Remote Utilization Management RN for Care Alignment
Humana
Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination of medical services and benefit determinations. You will work with a team handling post-acute care services including SNF, home health, and DME, reporting to the Manager of Utilization Management.You will apply clinical criteria to make determinations, complete requests within timeframes, and communicate with providers and members to facilitate care, while aligning with department andJ-18808-Ljbffr
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN for Care Alignment in Kansas City, MO vacancy
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation... ...Management team to manage post-acute care services such as SNF, Home Health and... ..., deliver coordinated services, and align with organizational goals. #J-18808-...Remote workWork from home
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- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday... ..., and Managed Long-Term Care (MLTC). This is a 100% remote... ...appropriate levels of care, and align services with payer...Remote workFull timeMonday to Friday
- ...Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the... ...administrative compliance. Unlike remote roles, this position relies... ...Nurse is a Registered Nurse (RN) responsible for performing... ...necessity or the current level of care.o Medical Provider Liaison:...Remote workFull timeImmediate startShift work
$38.91 - $60.31 per hour
...Colorado For This Fully Remote Position... ...balances quality of care with efficiency, cost... .... Provides case management and/or consultation... ...Registered Nurse (RN). Minimum Experience... ...: 3 years of utilization or case management... ...UCHealth base pay aligns with market standards...Remote workFull timeTemporary workLocal areaFlexible hoursShift work- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination... ...determinations for post-acute care services (SNF, Home Health, DME). You... ...One Home/Home Solutions team. This remote role requires compact RN license in your state, hospital/SNF...Remote workWork from home
- ...Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to support a 24/7 operation. The role requires RN licensure, 3+ years of RN experience, and 1... ...clinical criteria and coordination of care. The position involves collaborating with...Remote workWork from homeFlexible hours
- ...Role: Job Summary The Director of Utilization Management (UM) is responsible for leading and... ...closely with case management, managed care, and patient financial services to streamline... ...UM team, ensuring operational alignment with hospital objectives. Manage departmental...Remote workShift workDay shift
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...Colorado For This Fully Remote Position... ...balances quality of care with efficiency, cost... ...Provides case management and/or consultation... ...Registered Nurse (RN). Minimum Experience... ...Preferred: 3 years of utilization or case management... ...UCHealth base pay aligns with market...Remote workFull timeTemporary workLocal areaFlexible hoursShift work- ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a...Remote workWork from homeWeekend workAfternoon shift
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation... ...using information from physicians and care providers, and communicate with... ...care. The role emphasizes remote work, prior utilization management experience...Remote work
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...Location: California - Ability to work remote, but selected candidate must reside in... ...This position requires California RN Licensure. Candidates must have significant... ...or all of the following functions: utilization management, care management, behavioral health and other...Remote workContract workWork experience placementWork at officeLocal area- ...a health solutions company, seeks an Utilization Management RN to evaluate medical necessity and service... ...our Health Plan. You will authorize care, refer complex cases to medical directors... ...potential growth into CM roles. Remote work is available in Colorado and other...Remote work
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- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation... ...on physician information and other care providers, while communicating with... ...facilitate care.The role requires an RN license in the state of residence, 1+...Remote work
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- ...CVS Health is hiring a Medicare Precertification Utilization Management Nurse Consultant. The role requires nursing... ...involves collaboration with providers to ensure appropriate care and benefits. A BSN is preferred and a valid RN license is required. #J-18808-LjbffrRemote work
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- ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care including SNF, Home Health, and DME. You will work remotely, applying Milliman Care Guidelines or InterQual criteria...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical... ...Solutions Utilization Management team, focusing on post-acute care such as SNF, Home Health and DME.You will use clinical nursing...Remote work
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