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Remote Utilization Management Nurse jobs

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RN UTILIZATION MANAGEMENT NURSE - REMOTE IN OR

Consistently exhibits behavior and communication skills that demonstrate Optums commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Perform all function...

CompanyOptum
AddressPortland, OR
CategoryInformation Technology
Job typeFull-time
Date Posted 3 days ago See detail

RN Utilization Management Nurse - Remote in OR

Optum

Portland, OR

Consistently exhibits behavior and communication skills that demonstrate Optums commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Perform all function...

3 days ago seen See more...

RN - Utilization Management Nurse 2 - Remote - Florida Region

Humana

Indiana, United States

$69,800 - $96,200 a year

Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action 3-5 years of prior clinical experience preferably in an acute care hospital, skilled or rehabilitation clinical setting Comprehensive knowledge...

6 days ago seen See more...

RN - Telephonic Utilization Management Nurse- Medicare- Remote - Southeast Region

Humana

Indiana, United States

$69,800 - $96,200 a year

Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Coordinates and communicates with providers, members, or other parties to facilitate appropriate discharge planning i...

6 days ago seen See more...

RN - Utilization Management Nurse 2 - Remote - Florida Region

Humana

Vermont, United States

$69,800 - $96,200 a year

Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action 3-5 years of prior clinical experience preferably in an acute care hospital, skilled or rehabilitation clinical setting Comprehensive knowledge...

a week ago seen See more...

Utilization Management Nurse, Senior

Blue Shield Of California

Rancho Cordova, CA

$87,230 - $130,900 a year

Perform clinical claim reviews and first claim level determination approvals for members using FEP evidenced based guidelines, policies and nationally recognized clinal criteria Conducts clinical review of claims for medical neces...

3 days ago seen See more...

Prior Authorization Utilization Management Nurse Consultant

Cvs Health

Austin, TX

Must have active, current and unrestricted compact RN licensure in state of residence. 3+ years of clinical experience. Must be wiling and able to work Monday through Friday 8am to 5 pm CST with occasional weekend/holiday on-call....

4 days ago seen See more...

Registered Nurse, Utilization Management

Thoughtwave Software And Solutions

Baltimore, MD

$34.79 - $46.00 an hour

Concurrent review of patients clinical information for efficiency. Ongoing review of precertification requests for medical necessity. Monitor the activities of clinical and non-clinical staff. Coordinates patients discharge plan...

6 days ago seen See more...

PCS Case Manager/Utilization Review Nurse

Adams Health Network

Decatur, IN

Registered Nurse...

6 days ago seen See more...

Utilization Review Nurse Manager

Community Alternatives Inc

Charlotte, NC

$65,000 - $95,000 a year

Dental insurance. Health insurance. Life insurance. Paid time off. Retirement plan. Vision insurance. 8 hour shift. Monday to Friday. Please list you RN license number? What types of patients have you primarily worked with in your...

7 days ago seen See more...

Prior Authorization Utilization Management Nurse Consultant

Cvs Health

Frankfort, KY

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

2 weeks ago seen See more...

Utilization Management Nurse

Blue Eagle Consulting

Birmingham, AL

Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews. Current Nursing License and in good standing Prior Authorization and UM expert NCQA and InterQual expertise preferred Facets exper...

2 weeks ago seen See more...

Manager, Utilization Management - Remote (Maine)

Martin's Point Health Care

Portland, ME

Ensures that utilization review programs and guidelines are aligned with current industry evidence-based practice, as well as local, national, and regulatory compliance standards Manages the utilization review operations of the He...

a week ago seen See more...

Wound Care Certified Home Health Utilization Management Nursing, RN

Centerwell Home Health

Tampa, FL

$69,800 - $78,700 per year

Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.Use your skills to make an impact Typically requires Bachelors degree or e...

2 weeks ago seen See more...

Registered Nurse-Utilization Management

Department Of Veterans Affairs

Louisville, KY

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

2 weeks ago seen See more...

Utilization Management Nurse 2 -Post Acute Pre Auth WEEKENDS

Humana

Louisiana, United States

$69.9K - $88.5K a year

Licensed Registered Nurse (RN) in the state of Florida, or compact license, with no disciplinary action. Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting Comprehensive knowledge of...

3 weeks ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Bismarck, ND

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

3 weeks ago seen See more...

Utilization Managed Care Nurse

Access Healthcare Physicians, Llc

Spring Hill, FL

From $65,000 a year

401(k). Dental insurance. Health insurance. Life insurance. Paid time off. Vision insurance. 8 hour shift. Day shift. Monday to Friday. Medical records: 1 year (Preferred). CTST: 1 year (Required). RN: 5 years (Required). HEALTH P...

3 weeks ago seen See more...

Market Medical Director, Utilization Management - WellMed - Remote

Optum

San Antonio, TX

401(k)

Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values. Educates primary care physicians regarding systems, structures, processes and outcom...

3 weeks ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Harrisburg, PA

$29.10 - $62.31 an hour

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

a month ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Hartford, CT

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Springfield, IL

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

2 months ago seen See more...

Utilization Management Nurse - Dallas, TX

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required.. Minimum of two years Utilization Management acute care setting experience required. . Minimum of one-year drafting and submitting reco...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Columbus, OH

Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. We are health care innovators.Fundamentals:Through the use of cli...

2 months ago seen See more...

Texas Institute Utilization Management Nurse -Dallas

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required. Minimum of two years Utilization Management acute care setting experience required. Minimum of one year drafting an...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Phoenix, AZ

1+ year varied Utilization Management experience within an inpatient/Outpatient setting, concurrent review or prior authorization. 5+ years of variety clinical experience required including acute care, home health, or long term ca...

2 months ago seen See more...

Utilization Management RN PRN Remote

Adventhealth Corporate

Altamonte Springs, FL

$34.78 - $52.17 an hour

Benefits from Day One. Career Development. Whole Person Wellbeing Resources. Mental Health Resources and Support. Facilitating precertification and payor authorization processes as required, ensuring proper authorization has been...

a month ago seen See more...

Nurse IV (Utilization Management)

Department Of Veterans Affairs

Vancouver, WA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

2 months ago seen See more...

Behavioral Health Utilization Management, Remote - Kansas License

Unitedhealth Group

Overland Park, KS

Manage facility-based admissions for mental health and substance abuse through the continuum of care. Effectively collaborate with treating providers and facilities to ensure consumers are receiving treatment in line with best pra...

2 months ago seen See more...

Utilization Management Clinical Nurse Consultant

Cvs Health

Phoenix, AZ

3+ years clinical practice experience required.. Must have a active and unrestricted RN Licensure in the state of Arizona or Compact RN licensure. Utilization management experience preferred.. Acute care setting experience preferr...

2 months ago seen See more...

Nurse Manager - Utilization Management

Kaiser Permanente

Oakland, CA

Manages the operations of 24-hour departments that may be at multiple locations. Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal,...

4 weeks ago seen See more...

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