Remote Utilization Review Nurse
Sedgwick
- Remote job
Sedgwick, a leading provider in risk and claims management, is seeking an RN to join our US telecommuter team. This full-time role focuses on performing utilization review to maximize patient care quality and cost-efficiency while supporting a flexible work arrangement. You'll collaborate with physicians, claims staff, and clients to evaluate treatment utilization, ensure privacy, and uphold ethical and regulatory standards. A BSN and active RN license are required. #J-18808-Ljbffr Sedgwick
$65k - $78k
...learning, and career development. Your Role In Our Mission Review admissions, procedures, services, and supplies for medical... ...rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines....Remote workFull timeWork at officeWork from homeFlexible hours- ...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 Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation...Remote workMonday to Friday
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with...Remote work
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...Remote role but will need to go to Newark, NJ to pick up equipment and orientation one day... ...Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess... .... 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
- .... 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... ...the build and implements care management review processes (Prior Authorization,...Remote workCasual workWork at officeShift work
- ...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
- Sedgwick Claims Management Services Ltd seeks an RN Utilization Review professional to assess and optimize patient care for injured employees in a remote setting. You will evaluate treatment utilization, collaborate with physicians and claims teams, and promote cost-effective...Remote jobFlexible hours
- ...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
- ...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
- ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
- ...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
$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...Remote workHourly payPart time- ...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
- ...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
- ...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
- ...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
$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 Friday$40 per hour
...Managed Care Industry Registered Nurse (RN) $40/hour - Contract... ...reside in TX Full time remote Candidates must be based in TX... ...performing initial, concurrent review activities; discharge care... ...Provides information regarding utilization management requirements and operational...Remote workFull timeContract workWork at office$77.08k - $119.47k
...19,466.00 Responsible for Utilization Management, Quality Screening... ...Characteristics 1. Registered nurse with a New York State current... ...applicable to utilization review process. 8. Excellent... ...the work cannot be done from a remote location. Other...Remote workShift work- ...weekend hours are required to address utilization review cases. Roles and Responsibilities Prepares... ...have a current, unrestricted Texas nursing license or Compact License. Please include... ...Telecommuting Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
$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 work- ...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
- A leading staffing agency is looking for a Utilization Review Registered Nurse to work remotely with a major health insurance client. This role involves evaluating patient care cases and ensuring requested services align with medical necessity while adhering to confidentiality...Remote work
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract... ...Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This...Remote workFull timeContract work
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential for Extension... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
$45 - $50 per hour
Join Our Team as a Utilization Management RN - Make an Impact in Healthcare... ...you a dedicated Registered Nurse passionate about optimizing... ...outcomes. Whether working remotely or in a flexible hybrid setting... ...setting, you'll play a key role in reviewing authorization requests,...Remote workHourly payWork at officeFlexible hours$35 - $40 per hour
Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of home health care...Remote workContract workFlexible hoursWeekend work$55 per hour
...from Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location: Remote (must be based in California) Employment type... ...setting. Preferred: Experience in case management, utilization management, or discharge planning. Experience...Remote workFull timeContract workTemporary workLocal area
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