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Utilization review nurse near me

Utilization Review Nurse - Remote - Contract
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place Metairie, LA
Dec 1

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...
Remote Utilization Management RN Medicare/MA
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place Metairie, LA
Dec 1

A leading healthcare provider in Minnesota is seeking a Registered Nurse (RN) to join their team. The role involves collaborating with healthcare givers in reviewing medical care and services. Candidates should possess an active RN license and at...
FT Billing & Collection Specialist - Work From Home
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place Marrero, LA
Dec 1

[Accounts Receivable / Remote] - Anywhere in U.S. / Up to $32.59 per hour + bonuses / Medical, dental & vision / 401k match / PTO - As a Billing & Collection Specialist at Avesis, you will: Generate accurate and timely invoices for clients...
Utilization Management RN - Remote
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place Metairie, LA
Dec 1

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 connecting people with the care, pharmacy benefits, data...
Clinical Registered Nurse - Utilization Management - Remote
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place Metairie, LA
Dec 1

Job Opportunity: Registered Nurse Schedule: Monday to Friday - Eastern Time Location: Remote About the Role As a Registered Nurse, you will make an impact by performing advanced level work related to clinical denial...
Remote Clinical Review Nurse - Concurrent Care
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place Metairie, LA
Dec 1

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...
Travel Nurse RN - Utilization Review - $2,160 per week
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place Metairie, LA
Dec 1

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:...
Clinical Registered Nurse - Utilization Management - Remote
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place Metairie, LA
Dec 1

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...
Weekend RN - Remote Triage (Sat/Sun)
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place Metairie, LA
Dec 1

A healthcare system in Monroe, NC, is seeking a part-time Registered Nurse to provide high-quality care through evidence-based practices. The role involves nursing process assessments, collaboration with care teams, and remote work...
Quality Program Nurse, RN (Remote)
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place Metairie, LA
Dec 1

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...
Remote RN Utilization Review Case Manager I
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place Metairie, LA
Nov 30

A national risk management provider is seeking a remote Utilization Review Case Manager. This role involves gathering clinical information, certifying medical necessity, and managing stakeholder communications. Ideal candidates will have a nursing...
Clinical Claims Review RN - Remote
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place Metairie, LA
Dec 1

Provide support to all units within Claims to ensure all clinical components are met for CMS, NCQA, URAC, DOL, DOI, and all other State and Federal entities. Identify business priorities and necessary processes to triage and deliver work. Use...
Remote RN: After-Hours Telehealth Care
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place Metairie, LA
Dec 1

A healthcare organization in Massachusetts is seeking a Per Diem Registered Nurse for their After Hours Call Program. This remote role requires a commitment of at least one weekend per month and includes providing virtual visits and clinical...
Clinical Reviewer, Grievance & Appeals (Remote)
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place Metairie, LA
Nov 29

Clinical Operations Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring accurate administration of benefits, execution of clinical policy, timely access to appropriate levels of care and...
RN UM Clinical Appeals Nurse Remote
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place Metairie, LA
Dec 1

Job Summary 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 policies...
FT Customer Service Representative - Work From Home
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place Kenner, LA
Dec 1

[Administrative Assistant / Remote] - Anywhere in U.S. / Up to $29.98 per hour + bonuses / Medical, dental & vision / 401k match / PTO - As a Customer Service Rep at Symetra, you will: Respond to customer inquiries and concerns in a timely and...
RN Coordinator-Utilization Review/Full Time/Remote
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place Metairie, LA
Nov 25

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,...
PRN - Remote ENT Utilization Review Work
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place Metairie, LA
Nov 28

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,...
Travel Nurse - PACU - Post Anesthetic Care in Marrero, Louisiana - $7304/month
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place Marrero, LA
Nov 29

Job Opportunity: RN - PACU - Post Anesthetic Care\n\nPosition Details\nSpecialty: RN - PACU - Post Anesthetic Care\nLocation: Marrero, Louisiana\nFacility: Atlas MedStaff\nEmployment Type: Temporary\nContract Length: 13 weeks\n\nJob...
Clinical Claims Review RN - Remote
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place Metairie, LA
Dec 1

Clinical Claims Review At UnitedHealthcare, we are simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better.
Remote RN OASIS Documentation Specialist
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place Metairie, LA
Dec 1

A leading healthcare provider is seeking a Clinical Documentation Specialist to ensure compliance with CMS regulations by reviewing OASIS documents. The ideal candidate will have a California RN license, 2 years of clinical experience, and...
Remote RN Utilization Manager Reviewer (MA Only)
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place Metairie, LA
Nov 29

A healthcare organization is seeking a Utilization Manager Registered Nurse to join their team in Massachusetts. The role involves conducting clinical reviews for service authorizations and ensuring compliance with regulatory standards. Candidates...
Registered Nurse (RN) - General Ambulatory Services, Remote, Evenings
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place Metairie, LA
Nov 30

Remote Registered Nurse (RN) Nurse Triage The RN Nurse Triage provides high-quality, patient-centered care through telephone triage and clinical assessment. This role is 100% hands-on, responsible for assessing patient symptoms,...
Remote Research Assistant: Literature Review & Data
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place Metairie, LA
Nov 30

An established industry player is seeking a Research Assistant to support a literature review on teacher well-being. This role involves training in literature review processes, conducting literature searches, and collaborating with a lead...
Clinical Denials/Appeals RN - Remote
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place Metairie, LA
Nov 28

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 Documentation Integrity Specialist- RN- Remote
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place Metairie, LA
Dec 1

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...
RN UM Clinical Appeals Nurse Remote
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place Metairie, LA
Dec 1

RN UM Clinical Appeals Nurse Remote at Molina Healthcare in Caldwell, Idaho, United States Job Description JOB DESCRIPTION Job Summary The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals...
Manager, Utilization Management (RN required) - REMOTE
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place Metairie, LA
Nov 29

Discover Vanderbilt University Medical Center Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim...
Registered Nurse (Specialty Phone Triage) - Remote Opportunity
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place Metairie, LA
Dec 1

Registered Nurse (Specialty Phone Triage) - Remote Opportunity Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with...
RN UM Clinical Appeals Nurse Remote
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place Metairie, LA
Dec 1

Clinical Appeals Nurse (RN) 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,...