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
- ...Healthcare seeks an experienced RN to support Arizona Plan clinical member services review processes. The role requires... ...license and experience with utilization management, prior authorization, and both inpatient and outpatient settings. Remote position, must reside in...Remote job
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
- ...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
$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$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
....00/hr - $40.00/hr Remote (Compact Licensure Required... ...) - Open to LPN's & RN's About the Role... ...seeking an experienced Utilization Review Nurse to support our... ...and review patient authorizations, ensure compliance with... ...You’ll Do Process prior authorization and reauthorization...Remote workFull time$78k - $88k
Gainwell Technologies is seeking a skilled Utilization Review Nurse to perform prior authorization across prospective, concurrent, and retrospective reviews for... ...requires 3+ years inpatient experience and an active RN license in the U.S. Core hours 8:00 AM-6:00 PM ET;...Remote job$78k - $88k
Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity... ..., and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements....Remote jobFull timeContract workWork at officeWork from homeFlexible hours- ...Utilization Review NurseThis position has a remote option for those living close and will be able to come into the hospital as needed.The Utilization... ...Self, Leader of Others, or Leader of Leaders.The prior authorization role completes an assessment of a proposed service...Remote workFull time
$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$30 - $34 per hour
...Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation... ...Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions,...Remote workHourly payMonday to Friday- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration... ...Review to join our Utilization Management team. In this role,... ...assigned Qualifications Active RN license (WA; must be in good standing...Remote workContract work
- ...Utilization Management Registered Nurse Duration: 6 Month Contract... ...outpatient utilization review and prior authorization activities for a leading healthcare... ...Registered Nurse (RN) license. Associate Degree... ...to work independently in a remote environment. Comfortable...Remote workContract work
- ...Umpqua Health. Position Title Utilization Review Nurse Department Umpqua... ...Standard Time) Location Remote position Salary Wage Band... ...nursing 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
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on... ...schedule of 8 hours per day, requiring an RN with a Bachelor's degree, state licensure...Remote jobWork from homeMonday to Friday
$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- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of assignment: 13 weeks Shift / hours...Remote workShift workWeekend work
- ...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
$2,213 per month
...Job Description Job Description RN - Utilization Review - Travel Gross Pay (weekly): $2213.0 Taxable Pay (weekly): 680.0 Non-taxable Pay (weekly): 1533.0 Shift: Type - 8hr Days, Schedule - No schedule available Location: Fort Myers, FL Scheduled Hours...Remote jobWeekly payShift 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
$23.76 - $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... ...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- Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This role emphasizes OASIS review, coding accuracy, QA, and remote documentation audits. The ideal candidate holds an active Florida RN license, OASIS certification...Remote job
$1,862 per month
...Nursing Profession Registered Nurse (RN) Specialty Utilization Review Job ID 37761865 Job Title Registered... ...experience necessary. - Must be computer literate and have remote working experience. Compliance / Notes - Must...Remote workWeekly payContract workWork experience placementLocal areaMonday to FridayShift workWeekend work$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$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$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team.This role is ideal for an RN with strong experience in OASIS, coding, QA, and home health...Remote workMonday to FridayWeekend work- ...patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...needed 3-4 days for first week. This role will be remote BUT regular meetings/trainings require being onsite...Remote workReliefWeekend work3 days per week
- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective... ..., concurrent, and retrospective reviews. This full-time remote role supports compliant, cost-effective care under Alabama...Remote jobFull timeContract work
- ...Job Description Quick Job Details: Setting: Fully Remote – Utilization Review Schedule: Full-Time, Monday–Friday Hours: Standard... ...hours Patient Volume: N/A Job Requirements: Active RN license with Multi-State/Compact license required Minimum...Remote jobFull timeMonday to Friday
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