Remote Utilization Management Nurse
Santa Barbara Cottage Hospital
- Remote job
Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments to support timely, compliant decisions. The role requires reviewing both inpatient and outpatient services, familiarity with URAC and NCQA guidelines, and the ability to work independently in a fast-paced managed care environment. #J-18808-Ljbffr Santa Barbara Cottage Hospital
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports utilization management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities...Remote workWork from home
- ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
- ...Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments...Remote workWork from home
- ...Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote work
- ...Alliance for Health in California is seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior authorizations comply with... ...paths may substitute for experience. Hybrid work and remote- interview options are offered. #J-18808-Ljbffr...Remote workTemporary work
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical... .... This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-LjbffrRemote work
- ...Oak Street Health is hiring a Full-Time Utilization Management Physician Reviewer to provision accurate coverage determinations for inpatient... ...experience, and familiarity with managed care principles, with a remote work option and a competitive pay range. #J-18808-Ljbffr...Remote workFull time
- ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer to provide timely coverage decisions for inpatient and outpatient... ...maintaining patient-centered care. The position offers a remote work setup, competitive benefits, and opportunities to...Remote workFull time
- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within...Remote workFull time
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services... ...Medicare/Medicaid, strong communication, and US work authorization. Anticipated 40-hour weeks; remote work option. #J-18808-Ljbffr...Remote workFull time
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate...Remote jobFull timeWork from home
- A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote work
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation... ...PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving candidates in the EST or CST zones. You will coordinate, document, and communicate utilization and benefit management activities to ensure appropriate...Remote workFull time
- ...Utilization Management CNADubuque, Iowa, United StatesUtilization Management AssistantLocation: Onsite in Dubuque, IA. Also accepting remote applicants.Are you passionate about patient care and thrive... ...determine if a Utilization Review Nurse is needed to complete the call...Remote workWork at office
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ..., 0730-1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~ U.S. Citizenship...Remote workContract workImmediate startMonday to Friday- ...Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients, and prefers working in a professional...Remote workFull timeWork at office
$70k - $75k
...analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build... ...Job Description The Utilization Management Registered Nurseis responsible... ...education consistent with current nursing practice standards and the...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$26.01 - $56.14 per hour
...Position Summary Utilization management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Utilizes... ...Required Qualifications 2+ years of experience as a registered nurse in adult acute care/critical care setting. Must have active...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift- ...Utilization Management Specialist Shift: Monday through Friday 8:00 AM to 4:30 PM, with every fifth... ...~ Must be computer literate and have remote working experience. Compliance... ...City Fort Myers State FL TLC Nursing Associates, Inc. is an equal-opportunity...Remote workContract workWork experience placementLocal areaMonday to FridayShift workWeekend 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... .... Schedule and Work Model ~ Remote / Work from Home. ~32 hours per week...Remote workWork from homeShift work- UnitedHealth Group's Optum is seeking a Utilization Management Nurse to review patient records and craft defensible appeal letters in accordance with OPAS guidelines. This role supports 40 hours per week, Monday-Friday, with telecommuting flexibility across the U.S. and...Remote jobMonday to Friday
- Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective... ...with CMS, URAC, and other regulators. This fully remote role requires a US-based location, strong nursing background...Remote job
$42 per hour
IntusCare is seeking a Contract Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. The... ...transitions across care settings. The position is fully remote within the United States and offers a 1-year contract with...Remote jobHourly payContract work- Harris Health System, Inc. is seeking a Utilization Management Review Nurse to evaluate medical necessity, appropriateness, and efficiency of services, ensuring care aligns with evidence-based guidelines. The role involves partnering with Care Management, Physician Advisors...Remote jobFlexible hours
$54.1k - $142.58k
...Behavioral Health Utilization Management ClinicianWe're building a world of health around every individual... ...professional looking for a rewarding remote role that combines clinical expertise,... ..., Counseling, or PsychologyRegistered Nurses: Bachelor's degree in Nursing with an...Remote workHourly payFull timeShift workNight shiftWeekend work- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications...Remote jobWork at office
$32.01 - $68.55 per hour
..., each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...Remote workHourly payFull timeLocal area10 hours per weekFlexible hours$26.01 - $62.32 per hour
...bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work
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