Remote Utilization Management RN — Health Plan Expert
$29 - $52 per hourIntelliResume
- Remote job
UnitedHealth Group's Optum seeks a Utilization Management Nurse to ensure efficient, appropriate care. You will perform prior authorization reviews for skilled nursing facilities and acute inpatient rehabilitation, and determine medical necessity based on guidelines. This full-time, day-shift, remote role requires residency in Pacific or Mountain Time Zones. Pay ranges from $29.00 to $52.00 per hour, with a comprehensive benefits package and incentive programs. #J-18808-Ljbffr IntelliResume
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work$80k - $120k
...Clinical Expert, Care Team Operations (RN) Remote Thesis is building the AI... ...operations and care management activities for healthcare... ...is a broad-scope "utility player" role for a... ...remediation plans. Maintain and evolve... ...authorization, or population health workflows....Remote workHealth Insurance- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote job
- A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through... ...medical record reviews. The position is remote, requiring candidates to reside in PA,... ...providers, and managing discharge planning. Candidates must have an active PA RN...Remote job
$100k
...Contract Industry Health Care Work Experience... ...Salary $100,000 Remote Job Job Description... ...remote position. The Utilization Management (UM) Nurse is responsible... ...role supports the health plan's utilization... ...unrestricted Registered Nurse (RN) license in the...Remote workHealth InsuranceContract workWork experience placement- ...Utilization Management RNThere's no place like Liberty HealthCome... ...opportunities with Liberty Health, a dynamic leader in... ...timeliness, discharge planning, adherence to policies... ...License, (Compact, RN preferred)1–5 years managed... ...instructions to remote users.Visit for more...Remote workHealth InsuranceWork at office
- ...healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote jobHealth InsuranceContract work
$39 - $40 per hour
...Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one... ...with recent experience in health plan operations and utilization... ...knowledge in a new way. Experts add insights directly into...Remote workHealth InsuranceDaily paidContract workMonday to FridayShift workWeekend work- UnitedHealth 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 strong clinical nursing experience and an RN license. You will collaborate with...Remote jobHealth Insurance
- ...Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and coordinate plans of care. This role supports remote work within the Pacific, Mountain, or... ...planning. The ideal candidate holds an RN license and has 3+ years of clinical...Remote jobHealth InsuranceWork at office
$39.83 - $59.74 per hour
...At North Memorial Health, you’re part of an inclusive health team... ...Retirement Match or Pension Plan, based on workgroup... ...bias. About this position The Utilization Management RN, under the supervision of the... ...hours Call Requirement: None Remote or On-site:Hybrid Remote- Must...Remote workHealth InsuranceFull timeContract workFor contractorsFor subcontractorLive inWork at officeShift work$71.1k - $97.8k
...caring community The Utilization Management Nurse 2 uses clinical... ...Licensed Registered Nurse (RN) in an Enhanced Nurse... ..., or other healthcare/health insurance environments... ...working for a health plan, managed care... ...Nationwide Work Style: Remote Travel Requirements: None...Remote workHealth InsuranceFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$29 - $52 per hour
...Utilization Review Nurse, RN Optum is a global organization that... ...will directly improve health outcomes by connecting... ...utilization management. Reviews inpatient criteria... ...criteria and health plan guidelines. Reviews... ...flexibility to work remotely* as you take on some...Remote jobHealth InsuranceHourly payMinimum wageFull timeWork experience placementLocal areaMonday to FridayShift work- Point32Health is looking for a Clinical Pharmacist to manage pharmacy prior authorization requests. This role involves reviewing... ...at least 3 years of pharmacy experience. Benefits include health coverage, retirement plans, and a tuition program. #J-18808-Ljbffr Point32HealthRemote jobHealth Insurance
$57.28 - $88.92 per hour
Description Care Manager RN - REMOTE position. This position is Full time and... ...appeals between Providence Health and Services, California Region... ...a retirement 401(k) Savings Plan with employer matching,... ...Track: Nursing Department: 7000 UTILIZATION MGMT CA SOCAL Address: CA...Remote workHealth InsuranceMinimum wageFull timeLocal areaShift workDay shift$67.2k - $85k
...Number: 180127, Job Title: BH Utilization Manager RN, Salary: $67,200.00 - $85,000.00 Community Health Choice, Inc. (Community) is a... ...Health Insurance Marketplace Plans that offer individual health coverage... ...systems Work Schedule: Remote Other Requirements: Able...Remote workHealth InsuranceContract workWork experience placement- ...your abilities challenged. Vanderbilt Health is committed to an environment where everyone... ...education, and research. Organization Utilization Management Job Summary Manager within the... ...institutional and departmental goals and policy Plan and align section performance with...Remote jobHealth InsuranceTemporary workWork experience placementFlexible hours
- ...monitoring the utilization of behavioral health (BH) or physical... ...closely with Case Management to address... ...departmental needs. Plans, implements, and... ...the functions. Expert and resource for... ...and active NYS RN license required... ...opportunity for remote work may be possible...Remote workHealth InsuranceContract workWork at office
- ...Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote workHealth Insurance
- ...and program integrity through compliance management. Here, you'll champion the needs of... ...:Active, unrestricted Registered Nurse (RN) licenseStrong clinical background with... ...electronic medical recordsExperience in utilization review, case management, quality improvement...Remote workWork from home
- Cigna Health and Life Insurance Company in California is seeking an Utilization Management Clinical Reviewer to manage an active inpatient caseload from a remote location. You must be an RN licensed in California and available for a Monday-Friday shift 8:00 a.m.-5:00 p....Remote jobHealth InsuranceMonday to FridayShift work
- ...DescriptionProSidian is a Management and Operations... ...| Life Sciences & Health Care |... ...a Subject Matter Expert | Nuclear Energy Subject... ...Area or Telework (Remote) As Authorized to... ...regarding the project planning, execution, and deployment... ...and transfer of utility, and...Remote workHealth InsuranceFull timeContract workFor contractorsH1bWork at officeFlexible hours
$2,210 per week
...leader in personalized managed health care, focused on... ...available! 401k plan with company match... ...-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...is not limited to RN, LMSW, LMHC.... ...knowledge in a new way. Experts add insights...Remote workHealth InsuranceFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance... ...affordable, improve the health of patients, and restore the fulfillment... ...necessity Appropriate treatment plans Intensity and duration of...Remote workHealth InsuranceBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services. You will assess member needs... ...with healthcare professionals to plan care and discharge efficiently. You will work remotely within the Pacific, Mountain, or...Remote jobHealth Insurance
- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications with...Remote jobHealth InsuranceWork at office
- ...Utilization Management Clinical ReviewerMass General Brigham Health Plan is an exciting place to be within the healthcare industry. As... ...CredentialsMassachusetts Registered Nurse (RN) license requiredExperienceAt... ...6 months after hire.This is a remote role with occasional onsite...Remote workHealth InsuranceWork at officeFlexible hours
- Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring... ...offers competitive pay and comprehensive benefits including health insurance, 401K, and flexible work arrangements. #J-18808-...Remote jobHealth InsuranceFlexible hours
$71.1k - $97.8k
...caring community The Utilization Management Registered Nurse uses... ...Facility (SNF), Home Health, and Durable Medical... ...Compact Registered Nurse (RN) license in your state... ...review for a health plan or acute care setting... ...working in a fully remote, metrics-focused role...Remote workHealth InsuranceBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$26.35 - $39.53 per hour
...the belief that all health consumers are entitled... ...Summary: The Concurrent Utilization Review (UR) Nurse is... ...to members under a managed care health plan. This role involves assessing... ...: Registered Nurse (RN) or Licensed... ...Corporate office preferred / remote may be considered...Remote workHealth InsuranceHourly payWork at office
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