Remote Utilization Review Nurse - Case Management Pro
HealthEdge
- Remote job
HealthEdge is seeking a highly motivated Utilization Review RN to join our team. The role involves prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service, and level of care, including handling appeals. The position is remote in the US and is a contract role. Responsibilities include reviewing requests, coordinating discharge planning, analyzing care patterns, #J-18808-Ljbffr HealthEdge
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will collaborate with the patient’s physician, facility case manager, discharge planner and contracted providers to ensure appropriate, cost-effective care at the...Remote work
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...review or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J...Remote workContract work
$89.54k - $136.47k
...Overview Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must reside in the... ...Description As an integrated care manager, specializing in Utilization review... ...in acute care (required) ~3 years Case Management experience (preferred)...Remote workFull timeTemporary workShift work- A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This... ...Arizona and substantial experience in utilization review or case management. Strong communication skills and flexibility are...Remote workContract work
- ...Currently seeking a Utilization Management RN . Please see details... ...below: Position is remote - candidate must... ...active PA license or a Nurse Licensure Compact to include... ...medical record review to determine medical necessity... ...when needed. Refer cases that do not meet...Remote workImmediate startDay shift
$1,966 per week
...first 25 applicants Nurses – are you looking... ...leader in personalized managed health care,... ...Work-life balance. Remote/hybrid setting (once... ...This individual will utilize clinical knowledge... ...to a second level reviewer. This individual interfaces with case managers and disease...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours$35 - $45 per hour
...from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating... ...with Medicare guidelines. Refer cases outside established guidelines to the... ...communication with payer plan case managers, patients, and provider teams....Remote workContract workWeekend work$77.08k - $119.47k
...Department/Unit: Care Management/Social Work Work... ...0 Responsible for Utilization Management,... ...Characteristics Registered nurse with a New York... ...experience in case management, utilization... ...to utilization review process. Excellent... ...cannot be done from a remote location. Other...Remote workShift work$89.54k - $136.47k
...Remote Utilization Review Registered Nurse Sentara Health is hiring a Remote Utilization Review Registered Nurse... ...Virginia. As an integrated care manager, specializing in Utilization review... ...acute care (required) ~3 years Case Management experience (preferred)...Remote workFull timeShift work- ...Job DescriptionJob Description Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 5 Years Job Summary We are... ..., collaborate with healthcare providers and case management teams, and support high-quality, cost-effective patient...Remote workFull timeSecond jobWork at office
- ...facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving... ...Program JOB SUMMARY: The Utilization Review Nurse is to assess the medical... ...clinical data provided Certify cases that meet clinical review...Remote workFull timeTemporary workLocal area
$41 - $45.5 per hour
...Direct Government Clients Role: Nurse Case Management Senior Analyst Location: Remote (within plan states: IL, TX, NM,... ..., health education, and utilization management. Key Responsibilities... ..., concurrent, and retrospective reviews for inpatient, rehab, referrals,...Remote work- # Utilization Review NurseFully Remote • Involuntary Remote - ALL STATES - Remote All States, CA 90802## OverviewSalary... ...Utilization Review Nurse**Please make sure to complete all the... ...process, identify patients with ongoing case management needs and refer these claimants to...Remote workLong distance
$55 per hour
...Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location: Remote (must be based in California)... ...setting. Preferred: Experience in case management, utilization management, or discharge planning. Experience...Remote workFull timeContract workTemporary workLocal area$63k - $73k
...limit to what you can achieve. Utilization Review Nurse (RN) As a nurse at Sedgwick... ...to assist in the management of complex medical conditions... ...well-being of others in a remote work environment. Enjoy flexibility... .... Certification in case management, pharmacy, rehabilitation...Remote workWork experience placementLocal areaFlexible hours- ...Utilization Review NurseThis position has a remote option for those living close and will be able to... ...needed.The Utilization Review Nurse is responsible for... ...effectively and efficiently manage a diverse workload in a fast... ....Identify and present cases of possible quality of care...Remote workFull time
- ...Reports to the Health Plan Manager of Utilization Management. This position will... ...: 1. Current Registered Nurse license issued by the state... ...implements care management review processes (Prior Authorization... ...enhanced by coaching and/or case management interventions....Remote workCasual workWork at officeShift work
$82k - $88k
...Utilization Review Nurse Fully Remote • Involuntary Remote - ALL STATES - Remote All States, CA 90802 Salary Range $82,000.00 - $88,000.00 Salary... ...planning process, identify patients with ongoing case management needs and refer these claimants to the Case Management...Remote workFull timeShift work$38 - $40 per hour
...Title: RN -- Review Analyst Location: Remote Duration: 12 months with possible... ..., and retrospective utilization reviews for inpatient,... ...includes Utilization Management (UM) , Case Management , discharge... ...- Bachelor's degree in Nursing or a related field preferred...Remote workHourly payWork at officeMonday to FridayShift work$95k - $107.5k
...Full-time Description Title: Nurse Reviewer, Utilization Management Job Type: Full-time Location:... ...week in Brighton, MA office; 1 day remote FLSA Status: Exempt About Us... ...providers and internal teams, and escalates cases requiring physician-level judgment...Remote workFull timeLocal area- All Jobs > Utilization Review Nurse (PRN/Evening Shift) Fully Remote FL Part-time Description The Utilization Review (UR) Nurse is responsible for conducting... ...UR Nurse works collaboratively with physicians, case managers, revenue cycle staff, and interdisciplinary care...Remote workDaily paidPart timeReliefWork at officeShift workWeekend workAfternoon shift
$33 - $46 per hour
...Utilization Review Nurse Auditor Fully Remote Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position... ...Provide insight and direction to management on any compliance concerns regarding... ...reviews, Medicare compliance, case management, record retrieval, document...Remote workHourly payFull timeLocal areaMonday to Friday- ...global, innovative Total Talent management firm dedicated to... ...Field work contract role for a Utilization Review Nurse. The Utilization Review Nurse... .../Prior Authorization/Case Review Nurses with active... ...to work independently and remotely Experience in a healthcare...Remote workContract work
$89.54k - $136.47k
Work Shift Sentara Health is hiring a Remote Utilization Review Registered Nurse. As an integrated care manager, specializing in Utilization review, the registered nurse... ...experience in acute care (required) · 3 years Case Management experience (preferred) · Proficient...Remote workFull timeTemporary workShift work- ...Full Time, Days, Not a Remote position. Hours: 8:30-5:30,... ...At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed... ...position collaborates with case management in the development and implementation... ...ESSENTIAL FUNCTIONS Pro-actively participates as a...Permanent employmentFull timeWork experience placementWork at officeLocal areaMonday to FridayShift work
- ...Astrana Health is seeking a CA-licensed Utilization Review Nurse to support our Health Services... ...applying clinical judgement. This is a remote position for CA-licensed nurses with... ...least one year of outpatient utilization management experience in a fast-paced setting...Remote workShift work
- ...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
- Acentra Health is seeking a Nurse Case Manager to join our growing team. The Nurse Case Manager will evaluate beneficiaries' needs, develop individualized... ...outcomes while adhering to payer requirements. Position is remote, but candidates must reside in California, preferably in the...Remote job
- ...seeking an experienced RN for Utilization Review to assess medical necessity and... ...and patient care. This remote role involves coordinating with the FCC, care management, and interdisciplinary teams to... ...appropriate level of care across cases.The candidate should hold an active...Remote work
- ...The Registered Nurse, Utilization Review is a U.S.-licensed clinician who performs utilization management and review for a Michigan health plan client under our client's domestic... .... The role requires working knowledge of case management practice. May also support care...Work from home
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