Remote Prior Authorization RN - Utilization Review (WI)
$71.1k - $97.8kHumana
- Remote job
Humana is hiring a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team, working remotely. You will review prior authorization requests, ensuring proper clinical appropriateness, and adhere to Medicare and Medicaid guidelines. The ideal candidate should have a valid RN license in Wisconsin and at least two years of clinical experience. The role offers a competitive pay range from $71,100 to $97,800 annually, alongside comprehensive benefits including health insurance and retirement plans. #J-18808-Ljbffr Humana
$71.1k - $97.8k
...Humana is seeking a Prior Authorization RN for the Wisconsin Medicaid Market team. This remote position involves reviewing clinical appropriateness of prior authorization requests... ...clinical experience. A BSN and experience in Utilization Management are preferred. The role...Remote work$71.1k - $97.8k
Humana is seeking a Prior Authorization RN to join its team in the Wisconsin Medicaid Market, primarily working remotely. In this role, you will review prior authorization requests, ensuring medical... ...and familiarity with Utilization Management. Competitive benefits...Remote job- Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market team, primarily working from home. You will be responsible for reviewing PA requests, ensuring compliance with Medicare and Medicaid standards. This role requires a Wisconsin RN license and...Remote jobWork from homeFlexible hours
- Humana is seeking a Prior Authorization RN to join their Wisconsin Medicaid Market team. This fully remote position involves reviewing the clinical appropriateness of prior authorization requests while ensuring compliance with Medicare and Medicaid guidelines. The ideal...Remote job
- ...Health Administration, Inc. is seeking an RN Clinician to provide utilization management services in a remote role from Virginia. The ideal candidate must... ...care experience. Responsibilities include prior authorization reviews, care coordination, and managing appeals for...Remote work
- Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience...Remote job
$49.34 - $76.59 per hour
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote job$45.9 - $71.4 per hour
Description Utilization Review RN - Remote. The RN Care Coord ‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development...Remote jobHourly payLocal area$45.9 - $71.4 per hour
Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health... ...administration of medical management programs for prior authorization. These programs are developed to manage medical expense...Remote jobMinimum wageLocal areaShift work$28.37 - $36 per hour
...Acentra Health, LLC is seeking a Clinical Reviewer - RN - PRN (Remote U.S.) to interpret patient records, ensuring medical necessity and appropriateness of care. Ideal candidates will possess an RN license and relevant clinical experience. This position offers flexible...Remote workReliefFlexible hours$85.99k - $105.34k
...organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves... ...clinical service requests, conducting prior authorization reviews, and collaborating with... ...Applicants should have an active RN license and at least five years of...Remote workFull time- ...Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires... .... Responsibilities include reviewing prior authorization requests, collaborating with healthcare... .... Candidates must have a Compact RN License and at least 3 years of clinical...Remote work
- ...Kelsey-Seybold Clinic is seeking a Utilization Review Specialist (LVN) to conduct medical reviews... ...necessity for services requiring prior authorization. This role involves liaising with providers... ...utilization review. Flexibility for remote work is provided for Texas residents....Remote workHourly pay
- ...Coordinated Care Organization is hiring a part-time remote Utilization Review Nurse. The ideal candidate will be a licensed RN with experience in acute care and... ...review. Responsibilities include reviewing prior authorizations, ensuring quality care, and applying medical...Remote workPart time
- ...: Manager of Clinical Utilization Management - Denial Compliance... ...Type: Hybrid (85% remote, 15% onsite in... ...daily tasks, performance reviews, and any necessary disciplinary... ...Nursing Program; RN preferred. 2. Minimum of five years in prior-authorization, appeals & grievance,...Remote workPermanent employmentFull timeTemporary workFlexible hours
$20.38 - $36.44 per hour
...Psychiatric Association Inc seeks a Utilization Review Specialist (LVN) who will... ...for services requiring prior authorization and serving as a liaison for surgery... ...review experience and an active RN license. The position offers flexible remote work options adhering to...Remote workHourly payFlexible hours- ...solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal... ...experience and must hold an active RN license. Responsibilities include... ...reviewing medical records, performing prior authorizations, and documenting findings. This full...Remote workFull time
- ...Martin's Point Health Care is looking for a Utilization Review Nurse, responsible for ensuring quality medical outcomes through effective authorization processes. With 3+ years of nursing... ...Key responsibilities include reviewing prior authorizations, managing claims...Remote work
- ...Management Location: 100% Remote Schedule: M-F 9:00... ...an Illinois state RN license Assess and... ...Process prior authorization determinations within... ...Summary Works with the Utilization Management team primarily... ...necessity/utilization review and other utilization...Remote workContract work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident... ...Authorization Review to join our Utilization Management team. In this role,... ...Qualifications ~ Active RN license (WA; must be in good standing...Remote workContract work
$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in... ...Responsibilities Review and process prior authorizations and reauthorization requests in... ..., active nursing license (RN, LPN, or LVN) in good standing with...Remote workContract workFlexible hoursWeekend work$34 - $52.7 per hour
...Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our... ...0 facility. This job is REMOTE. FTE: 0.500000 Standard... ..., for a second level review as needed. Facilitates communication... ...experience is required; Prior utilization management or case management...Remote workHourly payTemporary workShift work$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation... ...Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions,...Remote workHourly payMonday to Friday- ...Utilization Review Nurse Join Martin's Point Health Care - an innovative, not... ...need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific... ...nursing experience as an RN, preferably in a hospital setting...Remote workWork at office
$35.29 - $47.37 per hour
...individual and their work-life balance ~ Remote work options and Flexible scheduling... ...currently hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed nurse... ...utilization management. Reviews prior authorization requests for appropriate care and setting...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours$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... ...and review patient authorizations, ensure compliance with... ...What You’ll Do Process prior authorization and...Remote workFull time$71.1k - $97.8k
...The Hong Kong Study Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a...Remote workWork from home$85k - $105.34k
UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as needed... ...for members. This role conducts prior authorizations, facilitates care coordination, and... ...QUALIFICATIONS Active, unrestricted RN license (BSN or MSN) in Oregon or a...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workContract workWork from home
- ...Health. Position Title Utilization Review Nurse Department... ...Standard Time) Location Remote position Salary Wage... ...nursing judgment to conduct prior authorization reviews, facilitate care coordination... ...Registered Nurse (RN), BSN (Bachelor of Science...Remote workFull timeWork at officeLocal areaMonday to FridayFlexible hours
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