Remote Utilization Management Nurse (RN)
Arkansas Blue Cross Blue Shield
- Remote job
Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least four years of nursing experience. This position supports work-from-home arrangements across listed states and emphasizes evidence-based patient care, cost containment, and compliance with URAC and state regulations. #J-18808-Ljbffr Arkansas Blue Cross Blue Shield
- ...Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the... ...administrative compliance. Unlike remote roles, this position relies heavily on... ...site UM Nurse is a Registered Nurse (RN) responsible for performing admission...Remote workFull timeImmediate startShift work
- ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote workWork from home
- ...CVS Health is seeking a Utilization Management Nurse Consultant (Remote) to support Florida Medicare home-care requests. You will review cases, determine coverage... ..., full-time setting. The position requires an active RN license, 2+ years of experience (including 1+ year in...Remote workFull time
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote work
- Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will oversee inpatient case reviews, coordinate referrals, and collaborate with physicians, discharge planners, and ancillary services to ensure safe, cost-effective...Remote job
- CVS Health is seeking a Utilization Management Nurse Consultant (UMNC) for a fully remote role. The incumbent will coordinate, document and communicate all aspects of the utilization/benefit management program to ensure appropriate care, timing and location while adhering...Remote job
- 100% Remote | Contract-to-Hire | Monday-Friday 8-5pm | California License Required We are seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) with a strong background in Inpatient Utilization Management to join a growing healthcare organization...Remote workContract workWork at officeMonday to Friday
$65.52k - $118.56k
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Preference will... ...human services-related field (psychiatric RN or Masters’ degree in Behavioral... ..., and regulatory organizations. #LI-Remote Pay ranges vary based on the candidate...Remote workFull timeWork at officeImmediate startWork from homeFlexible hours- ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a...Remote workWork from homeWeekend workAfternoon shift
$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology... ...there is an occasional opportunity for remote work based on business needs. As a... ...Qualifications: ~ Must be a Registered Nurse (RN) with a current, active, unrestricted...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit... ...documentation while working remotely with periodic travel to Humana offices... ...as needed. You must have a Compact RN license, 1+ year of RN experience, and...Remote work
- ...CVS Health in Florida is seeking a Utilization Management Nurse Consultant. This full-time remote (work from home in Florida) role requires an active Florida RN license and at least 3 years of inpatient nursing experience. You will review medical necessity, coordinate...Remote workFull timeWork from homeWeekend workAfternoon shift
$41.15 - $46.15 per hour
...Job Description Job Description Registered Nurse - Utilization Management (Remote) - Philadelphia, PA (Remote) - Contract - Mon-Fri, Day Shift Hours... ...technology tools. Requirements: • Active, unrestricted RN license in PA or Compact states. • Minimum of five...Remote jobContract workMonday to FridayDay shift$60.53k - $129.63k
...bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) Utilization Management Nurse Consultant - Remote Make a difference in patient care from the comfort of home. We're seeking experienced Registered Nurses...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$54.1k - $155.54k
...of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Registered Nurse (RN) - Remote Make a meaningful impact on patient care from wherever you work. We are seeking an experienced Registered...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$54.1k - $116.77k
...Monday-Friday 8:00am-5:00pm CST Position Summary The Utilization Management Nurse Consultant utilizes clinical experience and skills in a collaborative... ...setting. ~ Must have active current and unrestricted RN licensure in state of residence. ~ Utilization Management...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$65k - $85k
...Position Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is... ...ability to work independently in a fully remote environment. Budgeted... ...additional clinical review and escalate to an RN, Medical Director, or other...Remote workWork at office- Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care... ...and coordinating with care teams. Ideal candidates hold an RN license with 3+ years in case or utilization management,...Remote jobWork from home
- ...Overview NaphCare is hiring an experienced Utilization Management Registered Nurse just like you to join our Remote based, Arizona team . NaphCare is a family... ...Qualifications A current and unrestricted RN license in Arizona A minimum of 3 years’...Remote workFull timeShift work
$52 - $56 per hour
...Now find a role that uses both. We're hiring a contract RN for a New York health plan (Medicare Advantage, Medicaid... ...apply the same medical necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52–$56/hr based on experience Business...Remote jobContract workAfternoon shift$65k - $68k
...Utilization Management RN (M-F FROM YOUR HOME OFFICE) HealthCare Strategies Description Do you want to work from the comfort of your own HOME? Do you want to work for a progressive company that is a leader in their industry? F/T 40-hour/week Position Monday...Remote workFull timeWork at officeHome officeMonday to Friday$29.1 - $62.32 per hour
...will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary Utilize your clinical experience and skills in a... ...Qualifications Registered Nurse Education: Diploma RN acceptable; Associate degree/BSN preferred...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeShift workWeekend work- ...Mass General Brigham is seeking an RN for a remote Utilization Management role in the United States. The position involves clinical review, triage, and escalation support to ensure medical necessity and regulatory compliance. The role requires 2–3 years in case management...Remote work
- ...living communities and skilled nursing facilities a wide range of... ...The primary role of the Utilization Management Nurse is to review and monitor... ...facility. This is primarily a remote telephonic position with... ...years clinical experience as RN, LPN/LVN required. Minimum...Remote workFull timeContract workWork at officeWeekend work
- ...CVS Health is seeking an Utilization Management Nurse Consultant to assess and coordinate care for members... ...continuum of care. This role requires RN licensure, 2+ years in acute/critical... ...effective communication. A BSN is preferred; remote work is supported within the state(s)...Remote work
$113.73k - $170.46k
...quality care while efficiently utilizing medical resources. Reviews... ...Associate’s Degree in nursing or equivalent combination of... ...: ~ Registered Nurse (RN) licensure in the state of practice... ...variances to the on-site care management teams when appropriate. Reviews...Remote workFull timeWork experience placement- ...Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote work
- ...Cambia Health Solutions, Inc. is seeking an experienced Utilization Management Nurse to conduct prospective, concurrent, and retrospective reviews and apply clinical criteria to determine medical necessity. You will collaborate with physician advisors to support appropriate...Remote work
$71.1k - $97.8k
...a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...nursing • Licensed Registered Nurse (RN) in a compact state with no disciplinary... ...information.Travel: While this is a remote position, occasional travel to Humana'...Remote workFull timeTemporary workApprenticeshipWork at officeHome officeMonday to FridayShift work
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