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Case Manager / Utilization Review RN Remote

Interim HealthCare - Indianapolis, IN Indianapolis Indiana United States
(No Timezone Provided)

Currently seeking a qualified RN to staff a remote position for Utilization Review in Indianapolis.Must be Indiana Resident.It is a 3 month position, hours being Monday-Friday 8A-5P EST.High speed internet connection is required, along with the ability to connect to a router.Pay is $35/hour.Benefits...

Prior Authorization Nurse II - Remote Available

Centene San Diego California United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Prior Authorization Nurse II - Remote Available

Centene El Centro California United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Case Manager (**Remote** RN Required)

Emerus The Woodlands Texas United States
(No Timezone Provided)

Position Overview The purpose of this position is to provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The goal of the position is to enhance the quality of patient care through innovative and c...

Care Manager II (RN) - Remote Available

Envolve Pharmacy Solutions None null United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Utilization Management - RN (NOW REMOTE)

Morgan Stephens Spokane Valley Washington United States
(No Timezone Provided)

You must live within 25 miles of job location for remote positions.About us:Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates.   We are created and managed by experienced industry professionals in healthcare. As a lead...

Utilization Review RN (Remote - Compact/AZ RN License)

Change Healthcare None Washington United States
(No Timezone Provided)

The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...

Utilization Review RN (Remote - Compact/AZ RN License)

Change Healthcare Kansas City Kansas United States
(No Timezone Provided)

The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...

Utilization Review RN (Remote - Compact/AZ RN License)

Change Healthcare None South Dakota United States
(No Timezone Provided)

The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...

Utilization Review RN (Remote - Compact/AZ RN License)

Change Healthcare Moore Oklahoma United States
(No Timezone Provided)

The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...

Utilization Review Nurse (Remote)

Oscar Health None Arizona United States
(No Timezone Provided)

Hi, we're Oscar. We’re hiring a Utilization/Clinical Review Nurse to join our Clinical team.  Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need you...

Utilization Review Nurse (Remote)

Oscar Health Dallas Texas United States
(No Timezone Provided)

Hi, we're Oscar. We’re hiring a Utilization/Clinical Review Nurse to join our Clinical team.  Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need you...

Appeals Nurse - Remote Available

Fidelis Care None Michigan United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Behavioral Health Care Manager - Remote Available

Fidelis Care Bedford New Hampshire United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Utilization Review Nurse - Remote

Mercy Springfield Missouri United States
(No Timezone Provided)

The Utilization Review Nurse is responsible for the development, implementation, coordination, and follow-up of projects related to Mercy Care Management. This includes the validation, assimilation, and integration of information derived from projects, focus studies, in network and out of network pr...

Prior Authorization RN - Air Ambulance and Out of Country Team - Telecommute - 2020837

UnitedHealth Group St. Louis Missouri United States
(No Timezone Provided)

For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing  your life's best work...

Concurrent Review Nurse II - Remote Available

Centene Fresno California United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.   ...

Concurrent Review Nurse II - Remote Available

Centene Los Angeles California United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.   ...

Concurrent Review Nurse II - Remote Available

Centene Los Angeles California United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.   ...

Temporary Remote UM Care Manager (RN)

Home Nursing Agency Pittsburgh Pennsylvania United States
(No Timezone Provided)

Description Are you a registered nurse with a background in utilization management? Are you interested in the opportunity to work from home? UPMC Health Plan is looking for you! We are hiring temporary full-time Utilization Management Care Managers to support the Utilization Management Clinic...

Senior Advisor, Formulary Administration Pharmacist - Medicare (WFH)

CVS Health Solon Ohio United States
(No Timezone Provided)

Job DescriptionThe Senior Advisor is responsible for providing strategic and operational leadership and support for the development, implementation, and evaluation of Medicare Part D formularies, drug lists, and utilization management. This individual leads and supports creation and maintenance of f...

Grievance & Appeals Nurse (CA) - Remote Available

Envolve Pharmacy Solutions None null United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Concurrent Review Nurse --Remote Available

Fidelis Care Charlotte North Carolina United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.   ...

Clinical OASIS Review / Clinical Coder - Remote

BAYADA Oklahoma City Oklahoma United States
(No Timezone Provided)

Must have COS-C or HCS-O or COQS and HCS-D or BCHH-C $2,500 Retention Bonus BAYADA Home Health Care has an immediate opening for a Full time Medicare Case Manager with OASIS and Coding certification to work remotely. COS-C or HCS-O or COQS OASIS Certification, AND HCS-D Home Health Car...

Clinical OASIS Review / Clinical Coder - Remote

BAYADA Omaha Nebraska United States
(No Timezone Provided)

Must have COS-C or HCS-O or COQS and HCS-D or BCHH-C $2,500 Retention Bonus BAYADA Home Health Care has an immediate opening for a Full time Medicare Case Manager with OASIS and Coding certification to work remotely. COS-C or HCS-O or COQS OASIS Certification, AND HCS-D Home Health Car...

Clinical OASIS Review / Clinical Coder - Remote

BAYADA Tallahassee Florida United States
(No Timezone Provided)

Must have COS-C or HCS-O or COQS and HCS-D or BCHH-C $2,500 Retention Bonus BAYADA Home Health Care has an immediate opening for a Full time Medicare Case Manager with OASIS and Coding certification to work remotely. COS-C or HCS-O or COQS OASIS Certification, AND HCS-D Home Health Car...

Inpatient Care Management Nurse RN - Indiana - Remote

UnitedHealth Group Indianapolis Indiana United States
(No Timezone Provided)

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 and resources they need to feel their best. Here, yo...

Concurrent Review Nurse I- $7,500 Sign-On Bonus Remote available

Envolve Pharmacy Solutions Baton Rouge Louisiana United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ** ...

Utilization Management Nurse 2 (Remote

Humana Indianapolis Indiana United States
(No Timezone Provided)

About this job Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and ...

Remote MDS Coordinator (RN)

Avamere Wilsonville Oregon United States
(No Timezone Provided)

Overview Now Hiring Healthcare Heroes! Remote MDS Coordinator (RN) Shift Type: Full-Time  Shift:  Day Location: Portland Metro and Washington State As an MDS Coordinator with Avamere, you join a team with a culture and mission to enhance the life of every person we serve. This i...

Clinical OASIS Review / Clinical Coder - Remote

BAYADA Pennsauken Township New Jersey United States
(No Timezone Provided)

Must have COS-C or HCS-O or COQS and HCS-D or BCHH-C $2,500 Retention Bonus BAYADA Home Health Care has an immediate opening for a Full time Medicare Case Manager with OASIS and Coding certification to work remotely. COS-C or HCS-O or COQS OASIS Certification, AND HCS-D Home Health Car...

Senior Care Manager (CA) - Remote Available

Fidelis Care St. Louis Missouri United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Care Manager I (RN) - Remote Available

SilverSummit Healthplan Virginia City Nevada United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Positi...

Care Manager I (RN)- $7,500 Sign-On Bonus Remote Available

Centene Lafayette Louisiana United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ** ...

Care Manager I (RN) - Remote Available

Centene Bedford New Hampshire United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

RN, Care Manager (Utilization Review), Remote, Per Diem

Glendale Adventist Medical Center Bakersfield California United States
(No Timezone Provided)

Essential Functions: Leads the coordination of patient care with other disciplines within the care team, monitoring the appropriateness and timeliness of care. Ensures the interdisciplinary care plan is consistent with the patient's clinical course, continuing care needs and covered services...

Case Manager RN (Remote)

Change Healthcare Lake Mills Iowa United States
(No Timezone Provided)

This position is required to perform case management activities for health plan members. The activities will include assessing needs, developing a patient-centered care plan, monitoring outcomes, and coordinating interdisciplinary approaches and services. These functions may be performed onsite an...

Case Manager RN (Remote)

Change Healthcare Gautier Mississippi United States
(No Timezone Provided)

This position is required to perform case management activities for health plan members. The activities will include assessing needs, developing a patient-centered care plan, monitoring outcomes, and coordinating interdisciplinary approaches and services. These functions may be performed onsite an...

Case Manager RN (Remote)

Change Healthcare None Nevada United States
(No Timezone Provided)

This position is required to perform case management activities for health plan members. The activities will include assessing needs, developing a patient-centered care plan, monitoring outcomes, and coordinating interdisciplinary approaches and services. These functions may be performed onsite an...

Behavioral Case Mgr -Remote Available ($4,000 Sign-On Bonus)

Envolve Pharmacy Solutions Omaha Nebraska United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.   ...

DRG Coding Validation Auditor - Remote

UnitedHealth Group Dallas Texas United States
(No Timezone Provided)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry tha...

Care Advocate - Telecommute in TN

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and...

Registered Nurse Atrium Health At Home Union

Atrium Health Navicent Fairfax South Carolina United States
(No Timezone Provided)

Job Summary Serves a case management role, responsible for an assigned group of patients, typically geographically related and accountable for the oversight and overall management of the post-acute services in the home setting. Provides direct patient care and supervision of LPNs and HHAs in accorda...

Registered Nurse Atrium Health At Home Blue Ridge

Atrium Health Navicent Morganton North Carolina United States
(No Timezone Provided)

Job Summary Serves a case management role, responsible for an assigned group of patients, typically geographically related and accountable for the oversight and overall management of the post-acute services in the home setting. Provides direct patient care and supervision of LPNs and HHAs in accorda...

19 - 28006 - Compact or NY Russian Full Time Remote Registered Nurse (RN)

Oloop Technology Solutions New York New York United States
(No Timezone Provided)

Overview Nice to meet you, we’re Vesta Healthcare.Vesta Healthcare is a startup with a simple mission: Delivering extraordinary outcomes by unlocking the power of caregivers. We enable people with personal assistance to thrive at home, in their community by assuring their caregivers have the resour...

Nurse Reviewer - Remote El Paso, TX

HMSHost El Paso Texas United States
(No Timezone Provided)

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense o...

Transplant Nurse Case Manager RN - Telecommute - 2021660

UnitedHealth Group Dallas Texas United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care...

Senior Medical Policy Analyst (Remote)

Blue Cross and Blue Shield Association Baltimore Maryland United States
(No Timezone Provided)

Resp & QualificationsPURPOSE:In collaboration with the Medical Director, the Senior Medical Policy Analyst will research, analyze, evaluate, revise, and develop medical policies and operating procedures to support the corporate philosophy, provider and member contracts, and an accepted standard of m...

Coding Investigator Auditor - PIPELINE / WFH / (IL, MT, NM, OK, TX)

HDSC Tulsa Oklahoma United States
(No Timezone Provided)

Description:BASIC FUNCTION:This position is responsible for performing clinical, billing, coding and lowest cost setting reviews for services pre and post payment utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed; conducting research; ...

Remote Registered Nurse- Telephone Triage

Call 4 Health Portland Oregon United States
(No Timezone Provided)

Job Summary The Triage Registered Nurse will be part of a multidisciplinary team supporting general care processes, providers, and patients in an ambulatory community-based setting. The RN is responsible for evaluating and assessing patient’s health care needs based on telephonic evaluation and asse...