Remote Utilization Review Nurse Auditor
Paycom - ATS
Mount Laurel, NJ
- Remote job
ExamWorks is seeking a Utilization Review Nurse Auditor to perform quality utilization reviews and authorize medically necessary care. The role is fully remote with standard EST hours, requiring an active nursing license and coding certification. You will work with providers to assess level and duration of care, document findings, and ensure compliance with URAC and client requirements. The position emphasizes accuracy, turnaround-time adherence, and ongoing professional education within a team #J-18808-Ljbffr Paycom - ATS
Vacancy posted 6 days ago
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$33 - $46 per hour
...Utilization Review Nurse Auditor Fully Remote Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join their team! The Utilization Review Nurse...Remote workHourly payFull timeLocal areaMonday to Friday- Description: Nurses – are you looking for a change? Want to work no... ...~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces with...Remote workTemporary workWork at officeMonday to FridayFlexible hours
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Winston Staffing
Newark, NJ2 days ago $65k - $78k
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United States1 day ago$30 - $38 per hour
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United States4 days ago- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
Caribou, ME2 days ago - ...Centene Management Company LLC is seeking a qualified nurse reviewer to conduct concurrent inpatient and pediatric/adult case reviews... ...Medicaid members. Responsibilities include educating providers on utilization processes, sharing feedback with leadership for process...Remote work
Centene Management Company LLC
Louisiana, MO3 days ago - .... Reports to the Health Plan Manager of Utilization Management. This position will be an integral... ...OR LICENSURE: 1. Current Registered Nurse license issued by the state in which... ...build and implements care management review processes (Prior Authorization, Predetermination...Remote workCasual workWork at officeShift work
WVU Medicine
United States3 days ago - ...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 workContract work
IntePros
United States1 day ago - ...Apply Refer a Friend Back Remote Work from Home Share This Page... ..., Hanover, MD 21076 Category: Nursing Schedule: Day Shift Employment Type... ...hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
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Hanover, MD5 days ago - ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
Virtual Vocations Inc
United States3 days ago - ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
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United States1 day ago $73k - $75k
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United States18 hours ago$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to FridayJ Edward Staffing LLC
Aurora, CO3 days ago$100k - $120k
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Miami, FL1 day ago$40 per hour
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Albany Medical Center
United States2 days ago - ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded insurance options to our clients...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
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United States1 day ago - ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail-oriented and experienced Utilization Review Nurse to evaluate the medical necessity, appropriateness, and...Remote workFull timeSecond jobWork at office
Ova Technologies
Alpharetta, GA1 day ago - ...Remote RN Utilization Review Position Join a stable work-from-home team! This is a great opportunity for a local remote position. There is no... ...setting. Minimum Requirements: Education: ~ Nursing Diploma/Associate's Experience: ~2-5 years...Remote workFull timeReliefLocal areaMonday to FridayFlexible hoursShift work
Missouri Baptist Medical Center
United States18 hours ago - ...Summary Performs medical record review for severity of illness and... ...and Training: Nurse, Registered (RN) licensure... ...preferred. 2-5 years previous Utilization Review experience preferred.... ...Details: Days, Primarily remote; onsite orientation requirement...Remote workShift workWeekend work
Silver Cross Hospital
New Lenox, IL2 days ago - ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring...Remote workFull time
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Alamogordo, NM1 day ago $41 per hour
...Medical Review Nurse (RN) Remote position, however candidates must reside in the State of TX or State of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care industry using medically accepted criteria...Remote workContract workHireOps Staffing LLC
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Insight Global
United States1 day ago $77.08k - $119.47k
...119,466.00 Responsible for Utilization Management, Quality Screening... ...Characteristics # Registered nurse with a New York State current... ...applicable to utilization review process. # Excellent written... ...work cannot be done from a remote location. Other...Remote workFull timeShift workAlbany Medical Center
Albany, NY4 days ago- ...TechnologiesPosted: Gainwell Technologies seeks an Outpatient Coding Auditor, Senior Associate to audit medical records for correct ICD-10/... ...AAPC credentials, and solid knowledge of ICD-10, APC, ASC and CPT guidelines; remote work within the US is supported.#J-18808-LjbffrRemote work
Gainwell
New York, NY2 days ago - ...HumanaPosted: Humana Inc. is seeking a Senior Medical Coding Outpatient Auditor to lead coding-focused audit activities, validate coding... ...with clinical and analytics teams to improve audit strategies. Remote work with occasional travel is possible.#J-18808-LjbffrRemote work
Humana
New York, NY2 days ago - ...work in general. The 340B Auditor will: Be expected to conduct... ...Pharmacy directives utilizing best practice standards as set... ...Audits: Perform onsite and remote audits both independently and... ...following a policy checklist Review and finalize audit agendas and...Remote workContract workWork at officeImmediate startVisa sponsorshipWork visaFlexible hours
SpendMend LLC
Grand Rapids, MI14 days ago - ...TechnologiesPosted: Gainwell Technologies seeks a Senior Coding Auditor, Itemized Bill Reviewer to perform itemized bill review, chart review, and coding... ...; and ensuring compliance with coding standards. This remote role offers travel up to 10% and strong career...Remote work
Gainwell
New York, NY2 days ago $102k - $123k
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Los Angeles, CA2 days ago
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