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
- Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service necessity and efficiency, ensuring quality care based on clinical guidelines. The UMRN will work closely with various departments...Remote jobFlexible hours
$45k - $70k
...A leading healthcare company in the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical services and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for candidates having...Remote work$45k - $70k
...A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote work$72.59k - $119.77k
...Clinical Nurse Reviewer Per Diem Quality Management Saint Peter's is among the few hospitals in the world... ...a secure, Web-based system. Utilize software applications for data collection... ...located on-site with limited remote work hours as allowed based on...Remote workDaily paidFull timeWork experience placementShift work$88.85k
...Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established...SuggestedFull time- ...leading healthcare provider is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license...Remote workWork from home
- ...Department: Managed Services Please make sure you read... ...positions for this role. The Utilization Management (UM) RN performs utilization review activities, including,... ...level reviews. The UM nurse ensures a process that... ...is hybrid with remote and in-office assignment...Remote workWork at officeWork from homeRelocation package
$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex... ...in conjunction with the Medical Director. Assists management with training new reviewers to include daily monitoring...Remote workFull timeWork from homeRelocation packageFlexible hours- ...Projections. This includes reviewing records, preparing the... ...Degree or Diploma in Nursing required ~3-5... ...medical bill reviews and utilization reviews in injury... ...CNLCP), Certified Case Manager (CCM), Medical Coding,... ...#LI-LM03 #LI-Remote About Us For over...Remote workFull time
$88.85k
...safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves... ...telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers...- ...Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- ...Dane Street, LLC is seeking a remote Physician Reviewer for full-time work from home. The role requires an MD or DO, board-certified in Internal or Family Medicine, to perform utilization reviews, including preauthorization and appeals. Ideal candidates will have prior...Remote workFull timeWork from home
- A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities... ...service eligibility and facilitating care. This remote role requires an RN license and clinical experience. Benefits...Remote jobWork from home
- 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
- ...integrator of professional, technological and management solutions services. Founded in 1998,... ...? Avosys is seeking a Surgical Case Nurse Reviewer to provide services to the Travis... ...for the program through the effective utilization of the hospital medical record system....Remote workFull timeFor contractorsWork at officeLocal areaMonday to FridayShift work
$33.12 - $56.77 per hour
Elevance Health is seeking a Nurse Reviewer I to conduct preauthorization reviews for diagnostic imaging. This is primarily a virtual role based in Washington DC, suitable for new graduates. You will collaborate with healthcare providers to ensure proper treatment approvals...Remote job- A healthcare management firm is seeking a Work From Home PharmD Utilization Management Pharmacist to evaluate clinical requests and ensure members receive appropriate care. Applicants should hold a PharmD degree and an active pharmacist license, with experience in U.S....Remote jobWork from home
- ...Note: Candidates can be remote but must have an... ...Summary The Clinical Reviewer, Precertification RN,... ...a licensed Registered Nurse that is expected to function... ...and is responsible for managing a clinically complex... ...Precertification / Outpatient Utilization Management (UM) team...Remote workContract workWork at officeWork from home
- ...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
- ...A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
- ...Barbara Cottage Hospital seeks a Utilization Management RN – Pediatrics to ensure... ...patients. This fully remote role requires an active New... ...minimum of 2 years of pediatric nursing experience. Responsibilities... ...include performing concurrent reviews of clinical cases, collaborating...Remote 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
$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 workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift work- ...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
$58.66k - $142.45k
...Peer-to-Peer Utilization Review Nurse Mass General Brigham relies on a wide range of professionals... ...of the MGB Central Utilization Management team, specializing in identifying, preparing... ...Job Details (if applicable): ~ Remote / Work from Home. ~32 hours per week...Remote workWork from homeShift work$71.1k - $97.8k
...part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...guidelines/procedures. This role is a remote position, M-F 8am to 5pm EST with... ...minutes. Your recorded interview will be reviewed, and you will subsequently be...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend 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
$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 Certifications...Remote workContract workImmediate startMonday to Friday$45.75 - $62.9 per hour
...fulltime prior authorization nurse role; experience with health... ...position with potential for remote work. JOB SUMMARY:... ...Supervisor, UM Clinical, the Utilization/Case Manager Nurse coordinates the delivery... ...by conducting regular market reviews to remain competitive with organizations...Remote workFull time
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