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
$1,949.74 per month
...Nurse Specialty Utilization Review Job ID 17979666... ...Title Utilization Review RN Weekly Pay $1949... ...Job Description Remote Utilization Review RN responsible... ...necessity determinations, prior authorizations, continued stay reviews,...Remote workWeekly payShift work- ...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
$65 per hour
...Registered Nurse-Utilization Review Job ID #2038951... ...Utilization Review Registered Nurse (RN) supporting a health plan... ...$65.00 / hour Remote, California Profession:... ...Responsibilities Review prior authorization requests and clinical documentation...Remote work- ...Management Location: 100% Remote Schedule: M-F 9:00... ...an Illinois state RN license Assess and... ...Process prior authorization determinations within... ...Summary Works with the Utilization Management team primarily... ...necessity/utilization review and other utilization...Remote workContract work
- ...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
$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 jobFull time- ...QM objectives. Responsibilities: Reviews documentation and evaluates Potential Quality... ...: ~3+ years of experience as an RN ~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience with Medcompass...Remote 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- ...Utilization Review Nurse (Ur Nurse) Join our team at Cobalt Benefits Group... ...timely and effective care authorizations, transitions, and utilization... ...for services requiring prior authorization, applying utilization... ...Current, unrestricted RN license (State license required...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.... ...Innovative Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions,...Remote jobHourly payMonday to Friday- ...providing telephonic and e-referral case review and authorization of services utilizing established mental health and... ...This position is full-time, fully remote (work from home) and requires some... ...State of Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required....Remote workFull timeWork from homeShift workWeekend workAfternoon shift
$23.76 - $51.49 per hour
...Molina Healthcare is seeking a Registered Nurse (RN) to support clinical member services review and assessment processes. This role involves analyzing... ...hourly pay range between $23.76 and $51.49 and requires adherence to utilization management policies. #J-18808-LjbffrRemote workHourly pay$65k - $85k
...Santa Barbara Cottage Hospital is seeking a Utilization Review Specialist (RN) for a remote position, specifically for candidates based in Florida. The ideal candidate will possess a valid Florida RN License and certifications in OASIS and coding. The role involves thorough...Remote work$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- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
$65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30)... ...No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,...Remote work
$26.41 - $43 per hour
...for clinical member services review assessment processes.... ...Conducts reviews to determine prior authorization/financial responsibility for... ...care model. • Adheres to utilization management (UM) policies and... ...experience. • Registered Nurse (RN). License must be active and...Remote workHourly payWork experience placementWork at office$26.41 - $51.49 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- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote workHourly pay- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift 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... ...and utilization review. You will be responsible... ...RN experience, including Prior Authorization and Concurrent Review...Remote workDaily paidContract workMonday to FridayShift workWeekend work$99.31k - $131.09k
...Utilization Management RN California, USA Position is FULLY REMOTE; CA RESIDENTS PREFFERED At WelbeHealth, we are transforming the reality of senior... ...designated UM team Assist the team in reviewing prior-authorization requests for medical necessity and...Remote work$84.56k - $126.84k
...Email this Job Job Overview The Utilization Review RN participates as a member of a... ...00 This position will be primarily remote but there may be occasions when you are... ...provided by Patient Access regarding authorized length of stay and follows up with third...Remote workTemporary workPart timeLive inImmediate startRelocationRelocation packageShift workWeekend workAfternoon shift$80k - $90k
...0k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...Experience with utilization management systems... ...work independently in remote setting with minimum... ...similar functions. Prior experience in role... ...or prior-authorization work, or review of...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$51.43 - $79.84 per hour
...Overview Description – This is a remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift. The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in...Remote workDaily paidLive inShift workDay shift$63k - $65k
...Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and... ...making an impact on the health and well-being of others in a remote work environment. Enjoy flexibility and autonomy in your...Remote workWork experience placementLocal areaFlexible hours$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence... ...critical role in supporting utilization management operations by... ...applications This is a 100% remote role, and requires robust... ...–including policy, prior authorization, payment accuracy, and more...Remote workFull timeFlexible hoursShift work
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