Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review RN - Prior Authorization in Springfield, IL vacancy
  • $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 work
    Weekly pay
    Shift work

    Cynet Health

    Eureka, CA
    5 days ago
  •  ...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 work
    Full time

    Gainwell Technologies

    El Paso, TX
    4 days ago
  • $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

    TotalMed Staffing

    United States
    2 days ago
  •  ...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 work
    Contract work

    Integrated Resources

    Springfield, IL
    5 days ago
  •  ...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 work
    Contract work

    SPECTRAFORCE

    Washington DC
    2 days ago
  • $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 job
    Full time

    Umpqua Health

    Roseburg, OR
    2 days ago
  •  ...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

    US Tech Solutions

    United States
    3 days ago
  • $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 work
    Contract work
    Flexible hours
    Weekend work

    IntePros

    Phoenix, AZ
    4 days ago
  • $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 work
    Full time

    Medix

    New York, NY
    1 day ago
  •  ...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 work
    Full time
    Temporary work
    Summer work
    Work at office
    Flexible hours

    Cobalt Benefits Group

    United States
    1 day ago
  • $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 job
    Hourly pay
    Monday to Friday

    Astrana Health

    California, MO
    4 days ago
  •  ...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 work
    Full time
    Work from home
    Shift work
    Weekend work
    Afternoon shift

    MRINetwork

    United States
    2 days ago
  • $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-Ljbffr
    Remote work
    Hourly pay

    Molina Healthcare

    Nevada, IA
    1 day ago
  • $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

    Santa Barbara Cottage Hospital

    New York, NY
    5 days ago
  • $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 work
    Hourly pay
    Part time

    Santa Barbara Cottage Hospital

    New York, NY
    2 days ago
  •  ...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

    Guidehealth

    Chicago, IL
    4 days ago
  • $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 work
    Hourly pay
    Local area
    Immediate start
    Monday to Friday
    Shift work
    Weekend work

    Pacer Group

    United States
    1 day ago
  •  ...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

    TurningPoint Healthcare Solutions

    Florida, NY
    1 day ago
  • $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 work
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Miami, FL
    1 day ago
  • $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 work
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Doral, FL
    3 days ago
  •  ...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 work
    Work at office

    HealthHelp

    Houston, TX
    1 day ago
  • $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 work
    Hourly pay

    Astrana Health

    California, MO
    5 days ago
  •  ...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 work
    Full time
    Shift work

    Gibson Area Hospital

    Gibson City, IL
    2 days ago
  • $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 work
    Daily paid
    Contract work
    Monday to Friday
    Shift work
    Weekend work

    The Judge Group

    Chicago, IL
    3 days ago
  • $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

    WelbeHealth

    United States
    1 day ago
  • $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 work
    Temporary work
    Part time
    Live in
    Immediate start
    Relocation
    Relocation package
    Shift work
    Weekend work
    Afternoon shift

    Children's Hospital Colorado

    Aurora, CO
    2 days ago
  • $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 work
    For contractors
    Immediate start
    Work from home
    Home office
    Flexible hours
    Shift work

    Performant

    United States
    4 days ago
  • $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 work
    Daily paid
    Live in
    Shift work
    Day shift

    Providence Swedish Medical Center

    Seattle, WA
    4 days ago
  • $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 work
    Work experience placement
    Local area
    Flexible hours

    Sedgwick

    Memphis, TN
    3 days ago
  • $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 work
    Full time
    Flexible hours
    Shift work

    Cohere Health

    United States
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Review RN - Prior Authorization. Be the first to apply!