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$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 jobHourly payFull timeWork experience placementWork at office$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 workHourly payWork experience placementWork at office- ...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 workMonday to Friday
$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 workContract workWork at officeLocal areaMonday to Friday$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 workHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home- ...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
- ...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 workFull timeWork experience placementWork at officeWorldwideMonday to FridayShift work
- ...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 workContract workMonday to FridayFlexible hours
$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 workWeekly payLocal areaShift work$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 workHourly payMinimum wageFull timeContract workWork experience placementWork at officeLocal areaShift work- ...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 workContract work
- ...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 workContract workWork from homeShift work
- ...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 workFull timeMonday to Friday
- ...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 workFlexible hoursShift work
- ...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 workContract work
- ...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 workPart timeRelief
- ...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
- ...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
$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 workTemporary workWork at officeLocal area$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 workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$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 workFull timeMonday to Friday- ...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 workWeekly payContract workLocal areaShift workDay shiftWeekday work
- ...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 workWork at officeImmediate start
$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 workWork experience placementMonday to Friday- ...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 workFull timeImmediate startShift work
- ...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 workFull timePart timeReliefWork at officeLocal areaShift workRotating shiftDay shift
$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 workHourly payFull timeLocal area- ...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 workContract workShift work
- ...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 workContract workImmediate start
$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 workHourly payFull timePart timeWork at officeFlexible hours
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