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 4 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 workWeekly payShift workProvidence Health and Services
Eureka, CA4 days ago$35 - $40 per hour
Sagility LLC, a leader in healthcare transformation, seeks an RN Utilization Management Reviewer for a fully remote role. You will perform timely clinical decision reviews for services requiring prior authorization across various clinical areas, applying criteria like...Remote jobHourly pay$35 - $40 per hour
...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely... ...review for services requiring prior authorization in a variety of clinical areas, including... ...require weekends. Location: Fully remote work at home role. Secure, private...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend workSagility LLC
New York, NY15 hours ago$3,268 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler... ...2 days onsite and 3 days remote per week Floats between... ...experience required ~ Prior travel healthcare experience... ...needs assessment, and prior authorizations ~ Knowledge of CMS, DRG...Remote workWeekly payContract workLocal areaShift workNight shiftDay shift3 days per week- ...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
SPECTRAFORCE
Washington DC1 day ago - ...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
Integrated Resources
Springfield, IL4 days ago $89.54k - $136.47k
...Remote Utilization Review Registered Nurse Sentara Health is hiring a Remote Utilization Review... ...licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews... .... Education: N-3 Years RN- Diploma (required) BSN (preferred...Remote workFull timeShift workSentara Healthcare
Norfolk, VA1 day ago$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison... ...Essential Functions Process patient prior authorization and reauthorization requests in... ...accredited professional nursing program (RN, LPN, or LVN). Minimum of two years...Remote workContract workWeekend workIntePros
New York, NY15 hours ago$89.54k - $136.47k
...Overview Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must... ...licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews... .... Education N-3 Years RN- Diploma (required) BSN (preferred...Remote workFull timeTemporary workShift workSentara Hospitals
Virginia Beach, VA4 days ago- ...DescriptionJob Description Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-... ...Registered Nurse (RN) with experience in utilization... ...party payers regarding authorization and coverage... ...reimbursement methodologies and prior authorization processes...Remote workFull timeSecond jobWork at office
Ova Technologies
Alpharetta, GA1 day ago $35 - $40 per hour
...experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience... ...support clinical quality review and AI model development for prior authorization use cases. The ideal... ...Mon - Fri, 40 hrs/weekFully Remote PositionPay Range: $35 - $...Remote workLocal areaShift workPRIDE Health
Minneapolis, MN5 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 workFull timeMedix
New York, NY5 days ago- ...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
CHRISTUS Health
Alamogordo, NM2 days ago $50 - $55 per hour
...Remote Utilization Review RN | CA RN License Required - -Must sit in CA We're seeking an experienced Utilization Review RN for a remote MondayFriday... ...required Experience with Post-Service Review, Prior Authorization, and/or Concurrent Review Knowledge of ICD-10 and clinical...Remote workContract workTemporary workActalent
New York, NY5 days ago- ...care conditions. Reports to the Health Plan Manager of Utilization Management. This position will be an integral member of... ...Assists with the build and implements care management review processes (Prior Authorization, Predetermination, Concurrent Reviews, Retrospective Reviews...Remote workCasual workWork at officeShift work
Peak Healthcare
United States1 day ago $95k - $107.5k
...Description Title: Nurse Reviewer, Utilization Management Job... ..., MA office; 1 day remote FLSA Status:... ...coverage requirements to authorization requests, coordinates... ...coverage policy. Review prior authorization and... ...in Nursing (ADN/RN) required; Bachelor's...Remote workFull timeLocal areaBrighton Marine Health Center
Brighton, MA5 days ago- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary... ...license, 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
CVS Health
Jackson, MS4 days ago - ...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...Remote work
Integrated Resources
United States4 days ago - ...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
IntePros
United States4 days ago - ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...utilization review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive...Remote work
Sedgwick Claims Management Services
United States2 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 workHourly payPart timePersonify Health, Inc.
New York, NY1 day ago$69.39k - $88.61k
...Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within... ...degree in a related field, an active RN/Social Work/Clinical Counselor...Remote workFull timeCincinnati Children's
United States2 days ago- ...Network has been asked to assist a top health plan partner of ours with a need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an activeMA RN license. (Compact RN license may be possible for other plans)...Remote workContract workMonday to FridayFlexible hours
Community Health Network
Boston, MA3 days ago $30.37 - $59.21 per hour
...clinical member services review assessment processes.... ...reviews to determine prior authorization/financial... ...model. • Adheres to utilization management (UM) policies... ...• Registered Nurse (RN). License must be active... ...skill level. xhyhwjd Remote working/work at home options...Remote workHourly payWork experience placementWork at officeWork from homeMolina Healthcare
San Francisco, CA3 days ago- ...Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical necessity... ...the organization. The role requires Texas RN licensure and a nursing diploma, with...Remote work
Ascension
Austin, TX4 days ago - ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay... ...Admitting, Financial Counseling and payer teams to obtain authorizations, document appropriately, and support discharge planning while...Remote work
Cincinnati Children's Hospital
United States2 days ago - ...DescriptionJob DescriptionLocation: Fully remote. Candidates must be able to... ...an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role,... ...perform concurrent reviews, prior authorizations, medical necessity reviews, discharge...Remote workWork at officeImmediate start
Impresiv Health
Henderson, NV1 day ago - ...specific to the LTSS department. RN will be responsible for... ...care for members based on authorization and concurrent review. Provides monthly... ...appropriateness of treatment setting by utilizing the applicable medical... ...Info: *possible remote opportunity after training...Remote workContract workMonday to FridayFlexible hours
HealthCare Support
New York, NY1 day ago - ...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
Rangam
Pennington, NJ3 days ago $70.2k - $120.4k
...norm and every member feels valued.The Utilization Review RN will review and document member case... ...for reviewing and documenting prior authorization requests and member case history in... ...license requiredThis position is a Remote role. To be eligible for consideration...Remote workWork experience placementMedica
Minnetonka, MN3 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!
Related searches
- outpatient rn Springfield, IL
- sedation rn Springfield, IL
- ed rn Springfield, IL
- registered nurse office Springfield, IL
- labor & delivery rn Springfield, IL
- registered nurse remote Springfield, IL
- injection rn Springfield, IL
- gastroenterology rn Springfield, IL
- rn iv therapy Springfield, IL
- registered nurse healthcare Springfield, IL