Remote Inpatient Utilization Review Nurse
Centene Management Company LLC
Centene Management Company LLC is seeking a qualified nurse reviewer to conduct concurrent inpatient and pediatric/adult case reviews to validate medical necessity and appropriate level of care. The position involves documenting findings, coordinating discharge plans, and collaborating with medical leadership to ensure high-quality care for Medicaid members. Responsibilities include educating providers on utilization processes, sharing feedback with leadership for process improvements, and #J-18808-Ljbffr
$65k - $78k
...development. Your Role In Our Mission Review admissions, procedures, services, and... ...systems. Assist in training new nurses, provide feedback, and stay updated on clinical... ...~ Active RN license. ~3+ years of inpatient clinical experience. ~1+ year in prior...Remote workFull timeWork at officeWork from homeFlexible hours- TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective... ...services. Responsibilities include preauthorization, inpatient and continued stay reviews, and presenting complex cases...Remote job
- ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization... ...Perform utilization and concurrent reviews of inpatient cases using Milliman, Aetna, and BCBS criteria. Conduct...Remote workFull timeTemporary workSummer workWork at officeFlexible hours
- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness... ...an active Maine RN license and at least 3 years of inpatient clinical experience. Additional benefits include...Remote workFlexible hours
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization... ...MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient List). They effectively and efficiently manage a...Remote workFull time
$17.83 - $23.55 per hour
...- EH Duluth Department: 2813340 INPATIENT REHAB - IRF Job Description: Become... ...! We are looking for a Compassionate Nursing Assistant to join our Inpatient Rehab Unit... .... FTE: 0.7 Possible Remote/Hybrid Option: Shift Rotation: FTE...Remote workPermanent employmentLocal areaWork from homeFlexible hoursShift workNight shiftRotating shiftWeekend work- Currently seeking a Utilization Management RN . Please see... ...below: Position is remote - candidate must reside... ...PA license or a Nurse Licensure Compact to include... ...medical record review to determine medical necessity... ...medical necessity for inpatient admissions, continued...Remote workImmediate startDay shift
$1,966 per week
...the first 25 applicants Nurses - are you looking for... ...Work-life balance. Remote/hybrid setting (once trained... ...This individual will utilize clinical knowledge and... ...treatment or inpatient confinement. This individual... ...decision to a second level reviewer. This individual...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours$45 - $50 per hour
Join Our Team as a Utilization Management RN - Make an Impact... ...dedicated Registered Nurse passionate about... ...outcomes. Whether working remotely or in a flexible... ...ll play a key role in reviewing authorization requests... ...commercial products. Assess inpatient, outpatient, and post-...Remote workHourly payWork at officeFlexible hours- ...Management Location: 100% Remote Schedule: M-F 9:00am to... ...Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management... ...IL State Registered Nursing (RN) license in good...Remote workContract work
$55 per hour
...Akkodis is hiring a Concurrent Review Nurse to support our client in the... ...Healthcare space. Location: Remote (must be based in California... ...concurrent reviews of inpatient activities. This role is responsible... ...in case management, utilization management, or discharge planning...Remote workFull timeContract workTemporary workLocal area- ...189 About the unit We are a 64 bed Inpatient Rehab Unit that sees a variety of patients... ...hours of therapy across the 7-day week. Nursing continues the interventions practiced by... ...observation, either in person or via remote video monitoring, to maximize his/her safety...Remote workPart timeShift workNight shiftWeekend work
- ...private employer of Registered Nurses, we’re honored by the trust... ...Hospital offers a full range of inpatient and outpatient medical and... ...Grande Valley with our three remote ERs in McAllen/Mission, Edinburg... ...Talent Acquisition team is reviewing applications for our...Remote workTemporary workReliefLocal areaFlexible hoursShift work
$110k - $150k
...Inpatient Hospital Medicine Full-time inpatient position Rotating... ...from the medical record, reviews outside medical records, communicates... ...Physician Assistant or Nurse Practitioner program required... ..., regional office and remote employees. Health Savings Accounts...Remote workFull timePart timeWork experience placementWork at officeLocal areaNight shiftRotating shiftDay shift- ...developing, dynamic and collaborative Inpatient Transplant Nephrology team... ...pancreas transplant. As a Nurse Practitioner (NP) or... ...the early post-operative and remote post-transplant phase. Provide... ...The complete interview will be reviewed by a Mayo Clinic staff member...Remote workFull timeFlexible hoursNight shiftRotating shiftWeekend workDay shift
- ...Remote role but will need to go to Newark, NJ to pick up equipment and orientation one day... ...Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess... .... 2. Requires License Practical Nurse License or an active New Jersey Registered...Remote work
$55 - $65 per hour
Gridnaut Recruiting is hiring a remote Pediatric Inpatient Nurses (RN) contractor (pay $55-$65/hr). Contribute to frontier AI research and evaluation work. Ideal candidates: Remote contractor engagement supporting a leading AI lab.; Remote AI evaluation / expert contributor...Remote workHourly payTemporary workFor contractorsFlexible hours- Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with...Remote job
- .... Reports to the Health Plan Manager of Utilization Management. This position will be an integral... .../or Licensure: 1. Current Registered Nurse license issued by the state in which... ...the build and implements care management review processes (Prior Authorization,...Remote workCasual workWork at officeShift work
$55 - $65 per hour
...Apply your pediatric inpatient bedside expertise to help... ...translate real-world nursing documentation... ...Key Responsibilities Review and assess AI-generated... ...improvement chart review, utilization review, clinical documentation... .... Work Terms ~ Remote, hourly engagement....Remote workHourly pay- ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization review activities, ensuring appropriate... ...with regulatory requirements while working remotely. Key responsibilities: Conduct medical...Remote workFull time
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
- ...Summary Performs medical record review for severity of illness and... ...and Training: Nurse, Registered (RN) licensure... ...preferred. 2-5 years previous Utilization Review experience preferred.... ...Details: Days, Primarily remote; onsite orientation requirement...Remote workShift workWeekend 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
- ...Apply Refer a Friend Back Remote Work from Home Share This Page... ..., Hanover, MD 21076 Category: Nursing Schedule: Day Shift Employment Type... ...hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time$59.04 - $83.59 per hour
...range of professionals, including doctors, nurses, business people, tech experts,... ...designated patient population in the ambulatory, inpatient, operative, and/or procedural setting.... ...cardiac surgery or related specialty. Remote Type: Onsite Work Location: 75 Francis...Remote workHourly payDaily paidShift workRotating shift$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...Remote workContract workImmediate startMonday to Friday$40 per hour
...Managed Care Industry Registered Nurse (RN) $40/hour - Contract... ...reside in TX Full time remote Candidates must be based in TX... ...performing initial, concurrent review activities; discharge care... ...Provides information regarding utilization management requirements and operational...Remote workFull timeContract workWork at office$37.45 - $57.29 per hour
...Description: The Registered Nurse (RN) is a professional caregiver... ...of patients. The staff RN utilizes the nursing process by use of... ...response to interventions through review of achievement of goals, clinical... .... If applying for a remote or hybrid role, this includes...Remote workHourly payFull time
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