Top 191 Utilization review nurse (rn) Jobs in Remote

TX, RN Certified Case Manager - Workers Compensation
The Reny Company —Dallas, TX
- $80,000 - $90,000 a year
- 8 hour shift
- Remote
- Nursing
- RN License
- Research
- Mileage reimbursement
- Disability insurance
Quick Apply
Remote Care Management Nurse
Cambia Health Solutions —Utah
- $38.00 - $41.50 an hour
- Overtime
- Remote
- Background check
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Remote Care Management Nurse
Cambia Health Solutions —Idaho
- $38.00 - $41.50 an hour
- Overtime
- Remote
- Background check
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Utilization Management Nurse I, RN
Clever Care Health Plan —Huntington Beach, CA
- $34.98 - $42.85 an hour
- Full-time
- Remote
- Background check
- Spanish
- RN License
Healthcare CDI Specialist
The CSI Companies —Jacksonville, FL
- Contract
- Remote
- Mid-level
- Discharge planning
- Medical terminology
Quick Apply
10d
Concurrent Utilization Review Nurse, RN
NeueHealth —Los Angeles, CA
- $74,286.15 - $111,429.23 a year
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
RN - Utilization Management - MGH
The General Hospital Corporation —Boston, MA
- $41.72 - $105.65 an hour
- Part-time
- Remote
- RN License
- Mid-level
- Experience equivalent to degree accepted
- Opportunities for advancement
Quick Apply
5d
Clinical Medical Review Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
4d
Telephonic Registered Nurse Clinical Reviewer - EviCore - Remote
The Cigna Group —Remote
- $31 - $52 an hour
- 8 hour shift
- Remote
- Nursing
- RN License
- Computer literacy
- Paid holidays
- Health insurance
16h
Clinical Review Nurse
Ternium Revenue Cycle Management —Remote
- $65,000 - $85,000 a year
- Remote
- RN License
- 5 years
- Writing skills
- Dental insurance
- Paid time off
Quick Apply
Utilization Review Nurse
Cobalt Benefits Group LLC —Dallas, TX
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply
10d
Utilization Management Nurse Consultant
CVS Health —Washington, DC
- $26.01 - $74.78 an hour
- Weekends as needed
- Remote
- Nursing
- RN License
- Computer literacy
- Health insurance
- Dental insurance
3d
Lead Utilization Review-RN
Personify Health —Remote
- $38 - $43 an hour
- Email
- Remote
- Microsoft Outlook
- RN License
- Supervising experience
- Health insurance
- Dental insurance
6d
Clinical Reviewer (Part-time)
Neil Hoosier & Associates, Inc. —Remote
- $40 - $45 an hour
- Part-time
- Microsoft Excel
- Microsoft Outlook
- RN License
Quick Apply
Remote Nurse Case Manager - Utilization Review SNF
LTC Ally —Remote
- From $30 an hour
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Health savings account
- Health insurance
Quick Apply
RN - Utilization Management
Piedmont Healthcare Inc. —Atlanta, GA
- Full-time
- Remote
- Nursing
- RN License
- Bachelor of Science
4d
Utilization Management Nurse
Blue Eagle Consulting —Remote
- RN License
- Mid-level
- Nursing
Quick Apply
RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)
Adventist Health —Roseville, CA
- $59.23 - $81.24 an hour
- Part-time
- Remote
- Nursing
- RN License
- Mid-level
13d
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —Los Angeles, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
Nurse Case Manager (Remote Position)
First Choice Health Network Inc —Seattle, WA
- $99,000 - $102,000 a year
- 8 hour shift
- Remote
- Nursing
- Addiction Medicine
- RN License
- Profit sharing
- Wellness program
Quick Apply

I want to receive the latest job alert for utilization review nurse (rn) in remote

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse (rn) jobs near remote

TX, RN Certified Case Manager - Workers Compensation

The Reny Company -
Dallas, TX

Quick Apply

Job Details

Full-time
$80,000 - $90,000 a year

Benefits

Mileage reimbursement
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Flexible schedule
Life insurance
Paid sick time

Qualifications

Utilization review
RN License
Research
Case management
Clinical documentation
Workers' compensation
Certified Case Manager

Full Job Description

Currently seeking TX, LA, OK RN for a full-time Pre Auth/ Certified Case Manager in the TX area (either Houston or DFW). The ideal candidate will be a RN with Pre Auth/Case Management experience in worker’s compensation and also certified in case management.

Responsibilities of the RN Pre-Auth/ Certified Case Manager - Workers Compensation

Conducts prospective review of authorization requests including selected specialties, medical treatments and services, elective hospital admissions, ancillary services, home care and out of network referrals. The nurse makes clinical decisions based on established criteria and regulatory requirements. Prepares documentation and manages the utilization of membership, conducts chart review for medical appropriateness of services, and ensures that quality care is delivered in a cost-effective, timely manner. The Pre-Authorization Nurse works in coordination with an interdisciplinary team to achieve the organization mission as well as department specific goals and objectives.
Research and recommend resources and creates flexible, cost-effective options for catastrophically or chronically ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return to work if appropriate.
Contact customer, medical provider and injured parties on claims involving medical treatment and /or disability to coordinate appropriate medical care and return to work.
Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim.
Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines.
Works closely with injured worker, claims adjusters, employers, and medical providers to ensure best possible medical care is received for the Worker Compensation injury.
Partner with claim professional to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves.
Submit accurate billing documentation on all activities as outlined in established guidelines.
Perform other duties assigned.
Remote position- 85% telephonic & 15% field cases

Requirements of the RN Pre-Auth/Case Manager - Workers Compensation

Graduate of an accredited school of Nursing with a BSN preferred
Must be a Registered Nurse
3-5+ years nursing experience
Workers' compensation and UR experience strongly preferred
Strong technology, organizational and documentation skills a must
Able to work independently, be proactive, and assertive.
need to be a CCM

Benefits:

NO HANDS-ON NURSING REQUIRED!!!!
Remote position: DFW or Houston preferred location, will consider adjacent locations.
Top Salary and excellent benefits including Health Insurance and 401K

Job Type: Full-time

Pay: $80,000.00 - $90,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Flexible schedule
Health insurance
Life insurance
Mileage reimbursement
Paid sick time
Paid time off
Vision insurance

Schedule:

8 hour shift
Monday to Friday

Willingness to travel:

25% (Required)

Work Location: Remote

Quick Apply

Refine Your Search

utilization review nurse (rn) jobs in remote

TX, RN Certified Case Manager - Workers Compensation

Remote Care Management Nurse

Remote Care Management Nurse

Utilization Management Nurse I, RN

Healthcare CDI Specialist

Concurrent Utilization Review Nurse, RN

RN - Utilization Management - MGH

Clinical Medical Review Nurse (Remote)

Telephonic Registered Nurse Clinical Reviewer - EviCore - Remote

Clinical Review Nurse

Utilization Review Nurse

Utilization Management Nurse Consultant

Lead Utilization Review-RN

Clinical Reviewer (Part-time)

Remote Nurse Case Manager - Utilization Review SNF

RN - Utilization Management

Utilization Management Nurse

RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Nurse Case Manager (Remote Position)

I want to receive the latest job alert for utilization review nurse (rn) in remote

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected