Remote Inpatient Utilization Review Nurse
Well Sense Health Plan
WellSense Health Plan is seeking an Inpatient Utilization Management Clinician for a fully remote role in the United States. You will evaluate inpatient medical necessity, monitor treatment, and coordinate discharge planning with care management and medical directors to drive optimal outcomes. Qualifications include an active RN license, nursing degree, and 2 years of utilization review experience with InterQual. #J-18808-Ljbffr
Vacancy posted 8 hours ago
Similar jobs that could be interesting for youBased on the Remote Inpatient Utilization Review Nurse in Charlestown, NH vacancy
$41 - $45.5 per hour
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Wausau, WI5 days ago$78k - $88k
...Gainwell Technologies is seeking a skilled Utilization Review Nurse to perform prior authorization across prospective, concurrent, and retrospective... ...providers, uses InterQual/MCG criteria, requires 3+ years inpatient experience and an active RN license in the U.S. Core hours...Remote workGainwell Technologies
Juneau, AK2 days ago$78k - $88k
...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews... ...required during post-offer background check. 3+ years of inpatient clinical experience. 1+ year in prior authorization reviews...Remote workFull timeContract workWork at officeWork from homeFlexible hoursGainwell Technologies
United States5 days ago$71.61k - $111k
...9.20 Responsibilities Utilization management and quality... ...requirements through case review and inter‑rater... ...Characteristics Registered nurse with a New York State... .... Understanding of inpatient versus outpatient surgery... ...most of the time, as remote work is not feasible....Remote workShift workAlbany Medical Center
Albany, NY5 days ago$140 - $145 per hour
...Oscar is hiring a Physician Reviewer to join our Utilization Management Team. You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing... ...applying evidence-based guidelines. This remote role is open to candidates in the...Remote workHourly payWeekend workOscar
New York, NY4 days ago$29 - $52 per hour
...UnitedHealth Group's Optum unit is seeking a Utilization Review Nurse, RN to perform inpatient utilization management with evidence-based guidelines and medical... ...to coordinate patient care. The position offers remote work options for those in Pacific or Mountain Time, with...Remote workHourly payWeekend workColorado Psychiatric
Sacramento, CA3 days ago- ...Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization requests. The role requires documentation of clinical... ...criteria, and coordinating with Medical Directors. Remote options are available for eligible candidates. The...Remote work
University of Minnesota School of Nursing
Sacramento, CA3 days ago - ...Management Location: 100% Remote Schedule: M-F 9:00am to 5... ...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
Integrated Resources
Springfield, IL2 days ago $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 hoursHines
Rockford, IL5 days ago- ...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
Cobalt Benefits Group
United States3 days ago - ...UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient... ...Directors for complex cases. The position may offer remote work options and requires working a Monday–Friday schedule...Remote workMonday to FridayWeekend work
UnitedHealth Group
United States1 day ago $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 areaAkkodis
California, MO1 day ago- ...Currently seeking a Utilization Management RN . Please... ...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
The Judge Group, LLC
New York, NY1 day ago - ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail... ...Responsibilities Perform utilization reviews for inpatient, outpatient, observation, and post-acute care...Remote workFull timeSecond jobWork at office
Ova Technologies
Alpharetta, GA3 days ago $40 - $45 per hour
...driven RN or LPN with utilization management experience... ...coverage decisions, this remote opportunity offers the... ...in medical necessity review and behavioral health... ...Do • Review assigned inpatient, outpatient, and other... ...or Compact Multistate Nursing License • Experience...Remote workHourly payTemporary workMonday to FridayManpower Group Inc.
United States4 days ago- ...great opportunity for a local remote position. Schedule PRN (... ...commercial, behavioral health, inpatient, etc). Requirements: ~2 years of staff nurse experience performing care for... ...patients. ~2 years of utilization review (UR) experience reviewing hospital...Remote workReliefLocal areaMonday to FridayFlexible hoursShift work
BJC HealthCare
Saint Louis, MO1 day ago - ...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
kozmetickesluzby.vecnakraska.sk - Jobboard
United States3 days ago - ...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
CHRISTUS Health
Alamogordo, NM3 days ago - ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC7 hours ago - ...who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...company match Employee Referral Bonus Program Job Summary The Utilization Review Nurse is to assess the medical necessity and quality of healthcare...Remote workFull timeTemporary workLocal area
American Health Partners
Franklin, TN5 days ago - ...ASAP - Ongoing Shift Type: Day Shift; Call Assignment Type: Inpatient Call Required: Yes Board Certification Required: Yes... ...0 AM - 3:00 PM, 7:00 AM - 5:00 PM, and 7:00 AM - 7:00 PM, with remote on-call coverage from 7:00 PM - 7:00 AM Monday through Friday....Remote workContract workLocumImmediate startMonday to FridayShift workWeekend workDay shiftWeekday 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
Rio Grande Regional Hospital
Mcallen, TX1 day ago - ...Rehab Unit Inpatient 9S - Royal Oak HospAbout the UnitWe are a 64 bed Inpatient Rehab Unit... ...hours of therapy across the 7-day week. Nursing continues the interventions practiced by... ...constant observation, either in person or via remote video monitoring, to maximize his/her...Remote work
Corewell Health
Royal Oak, MI2 days ago $135.72k - $173.87k
...range of professionals, including doctors, nurses, business people, tech experts,... ...Assistant/Nurse Practitioner is a member of the inpatient General Medical Service team. The PA/NP is... ...better care. Our employees call it home. Remote Type Onsite Work Location 1153...Remote workFull timeShift workDay shift- ...leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the... ...insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and...Remote workFull time
Innovative Systems Group
Richardson, TX4 days ago - ...prescribes appropriate medical therapy utilizing evidenced based practice. Prescribes,... ...procedures within the scope of practice of the nurse practitioner license. Communicates... ...deadlines. This will role support inpatient Palliative Medicine needs. Work is...Full timePart time
Geisinger
Danville, PAmore than 2 months ago - ...Telenett is seeking a Remote Utilization Review Nurse to review medical records from a home office and determine medical necessity and care appropriateness. You will work with providers to develop compliant care plans and ensure high-quality, cost-efficient services for...Remote workHome office
Telenett
Texas City, TX1 day ago - ...Job TitleThis position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness...Remote workContract work
HireOps Staffing LLC
Dallas, TX5 days ago - ...in EPIC and InterQual, with demonstrated experience using both systems for clinical review and medical necessity determination. This position is in person (with possibility to be remote) Monday through Friday with no weekends or holidays. Pre-approved time off per contract...Remote workContract workMonday to FridayDay shift
Windsor Healthcare Recruitment Group
Orange, CA5 days ago - ...CorVel Corporation is seeking a Utilization Review Nurse to gather demographic and clinical information for prospective, concurrent, and retrospective... ...of stay in line with Case Management goals. This is a remote position with responsibilities including data collection,...Remote work
CorVel
Rancho Cucamonga, CA5 days ago
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