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
- ...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 job
- ...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
- ...This role involves conducting clinical reviews for prior authorization requests and documenting findings. Applicants must hold an active RN license and have at least two years of clinical... ...software is preferred. The role is remote and offers a structured weekday schedule...Remote workInternshipWeekday work
- ...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 work
- ...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
- ...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
- ...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
$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$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- ...Position Summary The Utilization Review Nurse works as responsible for ensuring... ...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
$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... ...utilization management. Reviews prior authorization requests for appropriate care and setting...Remote workHourly payPart timeCurrently hiringWork at officeLocal areaWork from homeMonday to FridayFlexible hours$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$85k - $105.34k
Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure... ...care. This role includes conducting prior authorizations, collaborating with healthcare teams,... .... The ideal candidate will have an RN license, 5 years of experience, and skills...Remote job- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates...Remote workContract workWork from home
$85k - $105.34k
...Utilization Review Nurse Remote; Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 9745... ...care for members. This role conducts prior authorizations, facilitates care coordination, and... ...Active, unrestricted RN license (BSN or MSN) in Oregon or a...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- ...Management is seeking a CA-licensed UM Review Nurse to review outpatient... ...have 1+ years of outpatient Utilization Management experience, work remotely, and maintain availability for shifts... ...Sunday. This role includes prior authorization and retrospective reviews and requires...Remote jobShift work
- ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
- ...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
- ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote workFull time
$60.2k - $107.4k
...Stryker Corporation is looking for a Utilization Review Nurse, RN, based in California. As part of this role, you'll manage inpatient utilization... ...clinical guidelines. The position offers the flexibility of remote work within the U.S., alongside responsibilities like...Remote work$69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare... ...Ideal candidates are experienced RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote work- ...Humana is offering a remote internship opportunity for a Utilization Management Behavioral Health Registered Nurse (RN). This role is part of the DOW SkillBridge Internship and is... ...military spouses. Interns will conduct clinical reviews, communicate with providers, and document...Remote workInternship
- ...BJC HealthCare (New) is seeking a remote RN with Utilization Review experience. This role involves evaluating the appropriateness and efficiency of hospital resources to ensure quality patient care. Candidates must have 2 years of RN experience and live within one hour...Remote work
$2,210 per week
...Paid Holidays Work-life balance. Remote/hybrid setting (once trained)... ...: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces with... ...includes but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ...Humana is offering a remote internship for a Utilization Management Behavioral Health Registered Nurse (RN) Intern. This role supports the National Medicaid team, focusing on clinical reviews and patient care. Candidates must be transitioning military service members...Remote workInternshipWork at officeWeekday work
$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- ...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
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