58 Utilization Review RN jobs in United States

Pennsylvania, US (Hybrid)

$72.7–116.6K / year

Company : Endorsed Job Description : JOB SUMMARY This is a full-time hybrid work from home position requiring travel within the assigned territory.

Massachusetts, US (Hybrid)

$100–105K / year

Job Description: Candidates must live in Massachusetts and hold an active, unrestricted Massachusetts RN license at the time of hire.

Riverside, California, US (Hybrid)

Job Description Job Summary Provides support for clinical facility site reviews.

New Hampshire, US (Hybrid)

$31.00 – $55.00 / hour

Position Purpose: Provides expertise based on experience with identifying, overseeing, and managing the coordination of transition of members in the community.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

United States (Remote)

$63.1–94.7K / year

Thank you for considering a career at Ensemble!

United States (Remote)

$63.1–94.7K / year

Thank you for considering a career at Ensemble!

United States (Remote)

Kingman Healthcare Incorporated (KHI) Staff Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case…

United States (Remote)

This is a remote position.

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care…

United States (Remote)

$68.4–105.9K / year

Company : Highmark Inc.

United States (Remote)

$80K / year

Applicants must reside in: Michigan, Florida, Idaho, Texas, Minnesota or Illinois.

United States (Remote)

$93.4–132.4K / year

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Clinical Claims Reviewer/ RN - Remote!

United States (Remote)

$100–130K / year

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors.

United States (Remote)

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes.

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…

United States (Remote)

$65–70K / year

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and…