Remote Utilization Management RN - Care Coordination
Humana
Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will work with the One Home/Home Solutions Utilization Management team handling post-acute care services (SNF, Home Health, DME) to ensure appropriate care in the right setting. Reporting to the Manager of Utilization Management, you will perform determinations using established criteria, communicate with providers #J-18808-Ljbffr
Vacancy posted 15 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN - Care Coordination in Columbia, SC vacancy
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ..., which oversees post-acute care services including SNF, home... ...necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
Humana
United States1 day ago - ...Utilization Management Registered Nurse at Humana uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care services including SNF, Home Health and DME. You...Remote work
Humana
Jackson, MS15 hours ago - Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote job
- Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. The role reports to the Manager of Utilization...Remote job
- Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...UM team managing post-acute care services including SNF, home... .... The role requires an active RN license, 1+ year RN experience...Remote job
- ...a Registered Nurse to support Utilization Management in a remote-friendly role. You will apply clinical... ...ensure appropriate services, coordinate with providers, and support care decisions in a fast-paced, tech-enabled environment. Required RN license and 2+ years in acute...Remote jobFlexible hours
- ...Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote team on weekends after training. You will review... ...determinations and collaborate with providers to coordinate care, ensuring members receive appropriate care....Remote jobWork at officeWeekend work
- Highmark Inc. is seeking a full-time RN with utilization management expertise for a remote role requiring weekend availability (Saturday... .... The position focuses on reviewing care appropriateness, applying criteria, and coordinating with Health Coach/case management to...Remote jobFull timeWeekend workWeekday work
- Humana Inc is seeking a Utilization Management Registered Nurse to interpret and coord intakes for medical services and benefit determinations in a fully remote capacity. You will support post-acute care services across SNF, Home Health and DME, reporting to the Utilization...Remote job
$47.37 per hour
Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care, and ensure... ...regulations. The role requires an active RN/LPN/LVN license and 2-4 years of clinical...Remote jobHourly pay$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’s managed care health plan client based out of Redding or Fairfield, CA. Anticipating to be temporary for at least...Remote workContract workTemporary workMonday to FridayWeekend workYoh, A Day & Zimmermann Company
Redding, CA22 days ago$47.03 - $63.48 per hour
...enabled revenue cycle management solutions for health... ...healthcare. The RN, Senior Utilization Review Quality... ...management denials. Coordinate with service line leaders... ...experience in an acute care environment required... ...experiences This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote ~ Full-time WHO IS GUIDEHEALTH? Guidehealthis a data... ...services Quality of care concerns Interfacingroutinely... ...reliable and user-friendly. Care Coordination & Quality Support Initiatingreferrals...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States15 hours ago- ...Humana Inc. is hiring a Utilization Management Registered Nurse for remote work. You will apply clinical nursing expertise to interpret, coordinate, document, and communicate medical services and... ...determinations for post-acute care settings. You will make criteria...Remote work
Humana
United States4 days ago - ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated... ...recommends alternative levels of care when appropriate. This role supports... ...Inpatient Acute Care Nursing Care Coordination Telephonic Clinical Review...Remote workPart timeMonday to Friday
The Judge Group
Philadelphia, PA9 hours ago - ...is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate member outcomes...Remote work
CVS Health
Alton, IL-7 $101.72k - $198.36k
...California - Ability to work remote, but selected candidate... ...position requires California RN Licensure. Candidates must... ...of the following functions: utilization management, care management, behavioral health... ...facilitating, planning and coordinating integrated delivery of care...Remote workContract workWork experience placementWork at officeLocal areaMolina Healthcare Careers
San Diego, CA25 days ago- Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations... ...Management team focused on post-acute care (SNF, Home Health, DME). The role emphasizes using...Remote job
- ...Behavioral Health Utilization Manager Behavioral Health Utilization Manager... ...in the appropriate level of care. Notifies Medical Director... ...turnaround times. Assists in the coordination of care of hospitalized... ...systems Work Schedule: Remote Other Requirements: Able to...Remote workContract workWork experience placement
Harris Health System
United States2 days ago - Humana Inc. is seeking a qualified Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations. You will report to... ...Utilization Management and contribute to post-acute care coordination across SNF, Home Health, and DME...Remote job
- ...Nurse to assess, plan, implement, and coordinate healthcare services and benefits for... ...collaborate with providers to facilitate care and treatment. You will identify... ...resource to internal and external stakeholders in utilization/benefit management. #J-18808-Ljbffr CVS HealthRemote job
- HealthEdge is seeking a Telephonic Utilization Management RN to coordinate, document, and communicate all aspects of the utilization/benefit management... ...clinical needs, review authorization requests, and ensure care plans align with medical necessity across inpatient and...Remote job
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical... ...and support the coordination, documentation and communication... ...Compact Registered Nurse (RN) license in your state of... ...Experience working in a fully remote, metrics-focused role...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome officeHumana
Tallahassee, FL2 days ago- Elevance Health is seeking a Wound Care Utilization Management RN to perform pre-certification and authorization... ...needs. You will review records, coordinate with physicians and home health... ...for continuity of care. This largely remote role requires in-person training...Remote jobMonday to FridayShift work
- ...experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on... ...collaborate with providers to coordinate treatment plans, ensuring appropriate care and utilization. The position requires 3+ years RN experience, an active RN license,...Remote job
$39 - $40 per hour
...Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the... ...responsible for evaluating healthcare services, coordinating care, and ensuring members receive high-...Remote workDaily paidContract workMonday to FridayShift workWeekend workThe Judge Group
Chicago, IL-7- ...seeking a Registered Nurse to support utilization management and care coordination. You will assess plans, coordinate... ...teams. Ideal candidates hold an RN license with 2+ years in acute/critical... ...office setup will be expected for remote work. #J-18808-Ljbffr CVS HealthRemote workHome officeWeekend workAfternoon shift
- ...Healthcare is seeking a registered nurse to support care management and care coordination activities remotely across the continuum of member care. You will work... ...services across behavioral health and LTSS, and utilizing motivational interviewing to drive member engagement...Remote job
$63.1k - $94.65k
...enabled revenue cycle management solutions for... ...have current compact RN license, or be... ...Information: Our Utilization Review team provides... ...of health care resources and assists... ...Denial Management Coordinates the P2P process with... ...: This is a remote role which requires...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work- ...RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage...Work at officeWork from homeHome officeMonday to FridayWeekend workWeekday work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN - Care Coordination. Be the first to apply!
