Remote Utilization Management RN
Humana
- Remote job
Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and be part of the One Home/Home Solutions Utilization Management team focused on post-acute care (SNF, Home Health, DME). The role emphasizes using clinical nursing skills, applying medical criteria to determinations, and communicating with providers and members #J-18808-Ljbffr Humana
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will work with the One Home/Home Solutions Utilization Management team handling post...Remote workWork from home
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. The role reports to the Manager of Utilization Management as part of the One Home/Home...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...You will use clinical nursing skills to determine medical necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: Full-Time Position Overview We are seeking an experienced Utilization...Remote workFull timeMonday to Friday
- ...Utilization Management Registered Nurse at Humana uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care services including SNF, Home Health and DME. You...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote ~ Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
- ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN performs telephonic review of hospital admissions and recommends alternative levels of care when appropriate. This role...Remote workPart timeMonday to Friday
- ...Humana Inc. is hiring a Utilization Management Registered Nurse for remote work. You will apply clinical nursing expertise to interpret, coordinate, document, and communicate medical services and benefit determinations for post-acute care settings. You will make criteria...Remote work
- ...Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document... ..., 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
$72.8k - $130k
...scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional Area, the... ...Qualifications: ~ Must be a Registered Nurse (RN) with a current, active, unrestricted RN License...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant (RN) to remotely review authorizations and assess medical necessity across multiple specialties. You will collaborate with care teams to ensure compliant, evidence-based reviews and timely decisions...Remote work
- ...provider of technology-enabled revenue cycle management solutions for health systems, including... ...results. The Opportunity: The RN, Utilization Review performs advanced utilization review... ...2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified...Remote workLocal area
- ...CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate...Remote work
$68.81k - $120.72k
...guidelines and regulatory requirements and manages concurrent and pre-bill denials to... ...concurrent authorizations for in-house patients, utilizing daily commercial authorization reports.... ...and Certifications: Registered Nurse (RN) [Required] AND Accredited Case...Remote workFull timeWork experience placementLocal areaShift workWeekend work- ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/...Remote workContract workTemporary workMonday to FridayShift work
$47.03 - $63.48 per hour
...provider of technology-enabled revenue cycle management solutions for health systems,... ...the possible in healthcare. The RN, Senior Utilization Review Quality will play an essential... ...patient and client experiences This is a remote position; however, candidates must be...Remote workTemporary workWork at officeLocal area$101.72k - $198.36k
...Location: California - Ability to work remote, but selected candidate must reside in... .... This position requires California RN Licensure. Candidates must have significant... ...or all of the following functions: utilization management, care management, behavioral health and...Remote workContract workWork experience placementWork at officeLocal area$63.1k - $94.65k
...technology-enabled revenue cycle management solutions for health systems,... ...*Must have current compact RN license, or be willing to... ...Schedule Information: Our Utilization Review team provides coverage... ...Abilities Required: This is a remote role which requires access to...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$47.37 per hour
Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care,... ...regulations. The role requires an active RN/LPN/LVN license and 2-4 years of clinical experience...Remote jobHourly pay- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
$39.4 - $53 per hour
...provider of technology-enabled revenue cycle management solutions for health systems,... ...the possible in healthcare. The Lead Utilization Review RN is a key contributor to the overall financial... ...degree Nursing required #LI-LS1 #LI-REMOTE Join an award-winning company...Remote workWork at officeLocal area- Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote job
- Humana Inc is seeking a Utilization Management Registered Nurse to interpret and coord intakes for medical services and benefit determinations in a fully remote capacity. You will support post-acute care services across SNF, Home Health and DME, reporting to the Utilization...Remote job
- ...Behavioral Health Utilization Manager Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned patients... ..., MS Excel, Outlook, and telephone systems Work Schedule: Remote Other Requirements: Able to work independently under general...Remote workContract workWork experience placement
- Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services... ...SNF, home health, and DME. The role requires an active RN license, 1+ year RN experience, and a focus on consumer...Remote job
- ...with providers to facilitate care and treatment. You will identify referral opportunities to integrate CVS Health products and programs and serve as a clinical resource to internal and external stakeholders in utilization/benefit management. #J-18808-Ljbffr CVS HealthRemote job
$71.1k - $97.8k
...a part of our caring community The Utilization Management Registered Nurse uses clinical nursing... ...Must hold Compact Registered Nurse (RN) license in your state of residence... ...Interqual. Experience working in a fully remote, metrics-focused role Experience as...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote job
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