Remote Utilization Management Nurse Reviewer
Dane Street
- Remote job
A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records, and collaborating with healthcare providers to optimize care. Candidates must have a valid nursing license and a minimum of two years of clinical experience. The position offers a competitive salary range, remote work options, and a comprehensive benefits package including health insurance, retirement plans, and performance bonuses. #J-18808-Ljbffr Dane Street
$45k - $70k
A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote job$78k - $88k
...a talented individual for a Nurse Reviewer (RN) who will be responsible... ...criteria, coverage policies, and utilization and practice guidelines as... ...as required. Assists management in training new Nurse Reviewers... ...Friday work schedule. Remote position; employees must be...Remote workPermanent employmentFull timeContract workTemporary workMonday to FridayFlexible hours$90k - $99k
DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes great... ...in conjunction with the Medical Director. Assists management with training new reviewers to include daily...Remote jobFull timeWork from homeFlexible hours- ...A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high typing speed and self-motivation along with the ability to work independently. Candidates must...Remote workWork from home
$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Remote | Utilization Management | Work from Home Are you an experienced RN looking to leverage your... ...across the continuum of care. What You'll Do Review clinical information and apply evidence-based criteria...Remote workHourly payFull timeTemporary workLocal areaWork from homeAfternoon shift$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations... ...healthier community. POSITION PURPOSE The Utilization Management Nurse evaluates clinical service requests to ensure medically...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant for a fully remote role. You will assess and coordinate care options, apply clinical criteria to determine coverage, and communicate with providers to ensure appropriate services for members....Remote workWork at office
- ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in... ...providers. This position offers the flexibility of remote work while supporting professional growth and...Remote work
$71.1k - $97.8k
...part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...experience in utilization management/review and or prior authorizations. Background... .... Travel: While this is a remote position, occasional travel to Humana...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift work- ...integrating, and monitoring the utilization of behavioral health (BH) or physical... ...to the Medical Director for review. Refer to and work closely with Case Management to address member needs.... ...note: There may be opportunity for remote work within all jobs posted by the...Remote workFull timeContract workWork at office
$70k - $75k
...Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to... ...Job Description The Utilization Management Registered... ...performing utilization review activities in compliance... ...consistent with current nursing practice standards and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...CVS Health is seeking a Utilization Management Nurse Consultant (Clinical Precertification RN) for Medicare, with remote, full-time weekday schedule. You will review cases, determine coverage using guidelines, and coordinate care to ensure appropriate treatment. The role...Remote workFull timeWeekday work
- A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...to oversee the design, implementation, and sustainability of Utilization Management clinical programs. You will ensure clinical integrity,... ...standardizing national UM strategy and workflows. This role is remote with potential travel to Humana locations; requires 40 hours...Remote work
- ...SSM Health in the United States seeks a registered nurse for utilization management to evaluate medical necessity of hospital admissions and procedures. You will ensure payors receive complete clinical information to support services provided and obtain hospital authorization...Remote workDay shift
- ...analytics, Guidehealth leverages remotely‑embedded Healthguides™ and a centralized Managed Service Organization to build... ...through precise and timely Utilization Review. In this role, you will apply... ...growth aligned with Illinois nursing regulations and contemporary clinical...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home
- ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical review and provider collaboration. The position requires an active RN license, 3+ years...Remote workFull time
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization... ...inpatient and outpatient utilization reviews while supporting transitions of care... ...LCD/NCD policies). This is a fully remote opportunity requiring discipline,...Remote work
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...Utilization Management, Utilization Review, or Case Management ~• Preferred...Remote workContract workImmediate startMonday to Friday- ...Utilization Management Nurse Des Moines, Iowa, United States Utilization Management Nurse Location... ...in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse... ..., outpatient tests, care, etc. Review requests and match up to an evidence-...Remote workFull timeWork at office
$26.35 - $39.53 per hour
...NeueHealth is seeking a Concurrent Utilization Review Nurse responsible for real-time clinical reviews to ensure the medical necessity of healthcare services. The role includes conducting assessments, coordinating with providers, and collaborating with the Medical Director...Remote workHourly pay- ...charging, and complete home energy management ecosystems. By leveraging... ...’s sales efforts in the Utility scale and Community Solar segment... ...America. Location : Remote USA, preferred location in the... ...revenue on a regular basis and review sales results to ensure that...Remote workFull timeWork from home
- ...Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities... ...: Graduation from accredited School of Nursing. Current, active, unrestrictive license to...Remote work
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license...Remote workContract work
- Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote job
- ...patient care across skilled nursing and long-term care settings... ...role with some flexibility for remote work based on business needs... ...community stakeholders to review clinical records, communicate... ...~ Experience in utilization management, medical record review, or long...Remote workWeekend workWeekday work
- CVS Health is seeking a Utilization Management Nurse - Precertification RN to support remote precertification processes. The role requires an active RN license and 3... ...-making using evidence-based criteria. You will review information, authorize services, and collaborate...Remote job
- ...Nurse Reviewer Contract Duration: Initial 6-months Pay: $27.50/hr on W2 Start Date: 9/8/2026 Location: Fully Remote (US Only) LPN State License must be active and in good standing... ...of quality standards by utilizing job aids, work instructions and...Remote workContract work
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote jobWeekend work$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are... .... In this role, you will use your clinical expertise to review cases, assess medical necessity, coordinate care, and...Remote workFull timeAfternoon shift
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