Registered Nurse (RN) - Utilization Management (Remote)
$45 per hourMitchell Martin
- Remote job
Registered Nurse - Utilization Management - Remote - Contract
This remote contract position requires a Registered Nurse specializing in Utilization Management. The role involves evaluating medical records to determine the necessity of patient services, adhering to compliance regulations, and acting as a patient advocate. Proficiency in generic technology tools is necessary.
Location: Remote
Position Type: Contract
Compensation: Pay Range: $45.00 Per HR
Summary:
This remote contract position requires a Registered Nurse specializing in Utilization Management. The role involves evaluating medical records to determine the necessity of patient services, adhering to compliance regulations, and acting as a patient advocate. Proficiency in generic technology tools is necessary.
Requirements:
Active PA or Compact RN License. Minimum of three years of acute care clinical experience. Experience in discharge planning and/or utilization management. Medical management/precertification experience preferred. Exceptional communication and interpersonal skills. Strong organizational and time management abilities. Proficiency in generic office software.
Qualifications:
BSN Preferred. Experience in hospital or healthcare settings. Knowledge of current medical practice trends. Ability to adapt to new ideas and methods. Team player with problem-solving skills. Comfortable with technology advancements.
Mitchell Martin- ...Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning and utilization review. Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective...Remote work
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications... ...Current, full, active, and unrestricted RN license ~ Certifications: BLS...Remote workContract workImmediate startMonday to Friday$71.1k - $97.8k
...part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to... ...Must hold Compact Registered Nurse (RN) license in your state of residence... ...Interqual. Experience working in a fully remote, metrics-focused role Experience...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- ...Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between... ...administrative compliance. Unlike remote roles, this position relies heavily... .... The on-site UM Nurse is a Registered Nurse (RN) responsible for performing admission...Remote workImmediate startShift work
$29 - $52 per hour
...Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...Qualifications: ~ Associate's degree ~ Unrestricted Registered Nurse License in your state of residence ~3+ years of bedside...Remote jobHourly payDaily paidMinimum wageFull timeWork experience placementLocal areaFlexible hours- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate...Remote workFull timeWork from home
- ...Humana Inc. is seeking an Utilization Management Nurse 2 to support coordination, documentation, and communication... ...and members to ensure optimal care in a remote Louisiana setting. The candidate must be a Louisiana-licensed RN with 3+ years of nursing experience, proficient...Remote work
- ...UnitedHealth Group is seeking a Utilization Management Nurse to ensure efficient and effective health services... ...healthier lives. This role offers remote work with time-zone requirements in... ...regions. Ideal candidates hold a compact RN license, 3+ years in Managed Care or...Remote work
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing... ...This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full... ...1. Graduate from an accredited Registered Nursing Program; RN preferred. 2. Minimum of five...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...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
- ...Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This remote role requires a Louisiana RN license and offers a stable, full-time schedule with standard business hours...Remote workFull time
- ...A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Remote workContract work
- ...UnitedHealth Group is seeking a Utilization Management Nurse to help ensure high-quality, cost-efficient care across the continuum. You will assess... ...levels of care in collaboration with care teams. This remote role requires Pacific or Mountain Time Zone residence. You...Remote work
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings... ..., and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings...Remote work
- ...WellSense Health Plan is seeking an Inpatient Utilization Management Clinician for a fully remote role in the United States. You will evaluate inpatient... ...outcomes. Qualifications include an active RN license, nursing degree, and 2 years of utilization review experience...Remote work
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization... ...denials Required qualifications: Current Registered Nurse license in the applicable state or multi-state...Remote workFull time
- ...Devoted Health is seeking a Clinical Guide for our Outpatient Utilization Management team. You will perform timely clinical reviews of outpatient... ...medical necessity and appropriate setting. This full-time, remote role supports CMS and Medicare Advantage requirements while...Remote workFull time
- ...in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity... ...planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual guidelines...Remote workFull time
- ...NeueHealth seeks a full-time Utilization Management (UM) Prior Authorization (PA) Nurse in California. You will review and authorize prior authorizations for treatments... ...effective outcomes. Requirements include California RN license, 2–3 years of clinical nursing with at least...Remote workFull timeContract work
- ...OncoHealth is seeking an UM Trainer to design, coordinate, and deliver training programs for the Utilization Management team. This role supports onboarding, development, and ongoing education to ensure compliance with regulatory and client requirements. The UM Trainer...Remote work
- ...Utilization Review NurseAstrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position... ...Health Plans. This is a remote position for CA-licensed... ...of outpatient Utilization Management experience in a fast-paced...Remote workLive in
- ...Centene Management Company LLC is hiring for a remote RN/LPN utilization reviewer. You will evaluate patient care, determine appropriate level of care, and contribute to discharge planning while coordinating with Medical Affairs. Role requires 2+ years acute care and...Remote workMonday to Friday
$90k - $110k
...health care services. Manages providers, members, team... ...discharge planners in utilization tracking, care coordination... ...Location Remote Travel None... ...Experience Compact Licensed RN, California and New York... ...Bachelor’s degree in nursing preferred; Associate degree...Remote workFull time- ...Working remotely in a full-time capacity, the Registered Nurse Utilization Management will manage complex reviews and processing of authorization requests for various medical... ...Current, unrestricted Registered Nurse (RN), Social Work, or Clinical Counselor Licensure...Remote workFull timeWork experience placement
- ...Description Job Description The utilization review and management (UM) component program ensures that... ...and rules. Qualifications ~ Registered nurse with active, unincumbered nursing... ...lunch This is an in-office, no remote work capability position Travel...Remote workWork at office
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