Utilization review nurse near me

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions...

Metairie, LA Order: 1270847 Order Type : Temp Are you detail-oriented with a strong legal background? Our client is seeking a Document Review Specialist to analyze bids and proposals, ensuring compliance and accuracy in...

Utilization Review - Fully Remote This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and inpatient admissions. The position requires...

Job Title: Care Management Coordinator/RN Pay rate: $45/HR W2 Duration: 3 months contract-to-hire 100% Remote Job Description: Position is remote -...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

A growing commercial insurance company is seeking a Clinical Review Nurse to assess medical necessity and appropriateness of treatments for Workers' Compensation claimants. This role involves collaboration with claims adjusters and conducting...

A national health organization is seeking a clinical professional to perform concurrent reviews and evaluate member health. This remote position requires a Nevada LPN or RN license and offers a pay range of $26.50 - $47.59 per hour, along with...

Employment Type: Full time Shift: Day Shift Description: RN - Outpatient General Surgery Albany, NY / Hybrid Remote FT If you are looking for an RN II position, this could be your...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Join to apply for the PRN - Remote ENT Utilization Review Work role at Medical Review Institute of America Flexible Independent Contractor (1099) Opportunity FOR PHYSICIANS ONLY Current Unrestricted MINNESOTA,...

A leading healthcare organization is seeking a Utilization Management Registered Nurse 2 to support medical services coordination. This remote position requires a valid RN license, with preference for candidates with 3+ years in skilled nursing...

MSSI is seeking a travel nurse RN Utilization Review for a travel nursing job in Minneapolis, Minnesota. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 12/08/2025 Duration: 13 weeks 40 hours per week Shift:...

RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25293) Location: Hybrid (Remote to Office-Based) - Jericho, NY Employment Type: Full-time Hourly Rate: For remote, it's $50/hr, and...

A healthcare organization in New York is seeking a Clinical Review Nurse to analyze prior authorization requests and determine the medical necessity of services. The ideal candidate will have a New York State nursing license and 2-4 years of...

Clinical Appeals Nurse The Remote Clinical Denials/Appeals Nurse will be directly responsible for securing pre-service approvals, and reviewing pre/post service denials, medical necessity review and completing appeals and/or coordinating...

Clinical/CDI Second Level Reviewer / Pre-Bill Auditor Seeking experienced Clinical Second Level Reviewer / Pre-Bill Auditor to support accurate documentation and coding practices that impact reimbursement, quality metrics, and compliance.

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

This position is responsible for conducting face-to-face assessments of members who may need skilled nurse assessment services. The incumbent completes all assessments using a skilled care acuity tool and provides a recommendation for services...

Clinical Appeals Nurse The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina...

Join to apply for the RN Call Assist Remote in PST role at Optum 1 day ago Be among the first 25 applicants Join to apply for the RN Call Assist Remote in PST role at...

A Certified or Registered Medical Assistant provides patient care under the direction of a medical provider. Responsible for rooming patients, taking vital signs, and facilitating the work flow of the physician schedule. Utilizes the EMR to...

Caring. Connecting. Growing Together. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by...

Business (Non-Clinical) General Summary: Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical, business,...

RN - Outpatient General Surgery Albany, NY / Hybrid Remote FT If you are looking for an RN II position, this could be your opportunity. Here at St. Peters Health Partners, we care for more people in more places. Position...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

Clinical Reviewer III, Licensed/Remote (Louisiana) Conducts and oversees treatment record and case management record reviews. Trends and analyzes findings for internal and external reporting. Reviews charts and analyzes clinical record...