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  • $38.16 - $59.15 per hour

     ...determined by a candidate's expertise and years of experience, among other factors. Position Highlights: Position: RN Utilization Review Location: Naperville, IL Full Time: 40 hours/week Hours: Monday-Friday, 8:00a-4:30p, rotating every 6-8 weekend... 
    Suggested
    Hourly pay
    Full time
    Part time
    For contractors
    Monday to Friday

    Endeavor Health

    Naperville, IL
    2 days ago
  • A leading medical review organization is seeking Board‑Certified physicians in Pediatric Hematology Oncology for flexible, remote Utilization Reviews. This role requires conducting independent reviews of pediatric cases, engaging in peer-to-peer discussions, and ensuring... 
    Suggested
    Remote job
    Part time
    Flexible hours

    Medical Review Institute of America

    Dallas, TX
    2 days ago
  • Alliant Health Group is seeking a Pediatric Review Nurse to join their professional multi-disciplinary team in Atlanta, Georgia. This role involves conducting comprehensive medical reviews for Pediatric Programs, managing Medicaid member documentation, and performing clinical... 
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    Alliant Health Group

    Atlanta, GA
    1 day ago
  •  ...We are home to Nevada’s ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are...  ...facility by ANCC, and we are on our journey to Magnet status. Review patient admissions for appropriateness, efficiency of resource... 
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    Shift work
    Weekend work

    University Medical Center of Southern Nevada (UMC)

    Las Vegas, NV
    3 days ago
  • $55 per hour

     ...Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare...  ...: Experience in case management, utilization management, or discharge planning. Experience...  ...Nurse, Out-Patient Case Manager Travel Pediatric ICU Registered Nurse - $840 per week... 
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    Full time
    Contract work
    Temporary work
    Local area
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    Akkodis

    California, MO
    1 day ago
  • We are seeking a DC licensed RN to perform utilization management reviews, ensuring healthcare services are medically necessary and meet quality standards. The role involves reviewing treatment plans, consulting with providers, documenting decisions, and supporting care... 
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    NRI, Inc.

    Washington DC
    3 days ago
  • $73k - $75k

    Utilization Review Nurse PRIMARY PURPOSE To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment... 
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    Work at office
    Flexible hours

    Sedgwick

    Columbia, SC
    2 days ago
  • Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued - they’re invaluable. Join... 
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    Contract work

    Providence

    Everett, WA
    2 days ago
  • $54 - $66 per hour

    We are recruiting for a Utilization Review Nurse to join a large healthcare organization within the Sacramento region. The Utilization Review Nurse is responsible for overseeing the daily operations of the UM Pre-Authorization team, ensuring referral requests are processed... 
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    Contract work
    Work at office

    Pacific Staffing

    Sacramento, CA
    3 days ago
  •  ...success. Job Description • Responsible for conducting timely reviews of all requests for services required to meet medical necessity...  ...providers against plan review criteria and benefit guidelines • Utilizes clinical information to determine if criteria for medical necessity... 
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    Integrated Resources Inc.

    North Charleston, SC
    1 day ago
  • WHAT WE'RE LOOKING FOR We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements. This... 
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    Permanent employment
    Full time
    Work at office
    Work from home
    2 days per week

    Berkshire Hathaway Homestate Companies

    Omaha, NE
    4 days ago
  • $35 - $40 per hour

    Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of home health... 
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    Remote work
    Flexible hours
    Weekend work

    IntePros

    Phoenix, AZ
    4 days ago
  • $65 per hour

     ...coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient...  ...care planning and discharge planning. Conduct utilization review to ensure appropriate level of care and services. Collaborate... 
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    Weekly pay
    Local area
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    Pride Health

    New York, NY
    4 days ago
  • General Summary of Position Job Summary: MedStar Health is looking for a Utilization Review Technician to join our team at MedStar Harbor Hospital. The Utilization Review Technician will collaborate with and assist the multidisciplinary team to meet individualized patient... 
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    MedStar Health

    Baltimore, MD
    4 days ago
  • $71.61k - $111k

     ...Range: $71,612.39 - $110,999.20 Responsibilities Responsible for Utilization Management, Quality Screening and Delay Management for...  ...based on Departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts... 
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    Shift work

    Albany Med Health System

    Albany, NY
    5 days ago
  •  ...PA, NJ, or DE Employment type: Contract to full-time hire Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This position is ideal for an RN with prior work in insurance utilization... 
    Full time
    Contract work
    Remote work

    IntePros

    New York, NY
    5 days ago
  •  ...compact)) Employment Type: 4-month contract with possibility of extension Overview We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex inpatient caseload across multiple care settings, including acute, subacute,... 
    Daily paid
    Contract work
    Remote work
    Shift work
    Weekend work

    US Tech Solutions

    Oklahoma City, OK
    3 days ago
  •  ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,...  ...in acute clinical care Experience with medical record review/utilization review/utilization management Additional Information Are you... 
    Contract work
    Private practice
    Monday to Friday

    Healthcare Support Staffing

    Mason, OH
    5 days ago
  •  ...plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are...  ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards,... 
    Contract work
    Remote work
    Monday to Friday
    Flexible hours

    Healthcare Support Staffing

    New York, NY
    5 days ago
  •  ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately...  ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,... 
    Private practice
    Immediate start

    Healthcare Support Staffing

    Indianapolis, IN
    5 days ago
  • $2,256.4 per month

    Job Overview Our Client is currently seeking Utilization Review for positions in Washington, DC for a 5×8 Days shift. The ideal candidate will possess a current DC license or Compact license depending on the state. You must have a license and at least 1 year of recent... 
    Shift work
    Day shift

    Specialty Professional Services, Corp.

    Washington DC
    5 days ago
  • 40 hours per week Position: Utilization Review (UR) Nurse Company Overview Telenett is a leading healthcare company based in Honolulu, HI. We provide innovative and high-quality healthcare services to our clients, including insurance companies, hospitals, and healthcare... 
    Relocation package

    Telenett

    Honolulu, HI
    4 days ago
  • Insight Global is looking for a Utilization Review Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for evaluating 3.5 patient care cases per hour (both inpatient and outpatient) and collaborating with doctors... 
    Hourly pay
    Remote work

    Insight Global

    Raleigh, NC
    4 days ago
  • Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside...  ...outpatient services. You’ll use advanced clinical judgment to review medical records, validate care plans, and authorize services that... 
    Immediate start
    Remote work
    Weekend work
    Day shift

    The Judge Group

    New York, NY
    5 days ago
  •  ...medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from... 
    Full time
    Contract work
    Remote work

    Innovative Systems Group

    Richardson, TX
    5 days ago
  •  ...expanding access to our unique model of care across the United States. Overview Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health... 
    Work at office

    NeuroPsychiatric Hospitals

    Crown Point, IN
    4 days ago
  •  ...knowledge of local and national coverage determinations Recent work experience in a hospital or insurance company providing utilization review services Knowledge of Medicare, Medicaid, and Managed Care requirements Progressive knowledge of community resources, health... 
    Permanent employment
    Work experience placement
    Local area

    Houston Methodist

    Houston, TX
    1 day ago
  • $4,801.16 - $7,761.5 per month

     ...advancement, and more. Benefits of Working at HHS webpage contains additional details. Position Details Functional Title: Utilization Review Nurse Job Title: Nurse II Agency: Health & Human Services Comm Department: UR Wav & Comm Srvs Ran Mmt St Posting Number:... 
    Full time
    Temporary work
    Part time
    Work at office
    Remote work
    Shift work

    Texas Health and Human Services

    San Antonio, TX
    1 day ago
  • Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Required Qualifications Nursing school graduate. California Registered Nurse License upon hire... 
    Minimum wage
    Work at office
    Local area
    Shift work

    Providence Health & Services

    Los Angeles, CA
    2 days ago
  • $78.56k - $110.91k

     ...Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Part Time | Weekends Salary: $78,561.60...  ...0 per year What You Will Do: Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical... 
    Temporary work
    Part time
    Local area
    Remote work
    Weekend work

    Ascension

    Nashville, TN
    2 days ago