Average salary: $75,400 /yearly

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  • Utilization Review RN

     ...ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication...  ...individual will defer decision to a second level reviewer. This individual interfaces with case...  ...licensure includes but is not limited to RN, LMSW, LMHC. # Successful completion of... 
    Suggested
    Temporary work
    Work at office
    Remote work
    Work from home
    Monday to Friday
    Flexible hours

    Hines & Associates Inc

    Freeport, IL
    15 days ago

  • Local Contract Nurse RN - Utilization Review

     ...Job Description Pyramid Consulting (Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Duration:... 
    Suggested
    Permanent employment
    Full time
    Contract work
    Part time
    Local area
    Remote work
    Shift work

    Pyramid Consulting (Travel)

    Philadelphia, PA
    9 days ago

  • Hospital RN - Care Coordination & Utilization Review

    $60 - $65 per hour

     ...Immediate need for a talented Hospital RN – Care Coordination & Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Santa Clara, CA (Onsite). Please review the job description below and contact me ASAP if you are... 
    Suggested
    Contract work
    Local area
    Immediate start

    Pyramid Consulting, Inc

    Santa Clara, CA
    1 day ago

  • RN Peer Review Specialist

     ...50 Job Summary The Peer Review Specialist facilitates provider peer review...  ...studies and assigned routine monitoring, utilizing defined guidelines and criteria of the...  ...Currently holds an unencumbered RN license with the State Board of Nursing where... 
    Suggested
    Full time
    Part time
    Work from home
    Shift work
    Day shift

    Sanford Health

    Hines, MN
    17 hours ago

  • Clinical Reviewer, Nurse (Medical Oncology) - 9am-6pm PST

    $32 - $37 per hour

     ...mission. Stay for the culture. The Clinical Review Nurse is responsible for performing...  ...approvals. Tasks are performed within the RN/LVN/LPN scope of practice, under the...  ...Nurse will: Perform pre-certification utilization reviews of Oncology treatment requests... 
    Suggested
    Work experience placement
    Immediate start
    Remote work
    Weekend work

    Maryland Staffing

    Annapolis, MD
    1 day ago

  • Remote RN: Medical Review & Appeals Specialist

    $65k - $85k

     ...A healthcare management firm is seeking a Medical Review and Appeals RN. This remote role involves reviewing and authorizing medical service requests, ensuring compliance with regulations, and implementing discharge planning. Candidates must have a Bachelors degree in... 
    Suggested
    Remote work

    UST HealthProof

    United States
    22 hours ago

  • Review Nurse, Prior Authorization/Utilization Management

     ...a "2025 Best Place to Work and Healthiest Employer", seeks a Review Nurse. The Review Nurse conducts prior approval and precertification...  ...Georgia nursing license required Preferred: ~ Utilization Review or Prior Approval Precertification experience Alliant... 
    Suggested
    Contract work

    Alliant Health Solutions, Inc.

    Atlanta, GA
    9 days ago

  • Utilization Review Nurse

    $35 - $45.94 per hour

     ...Description Job Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. Oscar is the...  ...duties as assigned Requirements: ~ Active, unrestricted RN licensure from the United States in [state], OR, active compact... 
    Suggested
    Hourly pay
    Full time
    Remote work
    Work from home
    Home office

    Oscar Health

    Dallas, TX
    3 days ago

  • Utilization Review Advisor- Physician (MD/DO)

     ...Inova Fairfax Medical Campus is looking for a dedicated physician advisor to join the Utilization Review Advisor team. This role will be full-time Position. The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews... 
    Suggested
    Full time
    Remote work
    Flexible hours

    Inova Health System

    Fairfax, VA
    4 days ago

  • District School Nurse (RN)

    $64.46k - $77.06k

     ...Description: District School Nurse (RN) Special Education Support Services 2...  ...Description Attached) Job Goal: To utilize those principles of health and education...  ...is recommended that every applicant should review this website to verify license requirements... 
    Suggested
    Zero hours contract
    Work at office

    Nye County School District

    Pahrump, NV
    17 hours ago

  • Oncology Utilization Management Registered Nurse

    $80k - $95k

     ...provide compassionate and accessible cancer care. As an Oncology Utilization Management RN, you help ensure patients receive timely and appropriate...  ...our Mission, Vision, and Core Values. Your clinical care review determinations for our hematology and oncology patients... 
    Suggested
    Remote work

    The Oncology Institute of Hope and Innovation

    Tampa, FL
    7 days ago

  • Medical Review and Appeals RN

    $65k - $85k

     ...Join to apply for the Medical Review and Appeals RN role at UST HealthProof 3 days ago Be among the first 25 applicants Who We Are...  ...acute patient care, discharge planning, case management, and utilization review, etc. Demonstrated clinical knowledge and... 
    Suggested
    Full time
    Temporary work
    Part time
    Work at office
    Local area
    Remote work
    Flexible hours

    UST HealthProof

    Aliso Viejo, CA
    4 days ago

  • Physician Reviewer - Utilization Management

    $211.2k - $277.2k

     ...Job Description Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members.... 
    Suggested
    Full time
    Local area
    Remote work
    Work from home
    Home office
    Weekend work

    Oscar Health

    Tampa, FL
    8 days ago

  • Clinical Reviewer (SCA) - Remote

    $28.37 - $39.19 per hour

     ...Acentra Health is looking for a Clinical Reviewer (SCA) to join our growing team. Job...  ...Summary: The purpose of this position is to utilize clinical expertise during beneficiary...  ...Qualifications Active unrestricted LPN, RN or Social Worker or other applicable... 
    Suggested
    Contract work
    Work at office
    Local area
    Remote work
    Flexible hours

    Acentra Health

    McLean, VA
    1 day ago

  • RN, Registered Nurse- Pre-Certification Pharmacy Review

     ...About the role The Pre-Certification Review Nurse - Pharmacy is responsible for reviewing...  ...processing coverage determinations and utilization management reviews for specialty...  ...and Active license as a Registered Nurse (RN) in the state of Ohio. Licensed Practical... 
    Suggested
    Permanent employment
    Casual work
    Work at office

    quantum-health

    Dublin, OH
    1 day ago

  • Registered Nurse (RN), Medical Record Review, Legal Nurse

    $80k - $85k

     ...Ciarimboli PC is immediately hiring a Registered Nurse (RN), Medical Record Review, Legal Nurse to join their team in Kingston and/or Scranton...  ...improvement, compliance, risk management assessment, or utilization review preferred. • In depth knowledge of medical practices... 
    Summer work
    Immediate start
    Remote work

    Harvis Inc

    Scranton, PA
    3 days ago

  • Registered Nurse RN PCU Oncology

    $10k

     ...semi-private rooms with the capability of utilizing up to 16 remote cardiac monitors which...  ..., cultural and discharge planning needs. Reviews patient history and physical with patient...  ...QUALIFICATIONS Must possess a current, valid RN license in state of practice, temporary/... 
    Hourly pay
    Price work
    Temporary work
    Part time
    Interim role
    Remote work
    Relocation package
    Flexible hours
    Shift work
    Night shift
    Weekend work

    Banner Health

    Sun City, AZ
    a month ago

  • Travel Nurse RN - Oncology Med Surg

     ...American Traveler is seeking a travel nurse RN Oncology Med Surg for a travel nursing...  ...weekend, holiday, or on-call requirements ~ Utilizes Epic EMR and Omnicell medication...  ...obtaining vital signs and weight, completing review of systems and medication reconciliation... 
    Daily paid
    Permanent employment
    Contract work
    Immediate start
    Shift work
    Day shift

    American Traveler

    Rapid City, SD
    2 days ago

  • Nurse Manager Utilization Management

    $131.4k - $169.95k

     ...of physicians and other health care practitioners; driving the utilization of systems for granting or terminating clinical privileges,...  ...membership, proctoring and continuing education; leading the review and approval of medical staff or provider staff Bylaws, Rules... 
    Full time
    Work experience placement
    Work from home
    Flexible hours
    Shift work

    Kaiser Permanente

    Portland, OR
    4 days ago

  • New Graduate Nurse - RN - Cardiovascular Surgery - PRN

     ...Team, Documentation Integrity Specialist, RN Case Manager, Social Worker, Pharmacy,...  ...Telephone/Verbal Orders, Acknowledging Orders, Reviewing Standing Orders and Order Sets, Scanning...  ...Pharmacy, and Review of ED Record • Utilizing the Electronic Medical Record (EMR) for:... 
    Hourly pay
    Temporary work
    Relief
    Shift work

    McLeod Health

    Florence, SC
    1 day ago

  • STAFF NURSE UNION, RN - ENDOSCOPY

     ...documents all required departmental cleaning utilizing cleaning checklist. # Performs and...  ...prints pictures when necessary. For RN Assigned as Charge Nurse: The Endoscopy...  ...Charge Nurse Job Duties: # Reviews Staffing daily, ensuring adequate staffing... 
    Part time
    Casual work
    Local area
    Immediate start
    Shift work

    Aultman Health Foundation

    Alliance, OH
    4 days ago

  • RN Registered Nurse, Acute Rehab - West Penn

     ...needs of the patient and skill level of the RN, LPN or support staff. Assigns duties and...  ...scope of practice as appropriate. Utilizes the nursing process to assess, plan,...  ...knowledge. Participates in systematic peer review and obtains informal feedback regarding... 
    Full time
    Part time
    For contractors
    Local area
    Shift work

    Highmark Health

    Pittsburgh, PA
    4 days ago

  • Clinical Review Nurse - Remote

     ...Description Job Description CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple...  ...decisions on the coverage, medical necessity, utilization and appropriateness of care per national...  ...* Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS *... 
    Remote job
    Permanent employment
    Work at office
    Local area

    ARC Group

    Jacksonville, FL
    29 days ago

  • Clinical Review Nurse - Remote

     ...Description ARC Group is recruiting for CLINICAL REVIEW NURSE REMOTE (GEORGIA RESIDENTS ONLY)...  ...determine coverage, medical necessity, utilization, and appropriateness of care per policy...  ...Valid, unrestricted Registered Nurse (RN) license Preferred Qualifications Inpatient... 
    Remote job
    Permanent employment
    Full time
    Work at office
    Local area

    ARC Group

    Jacksonville, GA
    29 days ago

  • Medical Review Director - CGS Administrators, LLC

    $76.55k

     ...team! Position Purpose: The Medical Review Director directs and oversees operations...  ...~5 years healthcare program management, utilization/case management, or medical review management...  ...Licenses and Certificates: Active RN licensure in state hired. Work Environment... 
    Full time
    Contract work
    For contractors
    Work at office
    Local area
    Remote work
    Monday to Friday
    Shift work

    CGS Administrators

    Springfield, IL
    3 days ago

  • Utilization Management Clinician I (RN)

     ...work environment. About the Role The Level I Utilization Management Clinician performs utilization review for medical or behavioral health requests using utilization...  .... Have a current, unrestricted license as an RN or LPN. Have at least two years clinical... 
    Full time
    Temporary work
    Part time
    Work at office
    Remote work
    Trial period
    All shifts
    Flexible hours

    Community Health Plan of Washington

    Seattle, WA
    8 days ago

  • Registered Nurse (RN) - Manager, Cardiac Stepdown

     ...North Cal is seeking a Registered Nurse (RN) Manager, Cardiac Stepdown for a nursing...  ...Patient Care Services, the Shift Manager utilizes the nursing process and organizational/ leadership...  ...Utilizes observation techniques, chart review, and patient interviews to evaluate staff... 
    Temporary work
    Part time
    Relocation package
    Flexible hours
    Shift work

    Tenet North Cal

    Modesto, CA
    14 days ago

  • Registered Nurse RN Emergency Department

     ...skills to make it happen. ED experienced RN with BSN is highly preferred. This is a full...  ...0 AM. You will also have the opportunity utilize our self-scheduling tool for shift and...  ..., cultural and discharge planning needs. Reviews patient history and physical with patient... 
    Price work
    Full time
    Temporary work
    Interim role
    Remote work
    Shift work
    Night shift
    Weekend work
    Afternoon shift

    Banner Health

    Gilbert, AZ
    a month ago

  • Supervisory Public Utilities Specialist

     ...Officer (K). A successful candidate in the Supervisory Public Utilities Specialist position will serve as the manager of the Customer...  ...these questions is not scored or rated. Your answers will be reviewed by the hiring manager and agency leadership if you are referred... 
    Full time
    Part time
    Work at office
    Remote work
    Flexible hours

    Bonneville Power

    Portland, OR
    4 days ago

  • PRN Dialysis Registered Nurse, RN

    $60 - $65 per hour

     ...founded over 30 years ago by a Dialysis RN who believes everyone is entitled to excellent...  ...a resource for staff. You will be utilizing your assessment skills, technical skills,...  ...based on current knowledge; consistently reviews and evaluates priorities as changes occur... 
    Hourly pay
    Relief
    Work at office
    Immediate start
    Remote work
    Monday to Friday
    Shift work

    Rendevor Dialysis

    Jarratt, VA
    1 day ago