Remote Inpatient Utilization Review Nurse

Centene Corporation

Centene Corporation is seeking a qualified nurse to perform concurrent inpatient utilization reviews, determine medical necessity, and support discharge planning according to policy. You will review clinical records, document decisions, and collaborate with providers and care teams to ensure appropriate care settings. The role requires 2–4 years of acute care experience, an LPN license, and strong clinical judgment. #J-18808-Ljbffr

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Remote Inpatient Utilization Review Nurse in Florida, NY vacancy

Remote Utilization Review Nurse
TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective... ...services. Responsibilities include preauthorization, inpatient and continued stay reviews, and presenting complex cases...
Remote job
TriWest Healthcare Alliance
Phoenix, AZ
4 days ago
Utilization Review Nurse
...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 work
Full time
Second job
Work at office
Ova Technologies
Alpharetta, GA
1 day ago
Utilization Review Nurse
...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 work
Full time
Temporary work
Summer work
Work at office
Flexible hours
Cobalt Benefits Group
United States
1 day ago
Remote Utilization Review Nurse: Flexible Hours & Growth
...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 work
Flexible hours
kozmetickesluzby.vecnakraska.sk - Jobboard
Caribou, ME
2 days ago
Utilization Review Nurse
$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 work
Full time
Contract work
Temporary work
Local area
Akkodis
California, MO
4 days ago
Remote Behavioral Health Utilization Review Nurse
$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 work
Hourly pay
Temporary work
Monday to Friday
Manpower Group Inc.
United States
2 days ago
Utilization Review Nurse Health Plans - Case Management
...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 work
Full time
CHRISTUS Health
Alamogordo, NM
1 day ago
Utilization Management Review Nurse
$34 - $42 per hour
...Utilization Management Review Nurse Department: HS - UM Employment Type: Full Time Location: 160... ...various Health Plans. This is a remote position for CA-licensed nurses. Candidates... .../retrospective review of elective inpatient admissions, outpatient procedures,...
Remote work
Hourly pay
Full time
Live in
Work at office
Monday to Friday
Shift work
Astrana Health, Inc.
United States
4 days ago
Utilization Review Registered Nurse
$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 work
Full time
Temporary work
Part time
Work at office
Work from home
Monday to Friday
Flexible hours
Hines
Rockford, IL
4 days ago
Nursing Assistant - EHD Inpatient Rehab (Nights)
$17.83 - $23.55 per hour
...- EH Duluth Department: 2813340 INPATIENT REHAB - IRF Job Description: Become... ...! We are looking for a Compassionate Nursing Assistant to join our Inpatient Rehab Unit... .... FTE: 0.7 Possible Remote/Hybrid Option: Shift Rotation: FTE...
Remote work
Permanent employment
Local area
Work from home
Flexible hours
Shift work
Night shift
Rotating shift
Weekend work
Essentia Health
Duluth, MN
10 hours ago
Utilization Review Nurse
...Management Location: 100% Remote Schedule: M-F 9:00am to... ...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 work
Contract work
Integrated Resources, Inc ( IRI )
Springfield, IL
2 days ago
Utilization Review Nurse
Currently seeking a Utilization Management RN . Please see... ...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 work
Immediate start
Day shift
The Judge Group
New York, NY
5 days ago
Utilization Review Nurse
$35 - $45.94 per hour
...Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.... ...Review. Work Location: This is a remote position, open to candidates who... ...Previous experience conducting concurrent or inpatient reviews for a managed care plan...
Remote work
Hourly pay
Full time
Work from home
Home office
Weekend work
Oscar Health
Tampa, FL
8 days ago
Utilization Review Nurse
$45 - $50 per hour
Join Our Team as a Utilization Management RN - Make an Impact... ...dedicated Registered Nurse passionate about... ...outcomes. Whether working remotely or in a flexible... ...ll play a key role in reviewing authorization requests... ...commercial products. Assess inpatient, outpatient, and post-...
Remote work
Hourly pay
Work at office
Flexible hours
The Hollister Group
Oklahoma City, OK
3 days ago
Utilization Management Review Nurse
...supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,... ...Experience: ~ Associate's Degree in Nursing (ASN) required; Bachelor's... ...work solutions include remote options, hybrid work schedules...
Remote work
Full time
Work at office
Monday to Friday
Flexible hours
AmeriHealth Caritas
Indiana
8 days ago
Registered Nurse Inpatient Rehab PRN
...Registered Nurse Inpatient Rehab PRNAs the nation's largest private employer of Registered Nurses... ...the Rio Grande Valley with our three remote ERs in McAllen/Mission, Edinburg, and... ...industry! Our Talent Acquisition team is reviewing applications for our Registered Nurse...
Remote work
Temporary work
Relief
Local area
Flexible hours
Shift work
IntelyCare
Mcallen, TX
1 day ago
Inpatient Rehab Nursing Assistant
...189 About the unit We are a 64 bed Inpatient Rehab Unit that sees a variety of patients... ...hours of therapy across the 7-day week. Nursing continues the interventions practiced by... ...observation, either in person or via remote video monitoring, to maximize his/her safety...
Remote work
Part time
Shift work
Night shift
Weekend work
Corewell Health
Royal Oak, MI
5 days ago
Remote CA Utilization Review Nurse (UM)
$34 - $47 per hour
Astrana Health Management in California is seeking a CA-licensed Utilization Review Nurse to support our Health Services Department. You will review... ...medical necessity according to plan criteria. This is a remote role for CA-licensed nurses; candidates must reside in...
Remote job
Hourly pay
Astrana Health Management
Monterey Park, CA
4 days ago
Utilization Review Denial Nurse — Hybrid/Remote
UCLA Health in Los Angeles hires a Denial Nurse Reviewer to support high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory guidelines to review and process adverse organization determinations. Responsibilities include reviewing denials...
Remote job
UCLA Health
Los Angeles, CA
5 days ago
Utilization Review Nurse - RN
...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...
Remote work
Full time
Virtual Vocations Inc
United States
3 days ago
Utilization Review Nurse
...To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization review activities, ensuring appropriate... ...with regulatory requirements while working remotely. Key responsibilities: Conduct medical...
Remote work
Full time
Virtual Vocations Inc
United States
1 day ago
Pediatric Inpatient Nurse for AI Training
$55 - $65 per hour
...Apply your pediatric inpatient bedside expertise to help... ...translate real-world nursing documentation... ...Key Responsibilities Review and assess AI-generated... ...improvement chart review, utilization review, clinical documentation... .... Work Terms ~ Remote, hourly engagement....
Remote work
Hourly pay
SaidGig
United States
23 days ago
Utilization Review Nurse
...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 work
Work at office
Immediate start
Flexible hours
2 days per week
Acrisure LLC
Bradenton, FL
1 day ago
UTILIZATION REVIEW NURSE
$93.18k - $136.95k
...Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse . The Utilization Review Nurse is responsible for utilization... ...-free environment. For positions that are available as remote work, Sentara Health employs associates in the following...
Remote work
Full time
Temporary work
Shift work
Sentara Healthcare
United States
4 days ago
Remote Utilization Review Nurse: Medicare & Home Health
...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-Ljbffr...
Remote work
Medix
United States
1 day ago
Utilization Management Review Nurse
...Utilization Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In... ...Necessity Criteria, respective to various Health Plans. This is a remote position for CA-licensed nurses. Candidates must live in...
Remote work
Live in
KZX - Astrana Health Management, Inc.
United States
5 days ago
Full Time - APP - Physician Assistant / Nurse Practitioner - Virtua Gastroenterology - Inpatient
$128.6k
Location 100 Brick Road Marlton, New Jersey Remote Type On‑Site Employment Type Employee - Full... ...experienced full‑time Physician Assistant or Nurse Practitioner to join our Gastroenterology team. This role provides inpatient gastroenterology care across five hospital locations...
Remote work
Full time
Temporary work
Flexible hours
Shift work
Rotating shift
Day shift
Virtua
Marlton, NJ
2 days ago
Registered Nurse - Utilization Review (Nursing)
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...in Utilization Management, Utilization Review, or Case Management Preferred...
Remote work
Contract work
Immediate start
Monday to Friday
J Edward Staffing LLC
Aurora, CO
3 days ago
Utilization Review Nurse - Managed Care
$39.64 - $61.45 per hour
...the core business hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity... ...What awaits you: ~ Work-life balance - This is a remote role! Candidates in the following approved states will be...
Remote work
Local area
Monday to Friday
Johns Hopkins HealthCare
Hanover, MD
5 days ago
Utilization Review Nurse-Remote-Contract
$40 per hour
...Managed Care Industry Registered Nurse (RN) $40/hour - Contract... ...reside in TX Full time remote Candidates must be based in TX... ...performing initial, concurrent review activities; discharge care... ...Provides information regarding utilization management requirements and operational...
Remote work
Full time
Contract work
Work at office
HireOps Staffing LLC
United States
3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Inpatient Utilization Review Nurse. Be the first to apply!