Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Inpatient Utilization Nurse (LVN/LPN)

Alignment Health

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will assist patients through the continuum of care in collaboration with the patient’s PCP, facility case manager, discharge planner and contracted providers to ensure appropriate, cost-effective care.

Responsibilities include reviewing inpatients, generating referrals, conducting follow-up reviews, and documenting in EZ-Cap/case management databases.

#J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Inpatient Utilization Nurse (LVN/LPN) in United States vacancy
  • $65k - $85k

     ...All Jobs Licensed Vocational Nurse (LVN) - Utilization Management & Inpatient Case Management Licensed Vocational Nurse (LVN) - Utilization Management & Inpatient Case Management Fully Remote Remote Worker - N/A Full-time Description Position Summary The Licensed Vocational... 
    Remote work
    Full time
    Work at office

    Blue Zones Health

    New York, NY
    11 hours ago
  • Alignment Health is seeking an experienced inpatient review nurse to join the remote utilization management team. You will review inpatients with complex medical...  ...with Milliman Care Guidelines experience and an active LVN license. #J-18808-Ljbffr Alignment Health
    Remote job

    Alignment Health

    Phoenix, AZ
    3 days ago
  •  ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through...  ...- Friday, 8:00 AM - 5:00 PM Pacific Time. Requires LVN or RN license (CA or willing to obtain in other... 
    Remote work
    Monday to Friday

    Alignment Health

    United States
    3 days ago
  • $77.91k - $116.86k

     ...saving them. Together.Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will...  ...have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact)Immediately... 
    Remote work
    Immediate start
    Monday to Friday

    Alignment Health

    Clifton, TX
    2 days ago
  •  ...accurate care decisions, the full-time Utilization Review Nurse LVN/LPN will perform clinical reviews for...  ...guidelines and maintaining compliance in a remote work environment. Key...  ...settings, including outpatient and inpatient requests Document decisions and escalate... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    3 days ago
  •  ...timely and accurate benefit determinations, the full-time LVN Utilization Review Nurse will conduct first-level clinical reviews of treatment...  ...level review for outpatient pre-certification requests and inpatient hospital stays to assess medical necessity Process appeals... 
    Remote work
    Full time
    Work at office
    Monday to Friday

    Virtual Vocations Inc

    United States
    5 days ago
  •  ...Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance, auditing DRG classifications... 
    Remote work
    Contract work

    Amerit Consulting

    United States
    12 hours ago
  •  ...Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a...  ...LPN/LVN licensure, 3+ years nursing in acute/outpatient settings, and...  ...UM experience in managed care. Remote opportunities are available. #J... 
    Remote work

    Integra Partners

    United States
    4 days ago
  •  ...Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a NCQA-...  ...as LPN/LVN, at least 3 years nursing experience, and 2+ years UM experience in managed care. Remote opportunities are available. #J-... 
    Remote work

    Integra Partners

    United States
    4 days ago
  •  ...Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a...  ...and has at least 3 years of nursing experience, with 2 years in UM within...  ...managed care. Colorado-based remote-friendly position with comprehensive... 
    Remote work

    Integra Partners

    United States
    3 days ago
  •  ...Integra Partners seeks a licensed LPN/LVN with managed care UM...  ...pre-service and post-service utilization reviews and appeals. You will...  ...program. The role requires active nursing licensure, 3+ years of nursing, and 2+ years in UM. Remote opportunities are available across... 
    Remote work

    Integra Partners

    New York, NY
    11 hours ago
  •  ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS...  ...compliant UM program. The UM Nurse will collaborate with our...  ...authorization and denial letter processes. Remote opportunities may be available... 
    Remote work

    Integra Partners

    United States
    2 days ago
  •  ...Integra is looking for a LPN/LVN experienced in the managed care...  ...pre-service and post-service utilization reviews and appeals for DMEPOS...  ...compliant UM program. The UM Nurse’s responsibilities include...  ...Health and wellness programs ~ Remote Opportunities Founded in... 
    Remote work
    Temporary work
    Local area

    Integra Partners

    Clifton, TX
    2 days ago
  • Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatients and collaborate with physicians...  ...care level. Qualified candidates will hold an active LVN or RN license, have at least 3 years in case management... 
    Remote job

    Alignment Health

    Raleigh, NC
    3 days ago
  •  ...Integra Partners is seeking a licensed practical nurse (LPN/LVN) experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. The role collaborates with the Medical Director on benefit and medical... 
    Remote work

    Integra Partners

    Brooklyn, NY
    3 days ago
  • Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will guide patients through the continuum of care, coordinating with physicians, case managers and service providers to ensure safe, cost-effective care aligned with... 
    Remote job

    Alignment Health

    Austin, TX
    3 days ago
  •  ...Integra Partners is seeking an LPN/LVN with managed care UM experience to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate...  ...hold an active LVN license, at least 3 years nursing experience, and 2 years UM experience in a... 
    Remote work

    Integra Partners

    Las Vegas, NV
    3 days ago
  •  ...Partners is seeking a licensed practical/vocational nurse to perform pre-service and post-service utilization management reviews, applying federal/state mandates...  ...with NCQA, CMS and state standards, and offers remote opportunities along with competitive compensation... 
    Remote work

    Integra Partners

    Columbia, SC
    3 days ago
  •  ...Integra Partners seeks a licensed practical nurse (LPN/LVN) with managed care experience to conduct pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director to review benefits and medical necessity within... 
    Remote work

    Integra Partners

    Yuma, AZ
    3 days ago
  • Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This role collaborates...  ...an NCQA-compliant UM program. The UM Nurse’s responsibilities include pre-service... 
    Remote job

    Integra Partners

    Tallahassee, FL
    4 days ago
  •  ...CVS Health is seeking an experienced radi-? nurse for a 100% remote Concurrent Review RN position. The role supports inpatient reviews, discharge planning, and care transitions across the continuum. Required is an active Louisiana RN license (or Compact), with 5+ years... 
    Remote work
    Weekend work

    4004 Aetna Medicaid Administrators

    United States
    2 days ago
  •  ...CVS Health is seeking a Nurse Consultant for a remote role focused on inpatient clinical reviews. The position emphasizes collaboration with hospitals and care teams to ensure appropriate levels of care and efficient discharge planning from a non-bedside capacity. Ideal... 
    Remote work

    CVS Health

    United States
    10 hours ago
  •  ...Integra Partners seeks an experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program, collaborating...  ...approvals, referrals, and handling appeals. Remote opportunities available and strong team culture.... 
    Remote work

    Integra Partners

    United States
    10 hours ago
  •  ...Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our...  .... Requires an active LPN/LVN license, 3+ years nursing experience, and 2+ years UM experience in a managed... 
    Remote work

    Integra Partners

    United States
    13 hours ago
  • CVS Health Corporation is seeking a Concurrent Review Nurse (RN) for a 100% remote role. The position involves reviewing inpatient stays, collaborating with care teams, and ensuring appropriate care levels in a remote setting. Requires 5+ years inpatient nursing, strong... 
    Remote job

    CVS Health Corporation

    Austin, TX
    1 day ago
  •  ...Integra Partners is seeking an LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director to review benefit and medical necessity within an... 
    Remote work

    Integra Partners

    United States
    11 hours ago
  •  ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program. You will collaborate with our Medical Director to assess benefits and medical necessity for DMEPOS under federal... 
    Remote work

    Integra Partners

    United States
    4 days ago
  •  ...Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS in a managed care environment....  ...requires active LPN/LVN licensure, at least 3 years of nursing in acute or outpatient care, and 2+ years UM... 
    Remote work

    Integra Partners

    United States
    2 days ago
  •  ...Integra Partners is seeking a Licensed Practical Nurse (LPN/LVN) with experience in managed care payor environments to perform pre-service and post-service utilization reviews and appeals for DMEPOS. The role collaborates with our Medical Director on benefit and medical... 
    Remote work

    Integra Partners

    New York, NY
    8 hours ago
  •  ...Integra Partners Holdings, Inc. is seeking a full-time remote LPN Utilization Management Nurse to perform pre-service and post-service utilization reviews for DMEPOS, ensuring NCQA standards and medical necessity criteria. The role collaborates with the Medical Director... 
    Remote work
    Full time

    Integra Partners Holdings, Inc.

    United States
    12 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Inpatient Utilization Nurse (LVN/LPN). Be the first to apply!