Utilization review nurse near me

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...

Clinical Documentation Integrity Specialist Position Purpose: Work Remote Position Utilizes advanced clinical and coding expertise to direct efforts toward the integrity of clinical documentation through the roles of reviewer, educator...

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.

A healthcare service provider is seeking a Registered Nurse - Case Review Specialist to provide remote support in reviewing cases for Federal Occupational Health. The ideal candidate will have at least 5 years of Nursing experience, a valid RN...

Clinical Claims Review At UnitedHealthcare, we're 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 Clinical Documentation Integrity Position Position Purpose: Work Remote Position Utilizes advanced clinical and coding expertise to direct efforts toward the integrity of clinical documentation through the roles of reviewer,...

A leading health insurance provider is seeking a Utilization Management Nurse 2 to support coordinated care for members healing at home. The ideal candidate will have an Associate Degree in nursing, a valid RN license, and at least three years of...

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...

Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday, 8:00 AM12:00 PM PST Compensation: $40,000$45,000 annually (part-time, 20 hours/week)...

Behavioral Health Contract Management Group Location: Charlotte - Utilization Management Position: Part time Hours Per Week: 4 Schedule Details/Additional Information: PRN, primarily weekdays, but might also...

A prominent medical institution is seeking a Nurse Rev II to conduct clinical assessments and evaluations for individuals in nursing facilities. This hybrid role includes statewide travel and offers flexible scheduling with no weekends or...

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...

Overview Contract role - 8/8/23-12/31/23, with possible extension Pay rate: $50-$65 Hourly Location: Remote IL Required License: RN, LCSW, LCPC Basic function: This position is responsible for discharge care...

Job Description Job Summary The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies...

A health care services provider is seeking a remote Quality Review Specialist in Illinois, Texas, New Mexico, or Oklahoma. The candidate will work 40 hours a week and assist in managing member and provider appeals while ensuring adherence to...

A fast-growing insurance company is seeking a Clinical Review Nurse to assess medical necessity for Workers' Compensation claims. This role offers a remote or office location option and requires an active RN license along with 5+ years of related...

A nationwide home infusion company is seeking a Quality Assurance Chart Review Nurse. This role involves reviewing clinical records for compliance and accuracy. Candidates should have a nursing degree, an active license, and experience in home...

A workforce solutions company is seeking a Registered Nurse-Case Review Specialist to provide support for Federal Occupational Health. This remote position requires extensive nursing experience and strong communication skills to ensure timely...

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.

A healthcare organization in New Orleans seeks a Registered Nurse to facilitate multi-disciplinary communications and manage patient discharge planning. Candidates must have a current RN license and BLS certification, with a preference for three...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

A leading educational institution seeks a Data Management Specialist to provide data management support for Investigator Initiated Trials, utilizing OnCore and EDC systems. The successful candidate will collaborate with protocol staff on data...

A nonprofit senior care organization is seeking an experienced RN for remote after-hours support in Edina, MN. Responsibilities include triaging emergency calls and coordinating care with clinical staff, hospitals, and families. Essential...

Mercy East Region Throughput Center Rn Find your calling at Mercy! The East Region Throughput Center RN serves as the clinical expert for the unit. There are three main focuses of this position: to be the first point of contact for...

RN Utilization Management MCHP RN Utilization Management MCHP is responsible for the coordination of the medical care provided to Plan members with Plan providers, the member's family and other resources as appropriate. Assist in the...

A leading health solutions company in Louisiana seeks a Medicare Precertification Utilization Management Nurse Consultant. This full-time position involves responsibilities such as assessing healthcare services, gathering clinical information, and...

Registered Nurse (RN) Outpatient Clinic- Float Team - Hybrid/Partially Remote The RN is responsible for providing clinical support to providers and patients in Clinical Practice Group (CPG) office. These duties may include: patient care,...

Caring. Connecting. Growing Together. At UnitedHealthcare, we're 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...

A leading behavioral health organization is seeking a Utilization Review Counselor in Illinois for a remote position. The role involves coordinating managed care services and providing financial case management support while maintaining ethical...

A leading healthcare organization is seeking a qualified RN for a role that involves auditing medical records and communicating clinical findings. The position requires an undergraduate degree or equivalent nursing experience, along with a current...