Registered Nurse - Virtual - Full Time (Day Shift)
$57.28 - $88.92 per hourProvidence Health & Service
RN Utilization Review - Remote position. This position will work Full-time, 8-hour day shifts.
Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills.
Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Associate's Degree in Nursing
- California Registered Nurse License
- 2 years experience working in a remote UR environment or working as an acute hospital case manager.
Bachelor's Degree in Nursing
Master's Degree in Nursing
Experience in a multi-hospital and/or integrated healthcare system.
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Posted are the minimum and the maximum wage rates on the wage range for this position. additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Job Category: Health Information Management
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Workplace Type: Remote
additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
$35 - $45 per hour
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$30 - $38 per hour
...Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis, working a minimum of 28... ...to successfully perform in a remote healthcare environment. Ability... ...opportunities alongside full‑time colleagues Mentorship and skill...Full timeRemote workHourly payPart timeWork at officeMonday to FridayWeekend work- ...Job Description RN Utilization Review - Remote position. This position will work Full-time, 8-hour day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical...Full timeRemote workMinimum wageLocal areaShift workDay shift
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$32 - $48 per hour
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...Management Group: Charlotte - Utilization Management Status: Part time Benefits Eligible:... ...and concurrent reviews. • Applies clinical guidelines... .... applicable state RN licensure required. Related... ...your FTE or status (e.g., full-time, part-time, per...Full timeRemote workDaily paidContract workTemporary workPart timeWork at officeFlexible hoursShift workDay shift- ...Molina Healthcare, Inc. is seeking a full-time Michigan Licensed Medical Review Nurse to manage the review of documentation in a remote capacity. This role involves ensuring medical... ...nursing experience and possess an active RN license in Michigan. Knowledge of coding and...Full timeRemote work
$85.99k - $105.34k
...focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical... ...interdisciplinary teams. Applicants should have an active RN license and at least five years of direct patient care...Full timeRemote work- ...A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Full timeRemote work
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$67.7k
...consulting firm is seeking a Medical Claims Reviewer to conduct medical reviews and provide guidance on claims. This remote role requires an active RN license, a bachelor's degree in... ...experience. Ideal candidates will work full-time Monday to Friday, with a salary of $67...Full timeRemote workMonday to Friday- ...solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate... ...experience and must hold an active RN license. Responsibilities include reviewing... ..., and documenting findings. This full-time position offers comprehensive...Full timeRemote work
$35 - $45.94 per hour
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$40 per hour
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$34 - $40 per hour
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...The Utilization Review Nurse gathers demographic and clinical information... ...of CorVel. This is a remote position. ESSENTIAL... ...environment Strong time management skills with... ...of operation required; RN is required unless local... ...package is available for full‑time regular employees...Full timeRemote workHourly payMinimum wageWork at officeLocal areaFlexible hours
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