Remote RN: Concurrent Review & Care Management
Centene Corporation
Centene Corporation seeks a clinical professional for their Medical Management/Health Services team. This role includes performing concurrent reviews to assess patient care, health, and discharge plans. The qualified candidate will possess a nursing license and have 2-4 years of relevant experience. The position offers a flexible remote working arrangement for candidates in the Eastern or Central time zones, along with competitive hourly pay and comprehensive benefits. #J-18808-Ljbffr
- A healthcare organization is seeking a Clinical Review Nurse - Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Remote jobWork at office
$27.02 - $48.55 per hour
...professional on our Medical Management/Health Services team.... .... Location: Remote. Must work PST hours. * Must hold RN license in California.... ...Position Purpose: Performs concurrent reviews, including determining... ...reviewing the type of care being delivered, evaluating...Remote workHourly payFull timePart timeWork at officeFlexible hours$69.38k - $92.28k
...MVP Health Care seeks a Professional Concurrent Review RN to ensure members receive appropriate care while navigating the healthcare continuum. This hybrid... ...RNs looking to transition into utilization management, requiring strong clinical judgment and excellent communication...Remote work$69.38k - $92.28k
...Shaping the Future of Health Care At MVP Health Care, we're... ...As a Professional Concurrent Review RN, you'll have the opportunity... ...to expand into utilization management, this position provides exposure... ...you'll be: Location: Remote Pay Transparency MVP Health...Remote workContract work- ...Providence is seeking an RN for a remote Utilization Review role. This per diem position involves conducting... ...prospective, retrospective, and concurrent utilization reviews for Southern California... ...solid understanding of Utilization Management. The qualified candidate will hold...Remote workDaily paid
- ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant... ...position offers the flexibility of remote work while supporting professional...Remote work
- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines and support high-quality patient outcomes. The role requires current...Remote work
$2,210 per week
...leader in personalized managed health care, focused on what's... ...Holidays Work-life balance. Remote/hybrid setting (once... ...to a second level reviewer. This individual interfaces... ...precertification and concurrent review within the... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours$68.04k - $118.8k
...Position Perform clinical reviews within the Medical Management Operations Concurrent Review utilization management... ...access to appropriate levels of care. Principal Accountabilities... ...'s degree in nursing. Valid RN License without restriction....Remote workWork experience placement- ...regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...Remote jobFlexible hours
$110k - $120k
...delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill...Remote work$75k
...Nurse, Concurrent Review WNS, part of Capgemini, is an Agentic... ...Transitional care reviews (Skilled Nursing... ...collaboration with Nursing Management Keeps current with... ...Qualifications RN graduate from an... ...process. Location - Remote WNS HealthHelp (A...Remote workWork at officeLocal areaMonday to FridayFlexible hours$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays... ...in supporting utilization management operations by conducting... ...help support high-quality care, regulatory compliance, and... ...applications This is a 100% remote role, and requires robust...Remote workFull timeFlexible hoursShift work$80k - $90k
...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...audit activity as assigned by management. Monitors, tracks, and... ...tools such as Millimen Care Guidelines (MCG) or InterQual... ...to work independently in remote setting with minimum supervision...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$77.91k - $116.86k
...Alignment Health seeks an Inpatient Review Nurse to join the remote Utilization Management team. The role involves reviewing... ..., and ensuring cost‑effective care while maintaining safety and quality... ...active, valid, unrestricted LVN or RN license in California (non‑compact...Remote jobMonday to Friday- ...Industrial Asset Management Council, Inc is looking for a Remote RN to join their team. The role requires 2 years of RN experience and Utilization Review expertise, supporting various units in a clinical review capacity. This work-from-home position offers flexible scheduling...Remote workWork from homeFlexible hours
- ...through compliance management. Here, you’ll... ...safeguard the quality of care, and influence... ...bedside setting to review and audit claims,... ...Registered Nurse (RN) license Strong... ...populations Remote work – enjoy the convenience... ...in retrospective, concurrent, and prospective...Remote jobFull timeTemporary workWork at officeWork from home
- ...has engaged in health care quality consulting and... ...outcomes. Our talented remote workforce spans the country... ...employee is an active RN and based in Alabama.... ...The Supervisor, Clinical Review plays a critical role... ...environment. 1 year of medical management / utilization review...Remote workContract work
- ...Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.... ...clinical background in managed care, home health, rehabilitation, and...Remote workFull timeFor contractorsWork at officeHome officeMonday to Friday
$34 - $40 per hour
...Clinical Review Nurse Duals Program Details... ...2027. They are managing both Medicare and Medicaid... ...handling inpatient concurrent review and average... ...clinical review RN license prior... ...managed care medical management... ...This is a fully remote position. Application...Remote workHourly payContract workTemporary work- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
- ...Job Description Fully remote- Must have state of MI unrestricted RN license. You will perform prospective, concurrent and retrospective review of inpatient,... ...service and level of care, including appeal requests... ...Prefer utilization management experience Additional...Remote workWork at officeFlexible hours
- ...Inland Empire Health Plan is seeking a Provider Quality Review Nurse, RN to manage quality assurance responsibilities. This role involves investigating care incidents and coordinating with healthcare facilities to ensure quality care delivery. The position requires a...Remote work
$91.25k - $120.91k
...Cucamonga is seeking a qualified healthcare professional for a short-term assignment focused on quality assurance and management. The role includes reviewing cases, providing recommendations, and working closely with Medical Directors. The ideal candidate will have at...Remote workTemporary work- ...A prominent healthcare provider in Bellaire is seeking a PRN Utilization Management Review Nurse. This role involves evaluating medical services, ensuring appropriate care levels, and collaborating with healthcare teams. Candidates must hold a Bachelor's in Nursing and...Remote workReliefShift work
- ...The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines... ...membership on a pre-service, concurrent and post-service basis. This...Remote workWork at officeLocal areaWork from homeHome officeMonday to Friday
$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create... ...Medical Director. Assists management with training new reviewers... ...required CEUs to maintain RN license and/or coding certification... ...bring together people who care deeply about making...Remote workFull timeWork from homeRelocation packageFlexible hours- A healthcare management company is looking for a Part-time remote Utilization Review Nurse based in Coos Bay, OR. The ideal candidate holds a nursing degree and has experience in acute care and utilization review. Key responsibilities include performing clinical reviews...Remote workHourly payPart time
- ...Utilization Management Review Nurse The Utilization Management Review Nurse reviews the medical necessity and appropriateness of healthcare... ...companies, and patients to ensure the quality of patient care is cost efficient. Duties and Responsibilities Conducts...Remote workWork at officeLocal areaWork from homeWeekend work
$93.9k - $117.3k
...our participants in managing their own health... ...the best possible care for the participants... ...through Utilization Review and Utilization Management... .... While providing concurrent utilization review,... ...active RN License in the State... ...hours per week) as a remote opportunity, with daily...Remote workTemporary workWork experience placementWork at officeLocal areaWork from homeMonday to FridayFlexible hoursWeekend work
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