Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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.

#J-18808-Ljbffr

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Virtual Health RN in Boston, MA vacancy
  • $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... 
    Suggested
    Full time
    Shift work
    Weekend work
    Day shift

    LifeBridge Health

    Baltimore, MD
    1 day ago
  •  ...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 work
    Full time
    Work from home
    Shift work
    Weekend work
    Afternoon shift

    MRINetwork

    United States
    3 days ago
  • $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 job
    Immediate start
    Monday to Friday

    Alignment Healthcare LLC

    New York, NY
    1 day ago
  • 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

    Visa Hunt

    New York, NY
    3 days ago
  • $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 work
    Full time
    Temporary work
    Part time
    Work at office
    Work from home
    Monday to Friday
    Flexible hours

    Hines

    Rockford, IL
    4 days ago
  •  ...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

    Molina Healthcare

    San Francisco, CA
    4 days ago
  •  ...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 work
    Relief
    Local area
    Work from home
    Monday to Friday
    Flexible hours
    Shift work

    BJC HealthCare

    Saint Louis, MO
    19 hours ago
  • $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 job
    Hourly pay
    Monday to Friday

    Astrana Health

    California, MO
    9 hours ago
  • $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 job
    Hourly pay

    Astrana Health

    California, MO
    2 days ago
  • 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

    TurningPoint Healthcare Solutions

    Florida, NY
    3 days ago
  •  ...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

    Varite

    United States
    2 days ago
  •  ...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 work
    Relief
    Weekend work
    3 days per week

    Children's Healthcare of Atlanta

    Atlanta, GA
    4 days ago
  •  ...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 work
    Full time
    Shift work

    Gibson Area Hospital

    Gibson City, IL
    3 days ago
  •  ...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

    University of Miami

    United States
    1 day ago
  • 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 job
    Monday to Friday
    Flexible hours

    Molina Healthcare

    New York, NY
    1 day ago
  • 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 job
    Full time

    Comagine Health

    Sacramento, CA
    4 days ago
  • 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 job
    Flexible hours

    kozmetickesluzby.vecnakraska.sk - Jobboard

    Caribou, ME
    3 days ago
  • $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 work
    Full time
    Contract work
    Temporary work
    Local area

    Akkodis

    California, MO
    19 hours ago
  • $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 work
    Hourly pay

    GreenLife Healthcare Staffing

    New York, NY
    2 hours ago
  • 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 work
    Immediate start
    Weekend work
    Day shift

    The Judge Group

    New York, NY
    4 days ago
  •  ...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 Systems
    Remote work
    Work at office

    Nexus Health Systems

    Houston, TX
    2 days ago
  •  ...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 work
    Night shift

    Nuvance Health

    Poughkeepsie, NY
    2 days ago
  •  ...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

    3B Healthcare, Inc.

    United States
    2 days ago
  •  ...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

    Guidehealth

    Chicago, IL
    3 days ago
  •  ...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

    Humana

    Columbus, OH
    19 hours ago
  • $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 work
    Work from home

    Humana

    Dover, DE
    19 hours ago
  • 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 work
    Work from home

    Humana

    Providence, RI
    19 hours ago
  •  ...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

    Humana

    Washington DC
    4 days ago
  •  ...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 work
    Shift work
    Weekend work

    AMN Healthcare

    United States
    3 days ago
  • $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 time
    Shift work
    Weekend work

    LifeBridge Health

    Randallstown, MD
    18 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Virtual Health RN. Be the first to apply!