Top 557 Outpatient nurse Jobs in Remote

PA Clinician (RN)
Artech —Austin, TX
- Contract
- Remote
- RN License
- Writing skills
- Mid-level
Quick Apply
Claims Review Nurse
Optum —San Diego, CA
- $28.94 - $51.63 an hour
- Full-time
- Remote
- CPR Certification
- Nursing
- RN License
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3d
Registered Nurse - Freelance AI Trainer Project
Meridial —Remote
- $6 - $65 an hour
- Remote
- Nursing
- Medication administration
- RN License
- Health insurance
Remote Triage Nurse (Full-Time)
Diana Health —Remote
- Full-time
- Remote
- Medication administration
- Mid-level
- Outpatient experience
- Paid parental leave
- Health savings account
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Nurse Navigator - Remote
Pager Health —Remote
- $35 - $37 an hour
- Email
- Remote
- Spanish
- Nursing
- RN License
4d
Utilization Management Nurse
Blue Eagle Consulting —Remote
- RN License
- Mid-level
- Nursing
Quick Apply
Medical Review Nurse - SNF/MDS Auditor
Machinify —Remote
- Remote
- Nursing
- RN License
- HIPAA
Medical Management - Utilization Management RN 145-2026
CommunityCare —Remote
- Full-time
- Remote
- Background check
- Nursing
- RN License
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Medical Management - Utilization Management RN 145-2011
CommunityCare —Remote
- Full-time
- Remote
- Background check
- Nursing
- RN License
Quick Apply
Health Nurse - Utilization Management
Alterwood Health —Remote
- $75,000 - $95,000 a year
- Full-time
- Microsoft Word
- Background check
- Nursing
- Health savings account
- Disability insurance
Quick Apply
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)
3:15 —Houston, TX
- $55,000 - $65,000 a year
- Full-time
- Remote
- Background check
- RN License
- Computer literacy
- AD&D insurance
- Health insurance
Quick Apply
Remote Care Coordinator ( Medical Assistant) – CCM/RPM
Telecare-USA —Remote
- From $2,500 a month
- Full-time
- Remote
- LVN
- Computer literacy
- Medical office experience
- Paid training
- Paid time off
Quick Apply
7d
Utilization Review RN Part- time Day - REMOTE
Providence —Irvine, CA
- $57.28 - $88.92 an hour
- 8 hour shift
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
9h
Nurse Navigator - Remote (Overnight)
Pager Health —Remote
- $35 - $37 an hour
- Overnight shift
- Remote
- Spanish
- Nursing
- RN License
5d
Utilization Management Nurse
Brighton Health Plan Solutions, LLC —Remote
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
CA Utilization Review Nurse I
CorVel Corporation —Rancho Cucamonga, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- LVN
- RN License
- Health savings account
- Disability insurance
Quick Apply
Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options
Talkiatry —Montana
- $180,000 - $215,000 a year
- Part-time
- Remote
- Nursing
- Psychiatry
- Outpatient experience
- Health savings account
- Paid holidays
Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options
Talkiatry —Idaho
- $180,000 - $215,000 a year
- Part-time
- Remote
- Nursing
- Psychiatry
- Outpatient experience
- Health savings account
- Paid holidays
Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options
Talkiatry —Rhode Island
- $180,000 - $215,000 a year
- Part-time
- Remote
- Nursing
- Psychiatry
- Outpatient experience
- Health savings account
- Paid holidays
Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options
Talkiatry —Vermont
- $180,000 - $215,000 a year
- Part-time
- Remote
- Nursing
- Psychiatry
- Outpatient experience
- Health savings account
- Paid holidays
10d

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PA Clinician (RN)

Artech -
Austin, TX

Quick Apply

Job Details

Contract

Qualifications

Teamwork
RN License
Interpersonal skills
Writing skills
Resource utilization in healthcare
Healthcare compliance
Nursing

Full Job Description

Job Overview

We are seeking an experienced Registered Nurse (RN) to perform pre-service, concurrent, and retrospective utilization reviews. The RN will collaborate with healthcare providers to ensure medically appropriate, high-quality, and cost-effective care while promoting positive member outcomes and optimizing healthcare resources.

This position does not involve direct patient care.

Key Responsibilities

Conduct pre-service, concurrent, and retrospective medical necessity reviews.
Assess the medical necessity of outpatient services and out-of-network services.
Evaluate the appropriateness of treatment settings within the scope of professional nursing practice.
Collaborate with healthcare providers and interdisciplinary teams to promote quality member outcomes.
Ensure compliance with applicable healthcare regulations, policies, and procedures.
Apply Texas Administrative Code (TAC) guidelines and criteria during the review process.
Review clinical documentation and determine coverage eligibility based on medical necessity requirements.
Promote effective utilization of healthcare resources while maintaining quality standards.
Document review findings accurately and thoroughly.
Participate in team meetings, training sessions, and quality improvement initiatives as required.

Required Qualifications

Active and unrestricted Registered Nurse (RN) license.
Experience conducting utilization review, medical necessity review, case management, or related healthcare review functions.
Knowledge of medical necessity criteria and healthcare utilization management practices.
Ability to interpret and apply Texas Administrative Code (TAC) regulations.
Strong analytical, critical thinking, and decision-making skills.
Excellent verbal and written communication skills.
Ability to work independently in a fast-paced environment.

Preferred Qualifications

Experience with Medicaid, managed care, or healthcare insurance programs.
Proficiency in Microsoft Word and Microsoft Excel.
Prior experience with pre-service, concurrent, and retrospective review processes.

Additional Information

Work Location: Austin, TX
No vaccination requirement
No travel required
High likelihood of contract extension

Skills

Utilization Review
Medical Necessity Review
Case Management
Texas Administrative Code (TAC)
Clinical Documentation Review
Healthcare Compliance
Quality Assurance
Microsoft Word
Microsoft Excel
Communication & Collaboration

Work Location: Remote

Quick Apply

Refine Your Search

outpatient nurse jobs in remote

PA Clinician (RN)

Claims Review Nurse

Registered Nurse - Freelance AI Trainer Project

Remote Triage Nurse (Full-Time)

Nurse Navigator - Remote

Utilization Management Nurse

Medical Review Nurse - SNF/MDS Auditor

Medical Management - Utilization Management RN 145-2026

Medical Management - Utilization Management RN 145-2011

Health Nurse - Utilization Management

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

Remote Care Coordinator ( Medical Assistant) – CCM/RPM

Utilization Review RN Part- time Day - REMOTE

Nurse Navigator - Remote (Overnight)

Utilization Management Nurse

CA Utilization Review Nurse I

Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options

Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options

Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options

Remote Psychiatric Nurse Practitioner (PMHNP) - Outpatient Practice. W2 w/Benefits, PT & FT options

I want to receive the latest job alert for outpatient nurse in remote

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