Remote RN: Utilization Review & Care Coordination
Centene Corporation
- Remote job
Centene is seeking a remote Utilization Review Nurse to perform concurrent reviews, determine appropriate levels of care, and support discharge planning for inpatient services. You will collaborate with Medical Affairs and care teams to ensure medically necessary care across multiple states, with a schedule Monday–Friday 8am–5pm in your time zone and occasional weekends/holidays. The ideal candidate has RN or LPN licensure, 2+ years acute care experience, and knowledge of Medicare/Medicaid #J-18808-Ljbffr Centene Corp.
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...Health is seeking a Registered Nurse (RN) for Utilization Management. You will review clinical information to support... ..., apply guidelines, and coordinate care with providers to ensure appropriate... ...care. This full-time role offers remote work from home in the United States...Remote jobHourly payFull timeWork from home- ...Sedgwick is seeking a remote RN Utilization Review professional in Tennessee to provide timely utilization reviews and advocate for cost-effective patient care. You will assess medical conditions, coordinate with clinicians, and support evidence-based treatment decisions...Remote workFlexible hours
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$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside... ...a massive impact on patient care? We are seeking a dedicated Utilization... .... Denial Management & Appeals: Coordinate the Peer-to-Peer (P2P) process with...Remote workWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week- CVS Health is seeking a Registered Nurse (RN) for Utilization Management. The role focuses on ensuring members receive appropriate care through evidence-based review and care coordination. The position targets candidates with strong clinical judgment and readiness to work...Remote job
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- HonorHealth is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater... ...focuses on reviewing medical necessity and coordinating reviews for diverse payers, ensuring appropriate level of care and data reporting accuracy....Remote job
$38 - $40 per hour
...Title: RN -- Review Analyst Location: Remote Duration: 12 months with possible extension... ..., and retrospective utilization reviews for inpatient, outpatient... ...length of stay, level of care, and intensity of... ...conduct member outreach, and coordinate care across the...Remote workHourly payWork at officeMonday to FridayShift work- CVS Health is seeking a Registered Nurse (RN) to join the Utilization Management team in a full-time, remote-capable role. You will review clinical information, apply guidelines, and coordinate care to ensure members receive the right care at the right time. The role requires...Remote jobFull time
- HealthEdge is seeking a motivated Utilization Review RN to perform prospective, concurrent and retrospective review of inpatient... ...ensure medical necessity and appropriate level of care. The role involves coordinating care across the health care continuum and may include...Remote jobContract work
- ...Health is seeking a Registered Nurse (RN) for Utilization Management to help ensure members receive appropriate care through evidence-based review and care coordination. You will review information,... .... The role emphasizes flexible, remote work within the state and a 24/7...Remote jobFlexible hours
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- ...States seeks a Registered Nurse (RN) for Utilization Management to review coverage and guide care decisions across the continuum... ...evidence-based review, care coordination, and collaboration with... ...The position is full-time and remote, with requirements for a flexible...Remote jobFull timeWork at officeFlexible hours
- HealthEdge Software, Inc. is seeking a motivated Utilization Review RN to perform prospective, concurrent, and retrospective review... ...ensure medical necessity and appropriate level of care. This role involves coordinating discharge planning and addressing appeals initiated...Remote jobContract work
- ...Partners is seeking a Virtual Utilization Review Specialist to join our remote team. You will perform medical... ...necessity reviews, manage denials, and coordinate with FCC and care management to optimize patient... ...candidates hold a current RN license, have at least 1 year in...Remote job
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$63.1k - $94.65k
...have current compact RN license, or be willing... ...are seeking Virtual Utilization Review Specialist with at least... ...utilization of health care resources and assists... ...Denial Management Coordinates the P2P process with the... ...Required: ~ This is a remote role which requires...Remote workFull timeTemporary workWork at officeLocal areaMonday to FridayShift work- CVS Health is seeking a Registered Nurse (RN) for Utilization Management to ensure members receive the right care at the right time through evidence-based reviews and care coordination. The role emphasizes collaboration with healthcare teams, clinical guidelines, and proactive...Remote jobFlexible hoursAfternoon shift
- ...experienced Registered Nurse (RN) to join our Utilization Management team. You will... ...receive the right care at the right time through evidence-based clinical review and care coordination. Active RN license and 2+... ...weekends, and holidays, in a remote-capable environment...Remote jobFlexible hoursAfternoon shift
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- ...employer to recruit a Case Manager - Utilization Review Specialist for a fully remote role in the United States. The position... ...necessity determinations, and coordination of multi-level appeals to support appropriate patient care and financial performance. The role leverages...Remote job
- ...Health Partners is seeking a Lead Utilization Review RN to drive medical necessity reviews, discharge planning, and appeals coordination while collaborating with physicians... ...revenue cycle integrity and patient care quality in a remote US-based environment. You will evaluate...Remote job
- ...Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team, helping ensure members receive appropriate care at the right time through evidence-based clinical review and care coordination. The role involves reviewing clinical information...Remote jobFlexible hours
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