Remote RN: Utilization Management & Appeals
Ishe
Optum is a global organization dedicated to improving health outcomes through care and technology. The Utilization Management Nurse will extract details from patient records and craft persuasive appeal letters per guidelines, within required timeframes. The role offers Monday–Friday, 40 hours weekly, with flexible start times and telecommuting from anywhere in the U.S. Compliance and collaboration across teams are emphasized. #J-18808-Ljbffr
Vacancy posted 7 hours ago
Similar jobs that could be interesting for youBased on the Remote RN: Utilization Management & Appeals in Brooklyn, NY vacancy
$60.2k - $107.4k
...services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company policies. The role offers a...Remote workFull timeMonday to FridayNHSHP
Brooklyn, NY1 day ago- ...UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements... ...and a competitive benefits package. Requires RN license, associate degree, and 3+ years...Remote workMonday to Friday
Anacalifornia
Brooklyn, NY1 day ago - ...Seeking a full-time remote Utilization Management RN, the successful candidate will manage medical record reviews and denial documentation, develop clinical appeal letters, and utilize clinical judgment to support healthcare provider clients. Key Responsibilities Perform...Remote workFull time
Virtual Vocations Inc
United States19 hours ago - ...currently seeking an experienced: UTILIZATION MANAGEMENT RN JOB SUMMARY: Day-to-day management... ...reimbursement and claim denials/appeals. Use critical thinking and problem-... ...Clearly communicates instructions to remote users. Visit for more information...Remote workWork at office
LibertyHealth System
Wilmington, NC3 days ago - Optum is seeking an Utilization Management & Clinical Validation RN to review medical records and extract key details for strong appeal letters. You will use ICD coding and evidence-based references to support decisions while adhering to HIPAA and policy guidelines. The...Remote job
$81.59 - $108.12 per hour
...varied workdays and times. This is a remote Stanford Health Care job. A Brief Overview The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the... ...healthcare costs. 4. Denials and Appeals Management: Address and manage...Remote workHourly payWork experience placementShift workStanford Health Care
United States3 days ago$63.1k - $94.65k
...-enabled revenue cycle management solutions for health systems... ...have current compact RN license, or be willing... ...Information: Our Utilization Review team provides... ...documentation relevant to the appeal process. Maintains... ...: This is a remote role which requires access...Remote workTemporary workWork at officeLocal areaFlexible hoursShift workEnsemble Health Partners
United States1 day ago$60.2k - $107.4k
...by technology to help millions live healthier lives. The Utilization Management & Clinical Validation RN role involves reviewing medical records, extracting pertinent details, and crafting evidence-based appeal letters per guidelines. You will enjoy telecommuting from...Remote jobFull time- ...(Community) is a non-profit managed care organization (MCO), licensed... ...: Behavioral Health Utilization Manager will perform concurrent... ..., adhering to BH UM and Appeals policies and procedures. Meets... ...telephone systems Work Schedule: Remote Other Requirements:...Remote workContract workWork experience placement
Harris Health System
Houston, TX4 days ago - ...Find your calling at Mercy! Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial...Remote workRelief
Mercy
Chesterfield, MO5 hours ago $75.3k - $135.4k
...you are willing to obtain an RN license for the state of... ...Supervises day-to-day activities of utilization management team. Monitors and tracks... .... Strong knowledge of appeals and utilization management principles... ...clearance required NOTE: REMOTE RN candidates may reside in...Remote workFull timePart timeWork experience placementWork at officeFlexible hours$2,150 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Remote Case Manager, Utilization Review for a travel nursing job in Boston, Massachusetts. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 10/15/2026 ~ Duration...Remote workTemporary workFor contractorsZero hours contractMonday to FridayShift work- ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...5 pm with one hour for lunch This is an in-office, no remote work capability position Travel ~ Some travel may be...Remote workWork at office
MedTrust LLC
Oklahoma City, OK15 days ago - ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
The Judge Group
Chicago, IL1 day ago - ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document... ..., and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings...Remote work
Guidehealth
Gary, IN4 days ago - ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
The Judge Group
United States2 days ago - ...Plan in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity,... ...discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual...Remote workFull time
Well Sense Health Plan
United States4 days ago $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 workkozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ3 days ago- ...NeueHealth seeks a full-time Utilization Management (UM) Prior Authorization (PA) Nurse in California. You will review and authorize prior authorizations... ...and cost-effective outcomes. Requirements include California RN license, 2–3 years of clinical nursing with at least 1 year...Remote workFull timeContract work
Neuehealth
Los Angeles, CA3 days ago - ...UnitedHealth Group is seeking a Utilization Management Nurse to review medical records and craft defensible appeal letters. The role supports telecommuting from anywhere in the U.S. and requires a state RN license, 3+ years bedside nursing, and strong data extraction skills...Remote work
University of Minnesota School of Nursing
Brooklyn, NY1 day ago - ...service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and... ...resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license... ...clinical practice and knowledge of Utilization Review Guidelines. The...Remote work
Healthfirst
New York, NY1 day ago $70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States2 days ago- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services... ..., reimbursement and claim denials/appeals.• Assesses and coordinates... ...Required Skills/Experience: Licensed RN (multistate or TX RN), 2 years acute...Remote work
3B Healthcare, Inc.
Austin, TX4 days ago - ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN performs telephonic review of hospital admissions and recommends alternative levels of care when appropriate. This role...Remote workPart timeMonday to Friday
The Judge Group
Philadelphia, PA4 days ago - ...Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members...Remote work
CommunityCare
United States2 days ago - ...To support a centralized Utilization Management department, the full-time Utilization Review Nurse... ...regulatory requirements while working remotely. Key responsibilities: Conduct medical... ...preferred Previous Utilization Management, Appeals, or Denials Management experience is...Remote workFull time
Virtual Vocations Inc
United States2 days ago - ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/...Remote workContract workTemporary workMonday to FridayShift work
InterSources
United States4 days ago - A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
$45 - $50 per hour
...organization in healthcare insurance, is seeking experienced Utilization Management RNs to play a vital role in reviewing prior authorization... ...an excellent opportunity to make an impact within a dynamic, remote environment where your expertise will support improved patient...Remote workContract workWork at officeThe Hollister Group LLC
Somerville, MA1 day ago- Centene Corporation is seeking a senior utilization management supervisor to oversee Prior Authorization, Concurrent Review... ...Retrospective Review teams. The role requires RN licensure with CA license consideration, and remote work options are available for candidates...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Utilization Management & Appeals. Be the first to apply!
