RN Utilization Review - Hybrid Work & Growth
Sedgwick
Sedgwick is seeking an RN Utilization Review professional to deliver timely, evidence-based utilization review services that maximize quality care and cost-effective outcomes. Active unrestricted RN license in the United States is required, with an Associate degree in nursing and four years of related experience (two years in clinical practice or one year in utilization review). A Bachelor's degree is preferred, and a comprehensive benefits package is provided. #J-18808-Ljbffr Sedgwick
- Rising Medical Solutions, LLC is seeking a Utilization Review Nurse to perform comprehensive UR activities and nurse summaries. The role requires an active RN license and clinical or UR/case management experience. You will document, review records, and collaborate with...SuggestedFull timeFlexible hours
$75k - $100k
...Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness... ...knowledge to provide judgment to review medical services with... ...skills, and experience. Work Location We are open to remote... ...Benefits ~ Remote and hybrid work options available ~ Performance...Hybrid workingFor contractorsWork at officeLocal areaImmediate startRemote work$47.03 - $63.48 per hour
...candidates must be willing and able to work within these scheduled hours,... ...redefining the possible in healthcare. The RN, Senior Utilization Review Quality will play an essential role in... ...Our culture is rooted in collaboration, growth, and innovation. Growth - We invest in...SuggestedTemporary workWork at officeLocal areaRemote work$63.1k - $94.65k
...*Must have current compact RN license, or be willing to obtain... ...We are seeking Virtual Utilization Review Specialist with at least 1 year... ...Responsible for ConnectCare and ADT work queues assigned to VUR for... ...of the principles of growth and development of the life span...SuggestedTemporary workWork at officeLocal areaRemote workMonday to FridayShift work$73k - $75k
...experience our caring culture, and enjoy work-life balance. Here, there’s no limit to... ...in Financial Services & Insurance RN Utilization Review PRIMARY PURPOSE :To provide timely, evidence... ...on-going learning and professional growth opportunities. Promoting a strong team...SuggestedWork at officeFlexible hours- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
$39.4 - $53 per hour
...consistently delivering outstanding results. Work Details & Compensation Pay Scale: $39.4... .... Position Overview The Lead Utilization Review RN is a key contributor to the overall financial... ...knowledge of the principles of growth and development of the life span and possesses...Work at officeLocal areaRemote work$27.02 - $48.55 per hour
...Purpose: Performs a clinical review and assesses care... ...and candidates who can work both Saturdays and Sundays... ...and appropriate utilization of services Provides education... ...(LMHP) required or RN - Registered Nurse - State... ...to work with remote, hybrid, field or office work schedules...Hybrid workingHourly payWork at officeRemote work10 hours per weekFlexible hoursShift workWeekend workWeekday work$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...Hourly payPart timeRemote work$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports... ...requires a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of related...Full timeRemote work- ...specific to the LTSS department. RN will be responsible for... ...authorization and concurrent review. Provides monthly telephonic outreach... ...of treatment setting by utilizing the applicable medical policy... ...Applies clinical knowledge to work with facilities and providers...Contract workRemote workMonday to FridayFlexible hours
$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside while still making a massive impact... ...revenue integrity. With a compressed 4-day work week, remote flexibility, and highly lucrative shift differentials...Work at officeRemote work10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week$35 - $43 per hour
.../hr Job Title Clinical Review Nurse – Concurrent Review... ...or hold an active CA RN license) Duration: 12 months... ...no time off). Regular work schedule 8 AM – 5 PM... ...Review will perform utilization management functions to... ...clarity, accountability, and growth with clear expectations...Remote work$34 - $40 per hour
...Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of... ...management skills. Ability to work independently in a remote... ...inclusive culture where innovation and growth are encouraged. We offer:...Full timeRemote work$31.02 per hour
...prior to hospitalization utilizing medical necessity... ...etc. (30%) Maintains a working knowledge of care management, utilization review changes, authorization changes... ...education and own professional growth. Performs other duties... ...Current State of PA RN licensure OR Current...Contract workFor contractorsLocal area- HealthEdge is seeking a highly motivated Utilization Review RN to join our team. The role involves prospective, concurrent and retrospective reviews... ...and outpatient settings. The position supports remote work in the US, requires an unrestricted RN license and may include...Remote jobContract work
- ...independently process complex grievances and conduct medical necessity reviews across inpatient, outpatient, and ancillary services. You will... ...candidates have an unrestricted USRN license, 2+ years in utilization management, and strong written/verbal communication. #J-18808...Remote job
- HonorHealth is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater Phoenix area. The position focuses on reviewing medical necessity and coordinating reviews for diverse payers, ensuring appropriate level of care and data...Remote job
$63k - $73k
...unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Utilization Review Nurse (RN) As a nurse at Sedgwick, you can build a meaningful and rewarding career while...Work experience placementLocal areaRemote workFlexible hours- Optum is seeking a Per Diem Utilization Management Nurse to review medical records and craft defensible appeal letters. You will extract pertinent case... ...telecommuting from anywhere in the U.S., with pay based on hours worked and local labor markets, plus comprehensive benefits for...Remote jobDaily paidLocal area
$1,992 per week
American Consultants is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Requirements Specialty: Utilization Review Discipline: RN Start Date: 10/19/2026 Duration: 13 weeks 40 hours per week Shift: 8 hours, days...Remote workShift workDay shift- Centene is seeking a remote Utilization Review Nurse to perform concurrent reviews, determine appropriate levels of care, and support discharge... ...zone and occasional weekends/holidays. The ideal candidate has RN or LPN licensure, 2+ years acute care experience, and...Remote jobMonday to Friday
- HealthEdge is seeking a motivated Utilization Review RN to perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity and appropriate level of care. The role involves coordinating care...Remote jobContract work
- HealthEdge Software, Inc. is seeking a motivated Utilization Review RN to perform prospective, concurrent, and retrospective review of inpatient and outpatient services to ensure medical necessity and appropriate level of care. This role involves coordinating discharge...Remote jobContract work
- Ensemble Health Partners is seeking a Virtual Utilization Review Specialist to join our remote team. You will perform medical necessity reviews... ...while controlling costs. Qualified candidates hold a current RN license, have at least 1 year in denials management and utilization...Remote job
$35 - $40 per hour
...integrity, claims cost containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely clinical decision review... ...to clinical teams on service planning as needed. Work closely with clinicians, medical staff, and peer reviewers...Hourly payTemporary workRemote workMonday to FridayFlexible hoursWeekend work$35 - $40 per hour
Sagility is hiring an RN Utilization Management Reviewer to perform day-to-day clinical and service authorization reviews for medical necessity, ensuring CMS compliance in decision-making. Requires RN license in Massachusetts, Associate degree minimum (Bachelor's preferred...Remote jobHourly payShift workWeekend work- WNS HealthHelp (A Capgemini Company) is seeking a licensed registered nurse to perform concurrent inpatient utilization reviews from a remote setting. You will collaborate with attending physicians and care teams to determine medical necessity and appropriate level of care...Remote job
$35 - $40 per hour
...more than 25,000 employees across 5 countries. Job title: RN Utilization Management Reviewer Job Description: We are currently hiring a talented RN,... ...Utilization Management experience. 2 or more years working in a clinical setting Desired Experience (nice to have):...Hourly payTemporary workCurrently hiringRemote workMonday to FridayFlexible hoursWeekend work- Quorum Health Corporate is seeking a remote Utilization Review Specialist with a registered nurse background to manage admission decisions and concurrent reviews, ensuring compliance with payer and regulatory standards. Responsibilities include coordinating appeals, documenting...Remote job
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