utilization review rn remote

Medix is seeking an experienced Registered Nurse to support Massachusetts workers’ compensation claims by reviewing medical treatment requests, evaluating records, and determining medical necessity and quality of care. This role offers a more predictable schedule and hybrid work arrangement in Manchester, NH.You will conduct utilization reviews, review...

AMN Healthcare Revenue Cycle is seeking a travel RN Remote Case Manager, Utilization Review for a Minneapolis assignment. The role oversees UR team leadership, medical necessity review, and collaboration with clinicians and payers to ensure proper patient status and care level.The position requires a BSN, Minnesota RN licensure, and UR experience, with 40...

Job Description /n GLC On-The-Go is seeking a travel nurse RN Case Management for a travel nursing job in Fort Myers, Florida. Job Description & Requirements/n /n - Specialty: Case Management /n - Discipline: RN /n - Start Date: 10/26/2026 /n - Duration: 13 weeks /n - 40 hours per week /n - Shift: 8 hours /n - Employment Type: Travel /n /n Registered...

Job DescriptionSolomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Jamaica Plain, Massachusetts. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 10/15/2026Duration: 11 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelOur client is looking to add a...

Job DescriptionGLC On-The-Go is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 10/12/2026Duration: 13 weeks40 hours per weekShift: 8 hoursEmployment Type: TravelGLC On-The-Go Job ID # . Pay package is based on 8...

Job Description /n Solomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Jamaica Plain, Massachusetts. Job Description & Requirements/n /n - Specialty: Utilization Review /n - Discipline: RN /n - Start Date: 10/15/2026 /n - Duration: 11 weeks /n - 40 hours per week /n - Shift: 8 hours, days /n - Employment...

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. is a remote role focused on medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions.You will interpret utilization data, determine appropriate actions, and support cost-effective, high-quality patient care. Responsibilities include reviewing...

Providence California Regional Services is seeking a Utilization Review RN for a remote, full-time position with day shifts. You will conduct prospective, retrospective, and concurrent reviews and review medical records daily for all payers. The role requires an active California RN license, an Associate's Degree in Nursing, and at least two years in...

RN Case Manager / Utilization Review - Syracuse, NY (#25268)Location: Acute Care/Academic Medical Center, Syracuse, NYEmployment Type: Full-timeHourly Rate: $65/hourAbout Greenlife Healthcare Staffing:Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We...

Baptist Health is seeking a Registered Nurse with associates-level education to conduct chart reviews for clinical financial resource utilization. The role coordinates with the care team to improve patient outcomes while decreasing length of stay and minimizing delays and denied days.Strong communication with payers is essential for efficient reimbursement....

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are We serve faithfully by doing what's right with a joyful heart. We never settle by constantly...

Job DescriptionHealth Advocates Network - Northeast is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/28/2026Duration: 13 weeks36 hours per weekShift: 12 hoursEmployment Type: TravelHealth Advocates Network is urgently hiring...

Job DescriptionFirst Connect Health is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 10/26/2026Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Travel Travel RN – Utilization Review Job PostingSystem:...

Humana Inc. is seeking a hands-on Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication assessments for pre-authorizations.You will review medication care plans, identify cost-effective utilization patterns, advise patients and providers, and follow established guidelines while working...

Humana Inc. is seeking a Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication reviews for pre-authorizations. This role requires independent determination of appropriate actions in varied assignments.The position emphasizes cost-effective utilization, quality patient outcomes, and adherence...

Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to...

Job DescriptionRead all the information about this opportunity carefully, then use the application button below to send your CV and application./nTLC Nursing is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida.Job Description & Requirements/n/n- Specialty: Utilization Review/n- Discipline: RN/n- Start Date:...

BH experience required. Must be licensed in OH or have a complact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH Medicaid population.  Strong behavioral health care experience required (Inpatient Mental Health/Psych, Substance Use Disorder, Rehabilitation/withdrawal management, outpatient BH...

Job Description /n TotalMed RN is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Irvine, California. Job Description & Requirements/n /n - Specialty: Utilization Review /n - Discipline: RN /n - Duration: 13 weeks /n - 40 hours per week /n - Shift: 8 hours, days /n - Employment Type: Travel /n /n /n We're looking...

BH experience required. Must be licensed in OH or have a complact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH Medicaid population.  Strong behavioral health care experience required (Inpatient Mental Health/Psych, Substance Use Disorder, Rehabilitation/withdrawal management, outpatient BH...