Remote RN: Clinical Utilization Review (Alabama)
Comagine Health
Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to support compliant, cost-effective care. Experience in Medicaid criteria, long-term care settings, and provider relations will help you succeed. A valid Alabama RN license and 3+ years of clinical practice are required.
#J-18808-Ljbffr- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care... ...care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role...Remote workFull timeContract work
$45 - $50 per hour
...looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...of accredited nursing programs with an active New York RN license. #J-18808-LjbffrRemote workHourly pay- ...Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a 100% remote, full-time role supporting Alaska contracts. The nurse will assess medical necessity and care quality through prospective, concurrent, and retrospective reviews, applying InterQual criteria...Remote workFull time
- ...Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge,... ...managing daily tasks, performance reviews, and any necessary... ...Registered Nursing Program; RN preferred. 2. Minimum of...Remote workPermanent employmentFull timeTemporary workFlexible hours
$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... ...must have a current RN license and at least 1 year of clinical experience. Competitive hourly compensation worth $30-$38...Remote workHourly payPart time- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
- ...Position Summary: The RN Integrated Care Coordinator (UM) provides... ...to the operation of our Clinical Team and the overall experience... ...are required to address utilization review cases. Roles and Responsibilities... ...Requirements This is a remote position. Our whole company works...Remote workLive inFlexible hoursWeekday work
- ...healthcare organization to recruit a Clinical Quality Reviewer. You will review medical records for quality and utilization concerns, and prepare clear... ...for quality improvement. Remote or onsite options are... ...The role requires an active RN or LCSW license, 3+ years of...Remote workHome office
- ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning... ...treatment. Key responsibilities Perform clinical assessments and evaluate patient conditions,...Remote workFull timeWork experience placement
- ...Job Title In this remote role, you will perform utilization reviews, ensuring compliance with clinical guidelines and patient care standards. Collaborate with interdisciplinary teams to assess patient needs and facilitate care coordination. Your expertise in medical...Remote workWeekly pay
- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical... ...and payers to ensure compliance with clinical guidelines, regulatory requirements, and... ...hospital-based) ~ Skilled experience with remote work Length of assignment: 13...Remote workShift workWeekend work
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team... ...Package What You’ll Do Review home health clinical documentation for accuracy and...Remote workMonday to FridayWeekend workWeekday work$48 - $65 per hour
...Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix... ...can touch prior authorization, utilization review, care coordination, patient... ...What we’re looking for ~ Active RN license ~ BSN preferred ~3+ years...Remote workLong term contractMonday to Friday$2,300 per month
...The Clinical Review Nurse (RN) supports the organization’s care management function by conducting clinical... ...reviews, ensuring appropriate utilization of medical services, and maintaining... ...healthcare outcomes for members. This is a remote role open to candidates residing in...Remote workWork at office- ...Authorization Nurse to review prior authorization requests... ...requires independent clinical judgment and strong... ...decision-making abilities. Remote position from LA with a... ...8-hour shifts. Active RN license in Louisiana... ...; health plan or utilization management background is...Remote workShift work
- ...Your future role at a glance Location: Remote Department: Ascension Care Management Insurance - Utilization Review Schedule: Day Shift | PRN until 12/31/26... ...make an impact in this role Comprehensive Clinical Review: Conduct prospective, concurrent, and...Remote workReliefLocal areaDay shift
$93.18k - $136.95k
...is looking to hire a Utilization Review Nurse. The Utilization... ...state, medical policy, clinical criteria). Facilitates... ...Review Nurse, RN, Care Coordination, or... ...that are available as remote work, Sentara Health employs... ...the following states: Alabama, Delaware, Florida, Georgia...Remote workFull timeTemporary workShift work- ...Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review patient... ...and payers to ensure compliance with clinical guidelines, regulatory requirements,... ...hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT -...Remote workTemporary workShift workWeekend work
- ...to the LTSS department. RN will be responsible for... ...and concurrent review. Provides monthly telephonic... ...of treatment setting by utilizing the applicable medical... ...community resources. Applies clinical knowledge to work with... ...Info: *possible remote opportunity after training...Remote workContract workMonday to FridayFlexible hours
$63k - $65k
...in Financial Services & Insurance Utilization Review RN As a nurse at Sedgwick, you can build... ...for patients in a nontraditional clinical setting. Apply your RN clinical knowledge... ...health and well-being of others in a remote work environment. Enjoy flexibility...Remote workFull timeWork experience placementLocal areaFlexible hours- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- Brighton Health Plan Solutions, LLC is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews remotely, with responsibilities across inpatient and outpatient reviews and coordination with providers. The ideal candidate holds...Remote jobWork at office
$63k - $65k
...Services & InsuranceUtilization Review RN**As a nurse at Sedgwick, you... ...patients in a nontraditional clinical setting.*** Apply your RN... ...and well-being of others in a remote work environment.* Enjoy flexibility... ...timely, evidence-based utilization review services to maximize quality...Remote workWork experience placementLocal areaFlexible hours$57.28 - $88.92 per hour
...Description Utilization Review RN - REMOTE position. This position is Part time and will work 8- hour, Day shifts. Provide prospective, retrospective... ...reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission...Remote workMinimum wagePart timeLocal areaShift workDay shift$1,851.96 per month
...Profession Registered Nurse (RN) Specialty Utilization Review Job ID 38245223 Job Title... ...computer literate and have some experience with remote work. Responsibilities Utilize clinical expertise to conduct reviews and assess the...Remote workWeekly payContract workLocal areaMonday to FridayShift workWeekend work$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing... ...this role: This is a 100% remote role, and requires robust internet...Remote workFull timeFlexible hoursShift work$48 - $55 per hour
...Description Job Title: Registered Nurse – Utilization Review (Remote) Location: Fort Myers, FL (Remote)... ...We are seeking an experienced RN to perform utilization review, assess... ...activities for assigned patients. Review clinical information and medical records to...Remote workContract workLocal areaMonday to FridayShift workWeekend workDay shift- ...Broward Pace Program sites. Job Title: Utilization Review RN Job Summary The Utilization RN... ..., concurrent, and retrospective clinical reviews to determine medical necessity... ...Environment Work Conditions ~ Remote role with reliable high-speed internet...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration:... ...Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $...Remote workContract work
- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews... ...of services, utilizing clinical criteria and guidelines. Qualified candidates... ...should have an active Maine RN license and at least 3 years of inpatient...Remote workFlexible hours
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