Remote Utilization Review Nurse
$90k - $107kyour Jared
Mass General Brigham Health Plan Holding Company, Inc. is seeking a Remote UM Nurse to support network adequacy review and authorization activities for members in ACO, HMO, and EPO products. The role requires clinical knowledge to review prior authorization requests, assess medical necessity, and render decisions within scope. The position offers a competitive salary range of $90,000 to $107,000 annually, with a remote work option and occasional onsite meetings. #J-18808-Ljbffr
Vacancy posted 1 day ago
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Annapolis, MD2 days ago - ...who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...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
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A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams. Applicants...Remote jobFull time- 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 job
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Gainwell Technologies is seeking a skilled Utilization Review Nurse to perform prior authorization across prospective, concurrent, and retrospective reviews for medical necessity, documenting findings and ensuring policy compliance. This home-based role supports providers...Remote job$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. Description Astrana Health is looking for an experienced...Remote jobHourly payMonday to Friday$35 - $45.94 per hour
...Utilization Review Nurse Remote Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the Role You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as...Remote workHourly payWork from homeHome officeWeekend workOscar Health
United States2 days ago- ...Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing Utilization Management team. This fully remote position plays a critical role in ensuring patients receive...Remote jobWork at office
- ...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, TX3 days ago - ...Job Title This 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...Remote workContract work
HireOps Staffing LLC
Dallas, TX4 days ago - ...Management Location: 100% Remote Schedule: M-F 9:00am to 5... ...Summary Works with the Utilization Management team primarily responsible... ...necessity/utilization review and other utilization management... ...IL State Registered Nursing (RN) license in good standing...Remote workContract work
Integrated Resources
Springfield, IL1 day ago - ...first 25 applicants This is full-time remote, but candidates must reside in IL or TX... ...performing accurate and timely medical review of claims suspended for medical necessity... ...and prioritization skills. ~ Registered Nurse (RN) with unrestricted license in state...Remote workFull timeContract work
Innovative Systems Group
Richardson, TX8 hours ago $35 - $43 per hour
...range $35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (California only – must reside in CA or hold an... ...Clinical Review Nurse – Concurrent Review will perform utilization management functions to ensure members receive the...Remote workIMCS Group
New York, NY3 days ago- ...levels possible. Job summary: Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure... ...position with two days per week in the office and three days remote. Candidates must also have flexibility to periodically work...Remote workWork at officeImmediate startFlexible hours2 days per week
Acrisure LLC
Bradenton, FL2 days ago $30.64 - $45.8 per hour
...Utilization Review Nurse The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective... ...of the Case Management department and of CorVel. This is a remote position. Essential Functions & Responsibilities:...Remote workHourly payFull timeWork at officeLocal areaFlexible hoursCorVel
United States2 days ago- ...Currently seeking a Utilization Management RN . Please see details... ...qualifications below: Position is remote - candidate must reside in... ...an active PA license or a Nurse Licensure Compact to include... ...conditions through medical record review to determine medical...Remote workImmediate startDay shift
The Judge Group, LLC
New York, NY1 day ago $35 - $40 per hour
...Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of...Remote workContract workFlexible hoursWeekend workIntePros
Phoenix, AZ8 hours ago$34 - $40 per hour
...recruiter to learn more. Base pay range $34.00/hr - $40.00/hr Remote (Compact Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-...Remote workFull timeMedix
New York, NY2 days ago$30 - $40 per hour
...Job Title: RN Clinical Review Nurse (Utilization Review Nurse) Job Description The Clinical Review Clinician for Appeals is responsible for... ...Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is...Remote workContract workTemporary workActalent
Houston, TX3 days ago$30 - $40 per hour
...RN Clinical Review Nurse (Utilization Review Nurse)The Clinical Review Clinician for Appeals is responsible for performing clinical reviews to... ...PTO, Vacation or Sick Leave)Workplace Type:This is a fully remote position.Application Deadline:This position is anticipated...Remote workContract workTemporary workActalent
Houston, TX2 days ago$55 per hour
...from Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location: Remote (must be based in California) Employment type... ...setting. Preferred: Experience in case management, utilization management, or discharge planning. Experience...Remote workFull timeContract workTemporary workLocal areaAkkodis
California, MO9 hours ago$30 - $40 per hour
...expertise into life-changing decisions, one review at a time? Why This Role Matters... ...applicable) ~ Graduate of an accredited nursing program (ADN or diploma required; BSN... ...med-surg, ICU/ED, or similar setting) ~ Utilization review/utilization management experience...Remote workHourly payImmediate startMonday to FridayFlexible hoursPersonify Health
United States21 hours ago- ...to meet QM objectives Responsibilities: • Reviews documentation and evaluates Potential Quality of... ...inpatient hospital experience • Registered Nurse in state of residence • Must have prior authorization utilization experience • Able to work in multiple IT platforms...Remote work
Varite
United States2 days ago - A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
IntePros
Phoenix, AZ9 hours ago - ...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-LjbffrRemote work
Medix
New York, NY3 days ago $30.64 - $45.8 per hour
...The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and... ...the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hoursCorVel
Rancho Cucamonga, CA5 days ago- ...Responsibilities Responsible for utilization review work for emergency admissions and continued... ...critical care and/or medical/surgical nursing At least 2 years utilization management... ...CMGT-BC) Expectations Comfortable with remote work arrangements and virtual collaboration...Remote workFor contractorsWork at office
Netsmart
New York, NY3 days ago - A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license...Remote workContract work
Rangam
Pennington, NJ2 days ago
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