift workWeekend work
$41.36 - $100 per hour
...Per Diem RN Opportunity At Brigham and... ...support patient care, research, teaching... ...Implementation, Coordinate, Monitor and... ...process. Perform utilization review to evaluate for appropriate... ...status change inpatient to observation (... ...call it home. Remote Type: Onsite...Remote workHourly payDaily paidShift workWeekend work$29 - $52 per hour
...Utilization Review Nurse, RN Optum is a global organization that delivers care, aided by technology to help millions... ...efficient and effective Inpatient utilization... ...principles in the coordination of care. Prepares any... ...flexibility to work remotely* as you take on some...Remote jobHourly payMinimum wageFull timeWork experience placementLocal areaMonday to FridayShift work- ...Case Manager, RN- Utilization Review Under the general supervision... ...appropriate level of care based on nationally... ...physicians, Care Coordinators, Resource Center Associates... ...stay reviews for inpatient admissions and clinical... ...collaboration in a remote or hybrid work environment...Remote workFull timeMonday to FridayShift work
- ...: 8am-4:30pm Job Summary: The Inpatient Utilization Review RN is a key member of the healthcare team... ...admission status, level of care, and reimbursement. The Inpatient... ...Utilization Review RN also assists with care coordination and discharge planning activities to...Live outWork at officeMonday to FridayFlexible hours
- ...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... .... Join a multidisciplinary team, coordinate with care teams, oversee CMS and payer...Remote work
- CVS Health is seeking a Utilization Management Nurse Consultant (RN) for a remote role. You will perform concurrent reviews for acute inpatient admissions and support timely transitions of care. Required RN license, 5+ years acute care, 2+ years UM/Case Management experience...Remote job
- ...Utilization Management – Care Management Shift options: 8:00–16:30 PST or 9:00... ...Details This is a 100% remote position. Requirements... ...Perform utilization review and medical necessity determinations... ...DRG/CPT coding and care coordination. Compliance / Notes...Remote workShift workWeekend work
- ...Registered Nurse to perform clinical reviews for authorization requests... ...standardized criteria and coordinate with physician peers when... ...multidisciplinary team focused on member care within a managed care... ..., including acute care and utilization management experience. #J-18...Remote job
- ...RN Utilization Review Coordinator The RN Case Manager/Utilization Review is responsible for performing... ...progression through the episode of care. This position also assists with discharge... ...appropriate admission status (inpatient, observation, outpatient, or outpatient...Full timeLocal area
- Optum is seeking an experienced Utilization Review Nurse (RN) to support inpatient care management in a remote-capable role. You will review admissions and preauthorizations using evidence-based criteria and collaborate with Medical Directors. The position requires an...Remote job
- ...UnitedHealth Group, is seeking a Utilization Review Nurse, RN, to perform inpatient utilization management. The role requires... ...to medical necessity criteria. Remote work is available for PST/MST... ...Applicants should have 3+ years in acute care and 1+ year in utilization...Remote jobShift workWeekend work
- ...POSITION SUMMARY - RN Utilization Review POSITION DUTIES -... ...stays, and services, while coordinating with providers and payers to... ...~ Skilled experience with remote work LENGTH OF ASSIGNMENT... ...organizations provide quality patient care that continually evolves to...Remote workTemporary workShift workWeekend work
- ...Clinical Guide Part A to support inpatient, behavioral health, and post-acute utilization review in alignment with CMS guidelines. This remote, full-time role requires a licensed RN with several years of UR... ...Directors to ensure timely, appropriate care. #J-18808-Ljbffr DevotedRemote jobFull time
- Optum is seeking an experienced Utilization Review Nurse (RN) to perform inpatient utilization management and medical necessity determinations. You will review... ...terms to ensure cost-effective, high-quality patient care. The role requires a current RN license, 3+ years of...Remote jobContract workWeekend work
- Optum is seeking an Utilization Review Nurse, RN, to support inpatient utilization management. The role reviews admissions and... ...medical necessity and cost-effective care, with a focus on patient outcomes. The position allows remote work for those in PST/MST, with a Monday...Remote jobMonday to FridayWeekend work
- ...and Dignity Health. With more than 700 care sites across the U.S., from clinics... ...Summary and Responsibilities As our Utilization Review RN, you will play a pivotal role in optimizing... ...physicians, consultants, and care coordination teams to apply evidence-based...Remote work
- ...Remote: Yes Area of Interest: Nursing... ...0.4 Department: Utilization Management Shift... ...We are seeking an RN Utilization Management... ...a key role in coordinating the organization’s... ...utilization of health care resources,... ...utilization management reviews using established...Remote workDaily paidTemporary workShift workWeekend work
- Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes... ...clinicians, perform case reviews, and support discharge planning... ...include an active RN license, 3+ years acute/inpatient...Remote job
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical... ...clinical nursing expertise, care management experience, and... ...to handle confidential PHI while coordinating with medical directors and other...Remote job
$1,966 per week
...managed health care, focused on what... ...-life balance. Remote/hybrid setting... ...individual will utilize clinical... ...outpatient treatment or inpatient confinement.... ...a second level reviewer. This individual... ...not limited to RN, LMSW, LMHC.... ...Nurse RN Clinical Coordinator - Neurosurgery...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours
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