Remote Utilization Management Nurse RN

Optum

Remote job

Optum is seeking a Registered Nurse with managed care experience to evaluate outpatient services and determine appropriate care in a remote role within the United States. You will translate complex medical guidelines into actionable care decisions and serve as a knowledgeable resource for team members. Responsibilities include identifying solutions to non-standard requests, collaborating with cross-functional teams, and supporting utilization management and case management activities. #J-18808-Ljbffr Optum

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse RN in Eden Prairie, MN vacancy

RN Care Management(Remote)
$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 work
Bi-weekly pay
Full time
Temporary work
For contractors
Local area
Work from home
Guidehealth
United States
2 days ago
RN Care Management(Remote)
Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho or Utah, conducting prospective, concurrent and retrospective reviews to ensure medical necessity...
Remote job
Cambia Health Solutions, Inc.
Washington, UT
3 days ago
Remote Utilization Management Nurse RN - Case Review Expert
$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 job
Weekend work
kozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ
3 days ago
Remote Utilization Management Nurse Consultant (RN)
...Corporation is seeking an experienced Registered Nurse to join our Utilization Management team in a fully remote precertification role. Preference is given to Virginia... ...or candidates holding Virginia and Compact RN licenses. The position involves reviewing clinical...
Remote job
CVS Health Corporation
Richmond, VA
3 days ago
Remote Utilization Management Nurse Consultant (RN)
CVS Health Corporation is seeking a Remote UM Nurse Consultant RN Precertification for Telework. This role involves reviewing clinical information... ...in a high-volume, computer-based setting and support utilization management from home. #J-18808-Ljbffr CVS Health Corporation
Remote job
Full time
CVS Health Corporation
New York, NY
2 days ago
RN Care Management(Remote)
...Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the... ...and administrative compliance. Unlike remote roles, this position relies heavily on... ...site UM Nurse is a Registered Nurse (RN) responsible for performing admission...
Remote work
Immediate start
Shift work
Wellstar Health System
Lagrange, GA
4 days ago
Sr. Utilization Management Nurse RN-Field Position
$72.8k - $130k
...scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional Area, the role... ...Qualifications: Must be a Registered Nurse (RN) with a current, active, unrestricted RN License...
Remote work
Minimum wage
Full time
Work experience placement
Casual work
Live in
Work at office
Local area
Optum
Westfield, MA
4 days ago
RN Utilization Management Specialist (Remote)
...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...
Remote work
Work from home
CVS Health Corporation
Albany, NY
11 hours ago
Remote Utilization Management RN
...Humana is seeking an Utilization Management Registered Nurse to interpret and coordinate medical services and benefit... ...for post-acute care. You will work remotely, reporting to the Manager of... .... Requirements include an active RN license in your state and 1+ year of...
Remote work
Humana
Florida, NY
1 day ago
Healthcare Nurse - Remote
...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...
Remote work
First Connect Health
Austin, TX
3 days ago
Remote Utilization Management Nurse
...Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations... ...make critical patient-care decisions. This full-time, remote position offers a competitive salary and comprehensive...
Remote work
Full time
IntelliResume
Brooklyn, NY
1 day ago
Remote Wound Care Utilization Management RN
Elevance Health is seeking a Wound Care Utilization Management RN to work primarily virtually with periodic in-person training sessions. The role requires an active RN license, WOCN or CWS certification, and at least 3 years in diverse health care settings. The RN will...
Remote job
Work from home
The Elevance Health Companies, Inc.
Grand Prairie, TX
3 days ago
Remote Utilization Management Nurse
Mass General Brigham Health Plan Holding Company, Inc. seeks a Nurse for utilization review to assess medical necessity and benefit coverage for ACO/HMO/EPO members. Remote with occasional on-site team meetings in Somerville, MA. Strong InterQual/Milliman experience and...
Remote work
Mass General Brigham
Somerville, MA
2 days ago
Remote Utilization Management RN
...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings... ..., and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings...
Remote work
Guidehealth
Gary, IN
4 days ago
Utilization Management RN
...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN... ...Discharge Planning Case Management Inpatient Acute Care Nursing Care Coordination Telephonic Clinical Review...
Remote work
Part time
Monday to Friday
The Judge Group
Philadelphia, PA
4 days ago
RN Care Management(Remote)
...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...
Remote work
Appworks
United States
2 days ago
Remote Utilization Management Nurse Consultant
CVS Health Corporation is seeking an Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. You will review... ..., from a home-based setting. The ideal candidate holds an RN license with 2+ years of clinical experience in adult acute...
Remote job
Work from home
Afternoon shift
CVS Health Corporation
Springfield, IL
2 days ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review... ...thorough documentation. The position requires active RN licensure, 3+ years of acute behavioral health or...
Remote work
Preferra Insurance
Phoenix, AZ
11 hours ago
Remote Utilization Management RN — Data-Driven, Impactful Care
...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
Guide-Health
Gary, IN
11 hours ago
Utilization Management Nurse Consultant
$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | 24/7 Operations Are you an experienced Registered Nurse looking to apply your clinical...
Remote work
Hourly pay
Full time
Temporary work
Work at office
Local area
Work from home
Afternoon shift
CVS Health
Topeka, KS
3 days ago
Remote Utilization Management RN - 6-Month Contract
...A 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 work
Contract work
The Judge Group
Chicago, IL
11 hours ago
Utilization Review Nurse - 257945
...HIRING: Utilization Review Nurse | Remote | UM Training Provided 5 Clinical Nurses Wanted for an Exciting... ...looking to transition into Utilization Management This is a unique opportunity! While... ...~ Active, unrestricted RN license in your state of residence OR...
Remote work
Full time
Contract work
Home office
Shift work
Medix™
United States
17 hours ago
Remote Utilization Management Nurse (Part-Time)
...nirvanaHealth, operating under RxAdvance Corp., is seeking a Utilization Management Nurse for a part-time remote role. The position focuses on prospective, concurrent... ...with standards. The role requires an active RN license and 0–2 years of UM or case management...
Remote work
Part time
Rxadvance Corporation
Southborough, MA
11 hours ago
Care Management RN - Full-time
$36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will be given to current employees and candidates... ...) in a health or human services-related field (psychiatric RN or Masters' degree in Behavioral Health preferred for...
Remote work
Full time
Work at office
Immediate start
Work from home
Flexible hours
Cambia Health Solutions
United States
3 days ago
Remote Utilization Management Nurse Consultant
...CVS Health Corporation in Springfield, IL is hiring a Utilization Management Nurse Consultant to assess and coordinate care, applying clinical criteria... ...and evening hours. Requirements include 2+ years of RN clinical experience in adult acute/critical care, active RN...
Remote work
Shift work
Weekend work
Afternoon shift
CVS Health
United States
1 day ago
Remote Utilization Management Nurse - Part-Time Weekend
...nirvanaHealth, a RxAdvance Corp. company, seeks a part-time Utilization Management Nurse for a remote role in the United States. You will perform prospective,... ...requires an Associate's degree in nursing, active RN licensure, and 0–2 years in UM or case management. Schedule...
Remote work
Part time
Weekend work
Rxadvance Corporation
Southborough, MA
11 hours ago
Remote Utilization Management RN — Clinical Review Leader
...Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to ensure timely, compliant...
Remote work
Full time
Guidehealth
Chicago, IL
11 hours ago
RN Care Management(Remote)
...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/...
Remote work
Contract work
Temporary work
Monday to Friday
Shift work
InterSources
United States
4 days ago
RN Care Management(Remote)
...Utilization Management NurseBurlingame, CA 94010OverviewSalary Range $143,098.... ...Utilization Management (UM) Nurse is a licensed nursing professional... ...to make decisions within RN's clinical scope of practice... ...may be in understaffed/remote areas, in the presence of pets...
Remote work
Work at office
North East Medical Services
Burlingame, CA
5 days ago
RN Claims Review and Utilization Management
...Description Job Description The utilization review and management (UM) component program ensures that external... .... Qualifications ~ Registered nurse with active, unincumbered nursing... ...lunch This is an in-office, no remote work capability position Travel...
Remote work
Work at office
MedTrust LLC
Oklahoma City, OK
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management Nurse RN. Be the first to apply!