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
- ...Utilization Management – Care ManagementScheduleShift: 8:00–16:30 or 9:00–17:30 PST.... ...New Year's Day.Assignment Details100% remote position supporting a centralized UM... ...required.Experience with utilization review, prior authorization, and pre-certification processes.Experience...Remote workWeekend work
- ...Utilization Management Nurse 2Become a part of our caring communityThe... ...Registered Nurse (RN) in an Enhanced Nurse Licensure... ...3+ years of experience in prior authorization, claims review, utilization management,... ....Travel: While this is a remote position, occasional travel...Remote workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday
- ...Position Summary: The RN Integrated Care Coordinator (UM... ...hours are required to address utilization review cases. Roles and... ...final determination. Conducts prior authorization, concurrent, and retrospective... ...Telecommuting Requirements This is a remote position. Our whole company...Remote workLive inFlexible hoursWeekday work
$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 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
$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 workFull timeContract workWork at officeWork from homeFlexible hours$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- ...Utilization Review NurseSentara Health Plans Community Care is looking to hire a Utilization... ...licensure. Conducts primary functions of prior authorization, retrospective review, medical... ....For positions that are available as remote work, Sentara Health employs associates...Remote workTemporary work
- ...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
- ...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
- ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start... ...timely and effective care authorizations, transitions, and utilization... ...reviews for services requiring prior authorization, applying... ...Current, unrestricted RN license (State license required...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
$71.1k - $97.8k
...The Hong Kong Study Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a...Remote workWork from home- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
- ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent payment denials. Key responsibilities...Remote workFull time
$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$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- ...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
$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- ...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
$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...Remote workHourly pay$26.41 - $51.49 per hour
...JOB DESCRIPTION This RN will act as a Care Review Clinician supporting our... ...This is a telephonic remote position and productivity... ...candidates will have previous utilization management, case... ...Conducts reviews to determine prior authorization/financial responsibility...Remote workHourly payWork experience placementWork at officeMonday to FridayWeekend work- ...HealthHelp is seeking a remote Utilization Review clinician (RN/LPN/LVN) to support medical necessity determinations across client programs. You will review cases, coordinate with providers, and ensure timely decisions in line with policy and regulatory requirements. Ideal...Remote workWork at office
$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$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.00 – $4... ...-paced environment. Comfortable working independently in a remote or office-based setting. Working Conditions May be exposed...Remote workWeekly payContract workWork at officeMonday to Friday- ...Care Review ClinicianThis RN will act as a Care Review Clinician supporting... ....This is a telephonic remote position and productivity... ...candidates will have previous utilization management, case... ...Conducts reviews to determine prior authorization/financial responsibility...Remote workWork at officeMonday to FridayWeekend work
- ...Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job Type:Full Time The individual... ...; Coordination with payers to authorize appropriate level of care and length of... ...time Job Shift Day Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr...Remote workFull timeWork at officeFlexible hoursShift work
- ...Utilization Review RN - RemoteUtilization Review RN - REMOTE position. This position is Part time and will work 8-hour, Day shifts.Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review...Remote workPart timeLocal areaDay shift
- ...Job Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient medical records to assess the appropriateness... ...experience (hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT - 13 weeks...Remote workTemporary workShift workWeekend work
- ...meaningfully. Note: New Jersey RN Active License is required.... ...work contract role for a Utilization Review Nurse. The Utilization... ...in Utilization Management/Prior Authorization/Case Review Nurses with... ...to work independently and remotely Experience in a healthcare...Remote workContract work
- ...Care Review Clinician This RN will act as a Care Review Clinician supporting... ...This is a telephonic remote position and productivity... ...candidates will have previous utilization management, case... ...Conducts reviews to determine prior authorization/financial responsibility...Remote jobLive inWork at officeMonday to FridayWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review RN - Prior Authorization. Be the first to apply!
- cath lab registered nurse Springfield, IL
- full-time registered nurse rn Springfield, IL
- rn urgent care Springfield, IL
- rn bsn Springfield, IL
- davita rn Springfield, IL
- rn risk management Springfield, IL
- surgery rn Springfield, IL
- oncology rn Springfield, IL
- dialysis rn Springfield, IL
- infusion rn Springfield, IL

