Remote Utilization Review RN - Prior Authorization
Integrated Resources Inc
A health care recruitment agency is seeking a Recruitment Manager to assess and analyze clinical service requests, verify member benefits, and process prior authorizations. Candidates must have an Illinois state RN license and 1-3 years of experience in hospital or medical clinic settings. This is a fully remote position, offering work within a collaborative multidisciplinary team. The role focuses on ensuring compliance with regulations and providing optimal member care. #J-18808-Ljbffr
- ...Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience...Remote work
$49.34 - $76.59 per hour
...A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote work- ...for clinical member services review assessment processes.... ...Conducts reviews to determine prior authorization/financial responsibility for... ...Molina care model. Adheres to utilization management (UM) policies and... .... Registered Nurse (RN). License must be active and...Remote workWork at office
$30.37 - $59.21 per hour
...for clinical member services review assessment processes.... ...Conducts reviews to determine prior authorization/financial responsibility for... ...Molina care model. Adheres to utilization management (UM) policies and... .... Registered Nurse (RN). License must be active and...Remote workHourly payWork experience placementWork at office$45.9 - $71.4 per hour
...Description Utilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled nursing review, appeals and grievance, delegation, medical policy development...Remote workHourly payLocal area$45.9 - $71.4 per hour
...Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health... ...administration of medical management programs for prior authorization. These programs are developed to manage medical expense...Remote workMinimum wageLocal areaShift work$28.37 - $36 per hour
...Acentra Health, LLC is seeking a Clinical Reviewer - RN - PRN (Remote U.S.) to interpret patient records, ensuring medical necessity and appropriateness of care. Ideal candidates will possess an RN license and relevant clinical experience. This position offers flexible...Remote workReliefFlexible hours- ...Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective Review* Admission Criteria... .../National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*Remote work
$85.99k - $105.34k
...organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves... ...clinical service requests, conducting prior authorization reviews, and collaborating with... ...Applicants should have an active RN license and at least five years of...Remote workFull time- ...Kelsey-Seybold Clinic is seeking a Utilization Review Specialist (LVN) to conduct medical reviews... ...necessity for services requiring prior authorization. This role involves liaising with providers... ...utilization review. Flexibility for remote work is provided for Texas residents....Remote workHourly pay
- ...Coordinated Care Organization is hiring a part-time remote Utilization Review Nurse. The ideal candidate will be a licensed RN with experience in acute care and... ...review. Responsibilities include reviewing prior authorizations, ensuring quality care, and applying medical...Remote workPart time
$65k - $78k
...development. Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews... ...and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements....Remote workFull timeContract workWork at officeWork from homeFlexible hours$20.38 - $36.44 per hour
...Psychiatric Association Inc seeks a Utilization Review Specialist (LVN) who will... ...for services requiring prior authorization and serving as a liaison for surgery... ...review experience and an active RN license. The position offers flexible remote work options adhering to...Remote workHourly payFlexible hours- ...solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal... ...experience and must hold an active RN license. Responsibilities include... ...reviewing medical records, performing prior authorizations, and documenting findings. This full...Remote workFull time
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident... ...Authorization Review to join our Utilization Management team. In this role,... ...Qualifications ~ Active RN license (WA; must be in good standing...Remote workContract work
- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...an Illinois state RN license Assess and analyze... ...eligibility Process prior authorization determinations within... ...Summary Works with the Utilization Management team primarily... ...necessity/utilization review and other utilization...Remote workContract work
$35 - $40 per hour
...$40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in... ...Responsibilities Review and process prior authorizations and reauthorization requests in... ..., active nursing license (RN, LPN, or LVN) in good standing with...Remote workContract workFlexible hoursWeekend work$34 - $40 per hour
...$34.00/hr - $40.00/hr Remote (Compact Licensure Required... ...) - Open to LPN's & RN's About the Role Medix... ...an experienced Utilization Review Nurse to support our mission... ...and review patient authorizations, ensure compliance with... ...What You’ll Do Process prior authorization and...Remote workFull time- ...Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires... .... Responsibilities include reviewing prior authorization requests, collaborating with healthcare... .... Candidates must have a Compact RN License and at least 3 years of clinical...Remote job
- ...meet QM objectives Responsibilities: Reviews documentation and evaluates Potential... ...Experience: ~3+ years of experience as an RN ~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience with Medcompass...Remote work
$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.0... ...Be Innovative Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions,...Remote workHourly payMonday to Friday$35.29 - $47.37 per hour
...individual and their work-life balance Remote work options and Flexible scheduling... ...currently hiring a Part-time REMOTE Utilization Review Nurse . If you are a licensed nurse with... ...utilization management. Reviews prior authorization requests for appropriate care and setting...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours- ...Position Summary The Utilization Review Nurse works as is responsible for... ...need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific... ...nursing experience as an RN, preferably in a hospital setting...Remote workWork at office
$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG... ...care for members. This role conducts prior authorizations, facilitates care coordination, and... ...QUALIFICATIONS Active, unrestricted RN license (BSN or MSN) in Oregon or a...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- ...Umpqua Health. Position Title Utilization Review Nurse Department Umpqua... ...Pacific Standard Time) Location Remote position Salary Wage Band 2... ...judgment to conduct prior authorization reviews, facilitate care coordination... ...Registered Nurse (RN), BSN (Bachelor of Science...Remote workFull timeWork at officeLocal areaMonday to FridayFlexible hours
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...visits and telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...visits and telephonic contact Authorize and coordinate referral for services....Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
- ...Molina Healthcare is seeking a Registered Nurse (RN) for a remote position supporting the Arizona state plan. The candidate will assess... ...background in hospital acute care and experience with prior authorization is preferred. Candidates must have an active Arizona RN...Remote work
- ...is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals... ...clinical nursing experience, including utilization review, and a valid RN license in Florida or Kentucky. Strong...Remote workFull time
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