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- ...(Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia... ...working. This position is remote - Full-time ONLY during training - 2-... ...inpatient admissions . Using the medical software criteria, establish the need...Remote workMedicalPermanent employmentFull timeContract workPart timeLocal areaShift work
Pyramid Consulting (Travel)
Philadelphia, PA19 days ago - ...Consulting is seeking a local contract nurse RN Utilization Review Level III for a local contract... ...convert into permanent and is fully Remote opportunity. Key Responsibilities... ...and judgement skills based on advanced medical knowledge to cases utilizing specified...Remote workMedicalPermanent employmentContract workLocal areaWorldwideShift work
Pyramid Consulting
Philadelphia, PA15 days ago - ...Medical Review Nurse (RN) Our client, a mutual insurance holding company, is looking for a Medical Review Nurse (RN) for their remote location. Responsibilities: The essential functions listed represent the major duties of this role, additional duties may be assigned...Remote workMedical
ICONMA
Reno, NV3 days ago - ...Pre-Service Medical Review Nurse RN Our client, a Healthcare company, is looking for a Pre-Service Medical Review Nurse RN for their remote location. Responsibilities: Conduct on-site review of subscriber's medical information in order to ensure appropriate benefit...Remote workMedical
ICONMA
Birmingham, AL2 days ago - ...Registered Nurse-Review Analyst Our client, a health insurance company, is looking for a... ...Registered Nurse-Review Analyst for their remote location. Requirements include two years... ...review experience, advanced knowledge of medical terminology, and proficiency in...Remote workMedicalWork at office
ICONMA
Reno, NV1 day ago $47.06k - $70.24k
...CERIS Professional Review Nurse I The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of... ...appropriate billing protocols, etc. This is a remote position. Essential Functions & Responsibilities...Remote workMedicalCorVel
Nashville, TN2 days ago$32 - $40 per hour
...Full time HEDIS Review Nurse openings in the state of GA area with a major healthcare company! Position will be Remote PAY RATE :$32.00 - $40.00 per hour HOURS : M-F 8am – 5pm OT will... ...(Outside of Workday JD): •Overread medical records. Complete secondary overread of...Remote workMedicalHourly payFull timeTemporary workMonday to FridayA-Line Staffing Solutions
Atlanta, GA2 days ago$79.75k - $127.59k
...Responsibilities Works with Medical Director and appropriate... ...updates and maintains list. Reviews reservation forms and the log... ...Graduate from an accredited Nursing Program required. Bachelor... ...with NH eligibility Remote: Fully Remote Area of Interest...Remote workMedicalDaily paidTemporary workWork at officeRotating shiftNew Hampshire Staffing
West Lebanon, NH2 days ago$150 per hour
...Registered Nurse / Wound Care (Tier 3) / Va Reviewer Location: Remote Employment Type: Contract (Case-based) Hourly Rate: Per Case Compensation (See details below... ...Wound Care Registered Nurse to provide expert medical reviews for the Veterans Administration. This is a...Remote workMedicalHourly payPrice workExtra incomeContract workPrivate practiceFlexible hoursGreenLife Healthcare Staffing
Richmond, VA2 days ago$29.05 - $67.97 per hour
...Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment... ...Further details to be discussed during our interview process. Remote position with location preference in MI, IL or WI Work hours...Remote workMedicalWork experience placementWork at officeMonday to FridayRemote Staffing
United States5 days ago$51.81k - $83.55k
...Professional Review Nurse The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills... ...appropriateness of medical care. This is a remote role. Essential Functions & Responsibilities...Remote workMedicalMinimum wageFull timeWork at officeLocal areaFlexible hoursCorVel
Syracuse, NY1 day ago$114k - $134k
...Reporting to the Nurse Manager of Quality Review, and as a member of the Population Health and Quality department... ...and Appeals team and the SFHP Medical Director to ensure that clinical quality... ...Bay Area and California. #LI-Hybrid (Hybrid remote/in?office) #J-18808-LjbffrRemote workMedicalWork at officeOhioleaguefornursing
San Francisco, CA1 day ago$39.72 - $61.66 per hour
...Care Manager RN: Utilization Review at Providence Health and Services... ...The Inpatient Registered Nurse (RN) Care Manager provides professional... ...Acute Care experience in a Medical Surgical or Inpatient setting... ...MT Workplace Type: Remote Pay Range: $39.72 - $61.66...Remote workMedicalMinimum wagePart timeLocal areaShift workProvidence Health and Services
Proctor, MT3 days ago$26.41 - $61.79 per hour
...this position we are seeking a (RN) Registered Nurse who must hold a compact license. \n This is a Remote position, home office with internet connectivity... ...for a RN with experience with appeals, claims review, and medical coding. \n \n JOB DESCRIPTION Job SummaryProvides...Remote workMedicalHourly payWork experience placementWork at officeHome officeMonday to FridayMolina Healthcare
Cedar Rapids, IA17 days ago$39.72 - $61.66 per hour
...Care Manager RN - Utilization Review at Providence Health and Services... .... Candidates must hold a nursing degree, Montana RN license, and... ...years Acute Care experience in a Medical Surgical or Inpatient setting... ...MT Workplace Type: Remote Pay Range: $39.72 - $61.66...Remote workMedicalMinimum wagePart timeLocal areaShift workProvidence Health and Services
Lakeside, MT3 days ago$56.44 - $87.63 per hour
...RN Utilization Review Part- time Day at Providence Health and Services... ...-time RN Utilization Review nurse conducts clinical reviews and... ...utilization management to ensure medical necessity and patient status... ...in a healthcare setting. This remote role requires nursing...Remote workMedicalMinimum wageFull timePart timeLocal areaShift workDay shiftProvidence Health and Services
Mission Hills, CA4 days ago$85 per hour
...Immediate RN Clinical Consultant - ADA Medical Accommodation Review remote contract opportunity. This is a 100% remote/work from home position. Pay Rate: $85.00/hr Work Details: Monday to Friday / 40 hours per week Work from home/remote...Remote workMedicalContract workImmediate startWork from homeMonday to FridayKMG Healthcare
Cleveland, OH3 days ago- ...Job Description Position Title: Utilization Review Nurse Location: Fully Remote Position Summary The Utilization Review Nurse serves as... ...requests in accordance with company policy. Assess medical documentation to determine the need for continued home...Remote workMedicalFlexible hoursWeekend work
IntePros
Phoenix, AZ22 days ago $65k - $78k
...Utilization Review Nurse It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...Remote workMedicalFull timeContract workWork at officeWork from homeFlexible hoursIntelyCare
Nags Head, NC3 days ago- ...Clinical Reviews, Denial And Appeals Rn Bring your passion to... ...+ Together Work location: Remote (Local candidates only) Work... ...~ Associates Degree in Nursing required ~ Bachelor's Degree... ...effective appeal strategies for medical necessity denials. Reviews...Remote workMedicalFull timeWork at officeLocal areaMonday to Friday
IntelyCare
Arlington, TX4 days ago - ...Job Description Job Title: Quality Review Specialist Location: Remote in IL, TX, NM, OK Duration: December 2025 to May 2026 contract to hire... ...Unit (FSU), Provider Telecommunication Center (PTC), and Medical Management Department (MMD) to ensure appeal process meets...Remote workMedicalContract workShift workWeekend work
Innovative Systems Group
Chicago, IL26 days ago - ...Utilization Review Nurse Responsible for utilization review work for emergency admissions... ...Review and evaluate electronic medical records of emergency department admissions... ...Expectations Comfortable with remote work arrangements and virtual collaboration...Remote workMedicalFull timeWork at officeShift workWeekend workWeekday work
Netsmart
Palm Coast, FL2 days ago $48 - $50 per hour
...Jobs is seeking a Registered Nurse (RN) Long Term Care for a nursing... ...not require on-site presence; remote support is acceptable)\n \n... ...and day programs \n Issue medical referrals and follow up on health... ...team meetings and case reviews \n Maintain accurate medical...Remote workMedicalHourly payFull timeMonday to FridayWeekend workAfternoon shiftVivian Staff Jobs
New City, NY19 days ago$26.5 - $47.59 per hour
...clinical professional on our Medical Management/Health Services team... ...have the flexibility to work remotely from their home anywhere in... ...requires an Iowa or compact nursing license. The work schedule is... ...Purpose: Performs concurrent reviews, including determining member...Remote workMedicalHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hoursIowa Staffing
Des Moines, IA5 days ago$72.48k - $108.72k
...Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day... ...and service authorization review for medical necessity and decision-making. The... ...This position is available to remote employees residing in Massachusetts...Remote workMedicalWork at officeHome officeCommonwealth Care Alliance
Boston, MA2 days ago$45 per hour
...) is seeking a local contract nurse RN Acute Care Case Management... ...Coordinator/RN Location: 100% Remote Duration: 03 months... ...limited to, health insurance (medical, dental, vision), 401(k) plan,... ...clinical condition through the review of medical records (including...Remote workMedicalContract workTemporary workWork at officeLocal areaShift workPyramid Consulting (Travel)
Philadelphia, PA13 days ago- ...Services is seeking a travel nurse RN Float PCU - Progressive Care... ...: Cerner Unit Notes **Medical Solutions auto deducts the 1.7... ...back in.** *Clinical Profile Review and the manager will call for... ...Techs? RNs read strips? Yes, remote cardiac monitoring. RNs read strips...Remote workMedicalTemporary workShift workNight shiftWeekend work
TheraEX Staffing Services
Seattle, WA7 days ago $40k - $45k
...Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday... ...'re seeking a Part-Time Utilization Review Nurse to conduct medical necessity reviews for treatment requests related to workers'...Remote workMedicalPart timeWork at officeFlexible hoursShift workCCMSI
Wichita, KS4 days ago- ...Caring is seeking a Registered Nurse (RN) PCU - Progressive Care... ...Patient Care Specialists conduct remote assessments and coordinate... ...reporting and compliance needs Reviews all available patient notes... ...Comprehensive insurance plans for medical, dental, and vision benefits...Remote workMedicalFull timeWork at officeLocal areaFlexible hours
Elara Caring
Toledo, OH7 days ago - ...is seeking a local contract nurse RN Hospice for a local contract... ...have Hospice Travel exp. Remote EPIC exp. strongly preferred... ...knowledge of pharmacology and safe medication management. Routinely... ...Performance Improvement Program: Reviews health records and gathers...Remote workMedicalContract workLocal areaImmediate startShift workNight shift
MetaSense, Inc.
Basking Ridge, NJ23 days ago
