Remote Utilization Management Nurse - LVN/LPN
NeueHealth
NeueHealth is hiring a Utilization Management Nurse (LVN/LPN) based in California for a remote, full-time role. The PA Nurse reviews prior authorizations, verifies coverage, and ensures medical necessity under state and plan policies. You will collaborate with Medical Directors, providers, and plans to resolve denials and improve processes. The position requires 2–3 years of clinical nursing experience, with 1 year in utilization review or case management, and an active CA license. #J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse - LVN/LPN in Los Angeles, CA vacancy
$65k - $85k
...Description: Position Summary The Licensed Vocational Nurse (LVN) – Utilization Management & Inpatient Case Management is responsible for... ...skills, and the ability to work independently in a fully remote environment. Budgeted Compensation: $65,000 - $85,...Remote workWork at officeBlue Zones Health
La Crescenta, CA20 days ago- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will assess inpatient needs, collaborate with the... ...Friday, 8:00 AM–5:00 PM Pacific Time. Candidates must have LVN or RN license and 3+ years in case management, plus...Remote workMonday to Friday
Alignment Health
Carson City, NV3 days ago - ...NeueHealth is seeking a Utilization Management Nurse (LVN/LPN) for a remote role based in California. The position focuses on reviewing prior authorizations, ensuring alignment with coverage policies and medical necessity, and collaborating with providers, patients, and...Remote work
NeueHealth
California1 day ago $60k
...Integra is looking for a LPN/LVN experienced in the managed care payor environment to... ...-service and post-service utilization reviews and appeals for DMEPOS... ..., Licensed Vocational Nurse, or Licensed Practical Nurse... ...development opportunities Remote Opportunities We are...Remote workTemporary workLocal areaIntegra Partners
Central City, CO4 days ago- 100% Remote | Contract-to-Hire | Monday-Friday 8-5pm | California License Required We are seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) with a strong background in Inpatient Utilization Management to join a growing healthcare organization...Remote workContract workWork at officeMonday to Friday
- ...To support a managed care environment, the full-time LPN Utilization Management Nurse will perform pre-service and post-service utilization... ...with the Medical Director in a remote setting. Key responsibilities... ...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN...Remote workFull time
Virtual Vocations Inc
United States3 days ago - ...Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a... ...competitive compensation with benefits, remote opportunities across multiple... ...with UM experience in managed care are encouraged to apply. #J...Remote work
Integra Partners
New York, NY5 days ago - ...Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...to optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote work
Integrated Home Care Services Inc
Tallahassee, FL2 days ago $60k
...Integra Partners seeks an LPN/LVN experienced in managed care UM to perform pre- and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director on benefit and medical necessity reviews within an NCQA-compliant UM program....Remote workIntegra Partners
Crystal Bay, NV1 day ago- ...Integra Partners is seeking a Licensed Practical Nurse to perform pre-service and post-service utilization management reviews and appeals within a NCQA-compliant UM... ...payor environments.The role requires an active LPN/LVN license, at least 3 years of nursing in acute or...Remote work
Integra Partners
Milton, MA1 day ago - Alignment Health seeks an inpatient review nurse to join its remote utilization management team. You will assess inpatient stays, collaborate with PCPs, discharge... ...and cost-effective care. The role requires LVN or RN licensure (CA) with willingness to obtain licenses...Remote job
- ...Blue Zones Health is seeking an LVN for Utilization Management & Inpatient Case Management in a fully remote role. The ideal candidate will perform concurrent reviews,... ...Requirements include CA LVN license, 3+ years nursing experience, and knowledge of CMS/Medicare Advantage...Remote work
Blue Zones Health
New York, NY5 days ago - ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and benefit determinations for post-... ...and work within the One Home/Home Solutions team. This remote role requires compact RN license in your state, hospital...Remote workWork from home
Humana
Helena, MT1 day ago - ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate care for members. The role requires a registered nurse with at least 3 years of experience and an active license in the resident state.The position operates...Remote workWork from home
CVS Health
Tallahassee, FL3 days ago $56.37k - $84.55k
...care experience for all. JOB SUMMARY The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to... ...Education: Licensed Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California nursing license...Hourly payFull timeContract workWork at officeWork from home- ...Arkansas Blue Cross and Blue Shield is seeking an RN Utilization Management Nurse to perform clinical reviews for medical necessity across various services. The role involves weekend coverage and work from home within Arkansas and several western states. The ideal candidate...Remote workWork from homeWeekend work
Arkansas Blue Cross
New York, NY5 days ago - ...CVS Health is hiring a Medicare Precertification Utilization Management Nurse Consultant. The role involves assessing care options, applying clinical criteria, and coordinating with providers to ensure appropriate services are delivered. Requires RN licensure and 3+ years...Remote workFull timeWork from homeMonday to Friday
CVS Health
Lexington, KY3 days ago $30 - $35 per hour
...Department: Enhanced Care Management (ECM) Reports To: Registered Nurse Clinical Case Consultant... ...Licensed Vocational Nurse (LVN) serves as a vital member... ...a combination of remote work, field-based member... ...Pacific Health Group utilizes AI-assisted tools to support...Remote workHourly payTemporary workWork at officeLocal areaMonday to FridayFlexible hoursAfternoon shiftPacific Health Group
Santa Cruz, CA25 days ago- ...Blue Zones Health seeks a Licensed Vocational Nurse (LVN) for Utilization Management & Inpatient Case Management in a fully remote role based in California. You will monitor inpatient services, perform concurrent reviews, and coordinate transitions of care while collaborating...Remote work
Blue Zones Health
California1 day ago $77.91k - $116.86k
...Together. Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist... ...have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately...Remote workImmediate startMonday to FridayAlignment Health
New York, NY1 day ago- ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS within a... ...LPN/LVN license, with at least 3 years of nursing experience and 2 years in managed care UM, and have knowledge of InterQual and...Remote work
Integra Partners
Atlanta, GA1 day ago - ...Cambia Health Solutions, Inc. is hiring a Utilization Management Nurse who will conduct reviews to ensure medical necessity and cost-effective outcomes. Working from home within the states of Oregon, Washington, Idaho or Utah, you will assess patient needs and collaborate...Remote workWork from home
Cambia Health Solutions, Inc.
Spokane, WA1 day ago - ...Astrana Health is seeking a Utilization Review Nurse with a Texas LVN license to support our Health Services Department in reviewing a high volume of outpatient... ...weekend and holiday rotation. The position is fully remote and will align with PST hours during probation,...Remote workTrial periodWeekend work
Astrana Health, Inc.
United States3 days ago - ...Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote workWork from home
Cambia Health Solutions, Inc.
Provo, UT1 day ago - ...Partners is seeking a licensed LPN/LVN with managed care UM experience to... ...pre-service and post-service utilization reviews and appeals for DMEPOS... ...with NCQA standards. The UM Nurse will review requests using... ...others to the Medical Director. Remote opportunities are available...Remote work
Integra Partners
Colorado Springs, CO1 day ago - ...CVS Health in Florida is seeking a Utilization Management Nurse Consultant. This full-time remote (work from home in Florida) role requires an active Florida RN license and at least 3 years of inpatient nursing experience. You will review medical necessity, coordinate...Remote workFull timeWork from homeWeekend workAfternoon shift
CVS Health
Fort Lauderdale, FL1 day ago - Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote jobWork from home
- Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required...Remote jobContract work
$29 - $62 per hour
...About This Role The Utilization Management Nurse Consultant role at CVS Health involves utilizing clinical experience to assess, plan, implement... .... Highlights Pay: $29 - $62/hour Location: Remote, TX Residency: Must reside in EST or CST Schedule: 2...Remote workWork at officeWork from homeAfternoon shiftCVS Health
Texas1 day ago- Astrana Health is seeking a CA-licensed Utilization Review Nurse to support the Health Services Department. You will review outpatient services... ...and refer cases to Medical Directors as needed. This is a remote role for CA-licensed RNs/LVNs, with candidates living in California...Remote jobCasual workWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse - LVN/LPN. Be the first to apply!
Related searches
- lvn clinic Los Angeles, CA
- wellness nurse lpn Los Angeles, CA
- nurse lpn lvn Los Angeles, CA
- school lpn Los Angeles, CA
- senior licensed practical nurse Los Angeles, CA
- lpn health care Los Angeles, CA
- lpn dermatology Los Angeles, CA
- mental health lpn Los Angeles, CA
- staff nurse lpn Los Angeles, CA
- licensed practical nurse Los Angeles, CA