Virtual Health RN
Well Sense Health Plan
WellSense Health Plan in Boston is looking for an Inpatient Utilization Management Clinician to evaluate inpatient medical treatments, monitor ongoing treatment, and facilitate discharge planning. This fully remote role offers a competitive salary range and excellent benefits.
The ideal candidate will have an active RN license, a bachelor's degree in nursing, and at least 2 years of utilization review experience. Join WellSense in helping our members achieve optimal health outcomes.
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$40.12 - $62.19 per hour
...Utilization Review Nurse RN ~Baltimore, MD ~SINAI HOSPITAL ~UTILIZATION REVIEW ~Full-time w/Weekend Commitment - Day shift - 8:00... ...License Experience: At least 2 years of experience in acute inpatient utilization review required Additional...SuggestedFull timeShift workWeekend workDay shift- ...telephonic and e-referral case review and authorization of services utilizing established mental health... ...management review of inpatient, residential, partial,... ...position is full-time, fully remote (work from home) and... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
$85.7k - $128.54k
## Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)Applyremote type: Fully Remotelocations: Anywhere in the U.S.time type: Full... ...Management Nurse Lead is responsible for reviewing requests for inpatient and prior authorization...Remote jobImmediate startMonday to Friday- Gainwell Technologies is seeking a skilled Utilization Review Nurse to conduct prior authorization and reviews for medical... ...needed. The successful candidate will have active RN licensure in the U.S., 3+ years inpatient experience, and 1+ year in prior authorization reviews...Remote job
$1,966 per week
...Holidays Work-life balance. Remote/hybrid setting (once... ...: This individual will utilize clinical knowledge and... ...treatment or inpatient confinement. This individual... ...decision to a second level reviewer. This individual interfaces... ...but is not limited to RN, LMSW, LMHC. Successful...Remote workFull timeTemporary workPart timeWork at officeWork from homeMonday to FridayFlexible hours- ...for clinical member services review assessment processes. Responsible... ...care model. Adheres to utilization management (UM) policies and... ...experience in hospital acute care, inpatient review, prior authorization,... .... Registered Nurse (RN). License must be active and...Remote job
- ...great opportunity for a local remote position. Schedule PRN... ..., behavioral health, inpatient, etc). Requirements: ~2... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing... ...both Missouri and Illinois RN licenses. ~ If candidate...Remote workReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 -... ...Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare...Remote jobHourly payMonday to Friday$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical...Remote jobHourly pay- TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews, assisting...Remote job
- ...Responsibilities: Reviews documentation and evaluates Potential... ...3+ years of experience as an RN ~ Registered Nurse in... ...Must have prior authorization utilization experience ~ Experience with... ...MUST HAVE UM experience, inpatient utilization management review...Remote work
- ...completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees... ...first week. This role will be remote BUT regular meetings/trainings... ...issues. Reviews concurrently all inpatients, including critical care, every...Remote workReliefWeekend work3 days per week
- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
- ...Case Manager RN (U) The Case Manager RN (U) coordinates the... ...recovery, outpatient observation and inpatient admissions to include care... .... Enter Ancillary notes utilizing the templates for care facilitation... ...patient care plans and review medical needs for continued hospital...Remote work
- Molina Healthcare seeks a Telephonic Care Review Clinician (RN) to support Medicare inpatient utilization management. You will verify medical necessity, review admissions and ongoing services against guidelines, and partner with providers, case management, and care coordination...Remote jobMonday to FridayFlexible hours
- Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full‑time position involves managing utilization reviews and ensuring compliance with clinical policies for quality...Remote jobFull time
- Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical... ...Qualified candidates should have an active Maine RN license and at least 3 years of inpatient clinical experience. Additional benefits...Remote jobFlexible hours
$55 per hour
...is hiring a Concurrent Review Nurse to support our client... ...space. Location: Remote (must be based in California... ...concurrent reviews of inpatient activities. This role... ...Experience in case management, utilization management, or... ...judgment within the scope of RN practice in California....Remote workFull timeContract workTemporary workLocal area$50 per hour
...an experienced Registered Nurse Clinical Reviewer for a fully remote position with an hourly rate of $50. This role involves conducting utilization reviews and ensuring healthcare... ...Candidates should have an active New York State RN license and 1-3 years of experience in acute...Remote workHourly pay- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...medical necessity for inpatient and outpatient services. You... ...advanced clinical judgment to review medical records, validate...Remote workImmediate startWeekend workDay shift
- ...Utilization Review Registered Nurse (UR RN) The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery of appropriate, efficient... ...Support (BLS) certification as required for facility based staff; optional for remote staff. Nexus Health SystemsRemote workWork at office
- ...Utilization Review Nurse Position at Vassar Brothers Medical Center... ...appropriate patient status (inpatient, observation, outpatient).... ...outlined in the Nuvance Health Remote Work Program Policy when utilizing... ...in nursing Current NYS RN License. CCM/ACM Preferred...Remote workNight shift
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Minimum of 3 years acute medical Care...Remote work
- ...oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote job
- ...an experienced Medical Director to conduct clinical reviews and guide decision-making in inpatient care. The role emphasizes collaboration and requires... ...clinical experience, with a focus on hospital medicine and utilization review. Join a distinguished team to impact patient...Remote work
$223.8k - $313.1k
A leading U.S. healthcare company seeks a Medical Director to conduct inpatient medical necessity reviews. This role requires an MD or DO with over 5 years of clinical experience. Responsibilities include performing clinical assessments, collaborating with a multidisciplinary...Remote workWork from home- A leading healthcare company is seeking a Medical Director to perform clinical reviews and assess medical necessity for inpatient cases. This role offers the chance to collaborate with a team of physicians, making a significant impact on patient care. Requires an MD/DO...Remote workWork from home
- ...A leading healthcare company in Washington, D.C. is seeking a Medical Director to oversee inpatient medical necessity reviews and utilization management. This role requires strong analytical and communication skills, as well as 5+ years of clinical experience post-residency...Remote work
- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued... ...management experience (hospital-based) ~ Skilled experience with remote work Length of Assignment: 13 weeks Shift / Hours...Remote workShift workWeekend work
$40.12 - $62.19 per hour
...Utilization Review Nurse RN - NE ~Randallstown, MD ~NORTHWEST HOSPITAL ~NW CARE MANAGEMENT ~Part-time - Weekends - Weekend shifts - 8:00am-4:30pm ~RN OTHER ~95496 ~$40.12-$62.19 Experience based ~Posted: Yesterday Apply Now Save...Part timeShift workWeekend work
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