Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote RN Care Review Clinician - UM/Discharge Planning

Molina Talent Acquisition

Molina Healthcare seeks a Remote RN Care Review Clinician for UM/Discharge Planning in California. You will verify medical necessity, review services against guidelines, and coordinate care across the delivery continuum to achieve quality outcomes.

The role requires an active RN license in CA, at least 2 years in hospital acute care or managed care, strong written and verbal communication, and Microsoft Office proficiency.

#J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote RN Care Review Clinician - UM/Discharge Planning in United States vacancy
  • $30.37 - $59.21 per hour

    RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req) CA, United States and 5 more Trending Job Description JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... 
    Remote job
    Hourly pay
    Full time
    Work experience placement
    Work at office

    Molina Talent Acquisition

    Sacramento, CA
    3 days ago
  • $30.37 - $59.21 per hour

     ...support for clinical member services review assessment processes....  ...through integrated delivery of care across the continuum. Contributes...  ...Adheres to utilization management (UM) policies and procedures. **...  ...experience. - Registered Nurse (RN). License must be active and unrestricted... 
    Remote work
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Los Angeles, CA
    3 days ago
  •  ...Behavioral Health Precertification/UM Clinician to review authorization requests and...  ...necessity and appropriate levels of care. The role is fully remote, with a consistent Monday–Friday...  ...with facilities, and support discharge planning while working within a collaborative... 
    Remote work
    Monday to Friday

    CVS Health

    United States
    4 days ago
  • $32 - $38 per hour

     ...expertise for the review of medical records...  ...appropriateness of care; verify that...  ...manner. Support discharge planning to promote understanding...  ...Registered Nurse (RN) in any state and/...  ...Management (UM), Utilization Review...  ...and caring leaders, clinicians, pioneering technologists... 
    Remote work
    Contract work
    Work at office
    Local area
    Monday to Friday

    Acentra Health

    United States
    2 days ago
  • $26.01 - $56.14 per hour

     ...passionate colleagues who care deeply, innovate with purpose...  ...Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization...  ...physicians, care managers, and discharge planners to support appropriate...  ...and apply health plan benefits and regulatory requirements... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work experience placement
    Work at office
    Local area
    Work from home

    CVS Health

    Austin, TX
    3 days ago
  •  ...Centene Corporation is seeking a Nurse Reviewer for remote work in the United States. The role involves performing concurrent reviews to determine appropriate level of care and discharge planning, with emphasis on medical necessity and care setting.Requires active Nursing... 
    Remote work

    Centene Corporation

    Lansing, MI
    2 days ago
  •  ...Eastern). The Utilization Review Clinician is responsible for...  ...and ensuring timely post-discharge follow-ups with completed...  ...to help prevent acute care readmissions. In this...  ...compliance with health plan guidelines, contractual...  ...therapy experience Active RN, OT, or PT license... 
    Remote work
    Full time
    Work experience placement
    Work at office
    Worldwide
    Monday to Friday
    Shift work

    WellSky

    New York, NY
    3 days ago
  •  ...and therapists in home care, hospice, and case...  ...assist a top health plan partner of ours with...  ...need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an...  ...experience, managed care, and discharge planning experience... 
    Remote work
    Contract work
    Monday to Friday
    Flexible hours

    Community Health Network, Inc.

    Boston, MA
    1 day ago
  • $1,759.5 per week

     ...Travel RN - Case Management/Utilization Review American Traveler Austin, Texas, United...  ...RN for a fully remote role requiring TX or compact...  ...licensure and 2 years of acute care UM experience. Details...  ...issues Coordinates discharge planning needs with healthcare... 
    Remote work
    Weekly pay
    Local area
    Shift work

    American Traveler

    Austin, TX
    2 days ago
  • $29 - $52 per hour

     ...Hospital Safe Discharge Case ManagerFor those...  ...of health care, here's your opportunity...  ...to facility CM/UM/Discharge staff...  ...to work remotely from anywhere within...  ...for transition planning activitiesManages...  ...appropriate for review of complex case...  ...NursingCurrent, unrestricted RN license -... 
    Remote work
    Hourly pay
    Minimum wage
    Full time
    Contract work
    Work experience placement
    Work at office
    Local area
    Shift work

    UnitedHealth Group

    Baltimore, MD
    3 days ago
  •  ...seeking a highly motivated Utilization Review RN to join our team. The RN will perform...  ...length of stay, and level of care, including appeals initiated by providers...  ...include authorizing services, coordinating discharge planning, and documenting outcomes while maintaining... 
    Remote work
    Contract work

    HealthEdge

    United States
    3 days ago
  •  ...Clinical Review Nurse - Concurrent Review TX All...  ...Description Location: 100% Remote - TX: RN only with TX license...  ...reviewing the type of care being delivered,...  ..., and contributing to discharge planning according to care policies...  ...experience required: UM experience preferred... 
    Remote work
    Contract work
    Work from home
    Shift work

    Executive Staff Recruiters / ESR Healthcare

    Austin, TX
    13 hours ago
  •  ...Molina Healthcare is seeking a Care Review Clinician (RN or LPN) for a remote, full-time position operating 8a-5p Pacific Time, Monday through Friday. You will support clinical member services review processes, verify medical necessity, and ensure alignment with established... 
    Remote work
    Full time
    Monday to Friday

    Molina Healthcare

    United States
    3 days ago
  •  ...Ensemble Health Partners is seeking a remote Utilization Review RN to assess and optimize patient care utilization across services. This role requires an active...  ..., with experience in utilization review or discharge planning preferred. Competitive pay with shift differentials... 
    Remote work
    Flexible hours
    Shift work

    Ensemble Health Partners

    United States
    13 hours ago
  •  ...HealthEdge seeks a motivated Utilization Review RN to perform prospective, concurrent, and...  ...medical necessity and appropriate care levels. The role includes discharge planning, care coordination, and appeals support, with remote work across the US. RN licensure is required... 
    Remote work
    Contract work

    HealthEdge

    New York, NY
    10 hours ago
  •  ...Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site...  ...necessity, insurance requirements, and discharge planning in collaboration with physicians and care teams. Ideal candidates hold an RN... 
    Remote work
    Part time
    Relief

    Trinity Health

    Mishawaka, IN
    2 days ago
  •  ...UM Nurse ReviewerUnder the guidance of the Utilization...  ..., the UM Nurse Reviewer will leverage expertise...  ...members receive suitable care at the right time and location...  ...secure and efficient discharge planning, and collaborating...  ...Unrestricted Current California RN or LVN licenseAt least... 
    Immediate start

    Universal Healthcare MSO, LLC

    Bakersfield, CA
    2 days ago
  •  ...Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review...  ...medical necessity, and appropriate care levels, contributing to discharge planning within care policies and guidelines...  ...experience (2+ years acute care UM or managed care preferred), nursing... 
    Remote work

    Spectraforce Technologies

    United States
    2 days ago
  • $47.03 - $63.48 per hour

     ...healthcare. The RN, Senior Utilization Review Quality will play...  ...education and ongoing action plans to ensure quality is...  ...in an acute care environment required Utilization review/discharge planning experience preferred...  ...This is a remote position; however, candidates... 
    Remote work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    Oregon State
    3 days ago
  • $63.1k - $94.65k

     ...have current compact RN license, or be...  ...Our Utilization Review team provides coverage...  ...utilization of health care resources and assists...  ...improvement team; planning, implementation,...  ...Utilization review/discharge planning experience...  ...Required: This is a remote role which requires... 
    Remote work
    Temporary work
    Part time
    Work at office
    Local area
    Flexible hours
    Shift work

    Ensemble Health Partners

    Remote
    3 days ago
  • $26.01 - $56.14 per hour

     ...About This Role The UM Nurse Consultant at CVS Health is a remote position ideal for...  ...concurrent reviews and collaborating...  ...high-quality patient care. Highlights Pay: $...  ...Louisiana or have Compact RN licensure What You...  ...Facilitate timely discharge planning and care... 
    Remote work
    Full time
    Monday to Friday

    CVS Health

    Louisiana, MO
    5 days ago
  •  ...Travel RN - Case Management/Utilization Review - Case ManagementAmerican TravelerSan Francisco, California...  ...with 2 days onsite and 3 days remote per weekDay shift schedule, 5x8-...  ...requiredExperience with utilization review, discharge planning, and care coordinationFamiliarity with... 
    Remote work
    Weekly pay
    Contract work
    Local area
    Shift work
    Day shift
    Weekday work

    American Traveler

    Emeryville, CA
    5 days ago
  •  ...Concurrent Review Registered Nurse (RN)Location: Fully remote. Candidates must be able to work a schedule aligned with Pacific Time (PST...  ...authorizations, medical necessity reviews, discharge planning, and transitions of care while collaborating with physicians, hospitals... 
    Remote work
    Work at office
    Immediate start

    Impresiv Health

    Henderson, NV
    3 days ago
  • $42 per hour

     ...admission utilization review across 13 acute care and critical access...  ...Management Assistant, UM Managers: Pam Long, Jennifer...  ...Experience: Licensed RN (multistate or TX RN)...  ..., Google Workspace, remote work experience Other...  ..., case management, discharge planning and utilization... 
    Remote work
    Work experience placement
    Monday to Friday

    Pacer Group

    Austin, TX
    2 days ago
  •  ...Utilization Management (UM) Nurse, you are...  .... Unlike remote roles, this position...  ...Nurse (RN) responsible for...  ...medical record reviews to ensure patients...  ...current level of care.o Medical Provider...  ...clients ongoing plan of care and conducts...  ...and Post Discharge* Completes chart... 
    Remote work
    Full time
    Immediate start
    Shift work

    Wellstar Health Systems, Inc.

    Marietta, GA
    a month ago
  •  ...Description: This is a remote, PRN position...  ...our mission: caring for every...  ...Retirement savings plan with employer...  ...Conduct clinical reviews of patient...  ...Facilitate timely discharges, transfers, and...  ...Registered Nurse (RN) program;...  ...physicians and clinicians caring for diverse... 
    Remote work
    Full time
    Part time
    Relief
    Work at office
    Local area
    Shift work
    Rotating shift
    Day shift

    Trinity Health

    Mishawaka, IN
    2 days ago
  • $26.01 - $56.14 per hour

     ...passionate colleagues who care deeply, innovate with...  ...management (UM) reviews and authorization activities...  ...unrestricted Registered Nurse (RN) license in the state...  ..., case management, discharge planning, managed care, or post...  ...working in a remote environment.EducationAssociate... 
    Remote work
    Hourly pay
    Full time
    Local area

    Oak St. Health

    Baton Rouge, LA
    5 days ago
  •  ...Overview Clinical Review Nurse - Concurrent Review TX Location: 100% Remote - TX: RN only with TX license SHIFT...  ...reviewing the type of care being delivered, evaluating...  ..., and contributing to discharge planning according to care...  ...Years of experience: UM experience preferred but... 
    Remote work
    Contract work
    Shift work

    Executive Staff Recruiters / ESR Healthcare

    Austin, TX
    13 hours ago
  •  ...Concurrent Review RN Immediate need for a talented Concurrent...  ...and is located in US (Remote). Please review the job...  ..., vision), 401(k) plan, and paid sick leave (...  ...the appropriateness of care and setting for members...  ..., length of stay, and discharge planning. Collaborate... 
    Remote work
    Contract work
    Immediate start

    Pyramid Consulting

    Atlanta, GA
    23 hours ago
  • $27.02 - $48.55 per hour

     ...Performs a clinical review and assesses care related to mental health...  ...needs, and discharge planning Analyzes BH member...  ...for behavioral health clinicians required. Clinical knowledge...  ...(LMHP) required or RN - Registered Nurse -...  ...to work with remote, hybrid, field or office... 
    Remote work
    Hourly pay
    Full time
    Part time
    Work at office
    Flexible hours

    Centene Management Company LLC

    Louisiana, MO
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN Care Review Clinician - UM/Discharge Planning. Be the first to apply!