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
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$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$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 officeLocal areaWork from homeHome officeMonday to FridayShift 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- ...Utilization Management Nurse 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 office...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- 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
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,60... ...Friday, 0730–1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications U.S. Citizenship (required...Remote workContract workImmediate startMonday 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
$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$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$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 jobWeekend work- 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 jobFull time
- ...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
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and compliance. You will support OPAS and enterprise goals while collaborating across teams to deliver high-quality reviews. Requirements...Remote jobWork at officeFlexible hours
- 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
- 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
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$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- CVS Health is seeking a Utilization Management (UM) Nurse Consultant to join our team. This is a 100% remote, full‑time role available to MST/PST residents. You will apply clinical expertise to review medical necessity, coordinate care, document outcomes, and ensure members...Remote jobFull time
- We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’ll... ...regulations (LCD/NCD policies) . This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
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- ...Remote in California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate... ...BE RESPONSIBLE FOR Reporting to the Utilization Management Supervisor, this position: Ensures... ...Desirable Qualifications Bachelor’s degree in Nursing Working knowledge of managed care, the...Remote workFull timeTemporary workPart timeLive inWork at officeLocal area
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