Remote Utilization Review Nurse
TriWest Healthcare Alliance
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, inpatient and continued stay reviews, and presenting complex cases for Medical Director review, while staying compliant with InterQual and TriWest policies.
#J-18808-LjbffrVacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Nurse in United States vacancy
$65k - $78k
...learning, and career development. Your Role In Our Mission Review admissions, procedures, services, and supplies for medical... ...rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines....Remote workFull timeWork at officeWork from homeFlexible hoursGainwell Technologies LLC
United States1 day ago- ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and contracted...Remote work
E2E Alignment Healthcare USA, LLC
Sacramento, CA2 days ago - ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with...Remote work
Centene Corporation
United States4 days ago - ...Centene Corporation is seeking a Remote Utilization Review RN to perform concurrent reviews and ensure medically necessary care for members. The role requires a CA RN license and acute care experience, with a Monday–Friday schedule and occasional weekend/holiday rotation...Remote workMonday to Friday
Centene Corporation
United States23 hours ago - Description: Nurses – are you looking for a change? Want to work no... ...~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces with...Remote workTemporary workMonday to FridayFlexible hours
Hines & Associates Inc
Rockford, IL1 day ago - ...who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...~ Employee Referral Bonus Program JOB SUMMARY The Utilization Review Nurse is to assess the medical necessity and quality of healthcare...Remote workFull timeTemporary workLocal area
American Health Plans Inc.
Franklin, TN2 days ago - ...one day in Newark NJ rest of role will be remote This position is responsible for... ...Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess... ...industry. 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
Winston Medical Staffing
Newark, NJ19 days ago - ...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
Virtual Vocations Inc
United States3 days ago $41 - $45.5 per hour
...Direct Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL, TX, NM,... ...assessments, health education, and utilization management. Key... ..., concurrent, and retrospective reviews for inpatient, rehab, referrals,...Remote job- TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers’ compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to determine medical necessity and appropriateness...Remote job
- ...Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities... ...critical care and/or medical/surgical nursing At least 2 years utilization... ...Expectations Comfortable with remote work arrangements and virtual...Remote workFull timeFor contractorsWork at officeShift workWeekend workWeekday work
Netsmart
United States17 hours ago $35 - $45.94 per hour
...Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews... ...Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona;...Remote workHourly payFull timeFor contractorsWork from homeRelocationHome officeWeekend workOscar Health
New York, NY2 days ago- ...This is a great opportunity for a local remote position. There is no communication... ...for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions... ...Minimum Requirements Education ~ Nursing Diploma/Associate's - Nursing...Remote workFull timeReliefLocal areaMonday to FridayFlexible hoursShift work
BJC HealthCare
Eastern, KY1 day ago - ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential... ...for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct...Remote workContract work
SPECTRAFORCE
Washington DC2 days ago - ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine RN...Remote workFlexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
Caribou, ME1 day ago - ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote workContract work
IntePros
United States1 day ago - ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded insurance options to our clients...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
Cobalt Benefits Group
United States1 day ago $35 - $45 per hour
...Base pay range $35.00/hr - $45.00/hr Direct message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs while ensuring compliance with federal,...Remote workContract workWeekend workIntePros
New York, NY2 days ago- ...Summary Performs medical record review for severity of illness and... ...and Training: Nurse, Registered (RN) licensure... ...preferred. 2-5 years previous Utilization Review experience preferred.... ...Details: Days, Primarily remote; onsite orientation requirement...Remote workShift workWeekend work
Silver Cross Hospital
New Lenox, IL2 days ago - ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail-oriented and experienced Utilization Review Nurse to evaluate the medical necessity, appropriateness, and...Remote workFull timeSecond jobWork at office
Ova Technologies
Alpharetta, GA3 days ago - ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
The Judge Group, LLC
New York, NY17 hours ago - ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...Must have a current, unrestricted Texas nursing license or Compact License. Please include... ...Requirements This is a remote position. Our whole company works remotely...Remote workLive inFlexible hoursWeekday work
Evry Healthcare Inc.
Eastern, KY22 hours ago $35 - $40 per hour
...are seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior... ...day Mon - Fri, 40 hrs/week Fully Remote Position Pay Range: $35 - $40 per...Remote workHourly payLocal areaShift workPRIDE Health
Minneapolis, MN22 hours ago- ...submit it. Responsible for performing Workers' Compensation utilization review, which includes prospective, concurrent, expedited, and... ...Education: Diploma, Associate, bachelor's degree in nursing, or Master's level (or higher) degree in a Nursing, Health or...Remote workLong distance
Tristar Insurance Services LLC
United States21 hours ago $77.08k - $119.47k
...$119,466.00 Responsible for Utilization Management, Quality Screening... ...Ideal Characteristics Registered nurse with a New York State current... ...applicable to utilization review process. Excellent written and... ...work cannot be done from a remote location. Other Requirements...Remote workShift workAlbany Medical Center
Albany, NY2 days ago$55 per hour
...from Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location: Remote (must be based in California) Employment type... ...setting. Preferred: Experience in case management, utilization management, or discharge planning. Experience...Remote workFull timeContract workTemporary workLocal areaAkkodis
Sacramento, CA1 day ago$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 U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to FridayJ Edward Staffing LLC
Aurora, CO3 days ago- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
United States1 day ago $40 per hour
...Managed Care Industry Registered Nurse (RN) $40/hour - Contract... ...reside in TX Full time remote Candidates must be based in TX... ...performing initial, concurrent review activities; discharge care... ...Provides information regarding utilization management requirements and operational...Remote workFull timeContract workWork at officeHireOps Staffing LLC
United States3 days ago- 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
Rangam
United States22 hours ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review Nurse. Be the first to apply!
Related searches
- utilization review registered nurse United States
- utilization review nurse United States
- remote utilization review nurse part time United States
- remote utilization review nurse United States
- software engineering manager remote United States
- remote recruitment consultant United States
- remote data manager United States
- business intelligence analyst remote United States
- benefits specialist remote United States
- remote video game United States