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Remote Jobs with RN licensure Certification

16 fresh jobs found

Utilization Review Nurse
Remote

Level of Care Reviews Medical necessity reviews RN licensure Evidence-Based Guidelines Treatment Clinical Guidelines Clinical Judgment Clinical Review Clinical Practice +14

USD 70K+

Quality Improvement Specialist
Remote-IL, United States

Centene Corporation

Intervention Development Performance data analysis RN licensure URAC Member education Internal Auditing Focus Groups Member Outreach Provider education +40

USD 55K+

Market Clinical Quality Specialist II
Florida WFH, United States

Microsoft Access Accreditation Utilization Review Clinical Experience Certification Visio Quality improvement RN Technical Writing +27

USD 70K+

Nurse Supervisor, Utilization Management Clinical Quality
Remote

Nurse Management HEDIS measures Clinical auditing Escalations RN licensure Insurance experience Ncqa standards Healthcare quality MCG +37

USD 88K+

Utilization Management Clinical Care Reviewer II - MUST be Multi-State Licensed
Dayton WFH, United States

Change resiliency Clinical care review Registered Nursing Proper grammar usage Medical Necessity Review Phone Etiquette Discharge planning Clinical Care Accreditation +35

USD 61K+

Care Manager (RN)
Remote-MO, United States

Centene Corporation

Service plan RN licensure Compliance Documentation Personalized care plans Complex Care Management Resource support Social determinants Service Assessment Foster care +27

USD 55K+

Triage Nurse - RN - Evening Hours - 3pm-1:30am and Every other Weekend
Dayton WFH, United States

Health information service Decision support software Clinical triage Critical reasoning Nursing process URAC Proper grammar usage Decision support Ncqa standards +27

USD 61K+

Clinical Review Nurse - Prior Authorization (RN)
Remote-CA, United States

Centene Corporation

RN licensure Service authorization Medical appropriateness Authorization requests Guidelines Clinical reviews Health management systems Medicaid regulations Health management +24

USD 95K+

Advanced Practice Clinician - Home Based Primary Care
Ellensburg, WA, United States

Kittitas Valley Healthcare

Geriatrics Patient Assessment Nursing Collaboration Communication

Entry Mid Full Time

USD 50K+

UM Operations Strategy & Implementation Lead - UM Focused
Dayton WFH, United States

Regulatory reporting NCQA Population health Accreditation Certification CMS Visio Six Sigma Utilization management +34

Senior Full Time

USD 81K+

Clinical Care Reviewer II BH - MUST HAVE a BH UM Background
Mississippi WFH, United States

Registered Nursing Medical Necessity Review Proper grammar usage Phone Etiquette Provider engagement Clinical Care Discharge planning Customer Care Accreditation +33

USD 55K+

Medical/Clinical Policy Writer
Dayton WFH, United States

Clinical policy development Bibliographic software Government relations NCQA Medical Writing Healthcare administration Certification Clinical expertise Policy Development +20

USD 70K+

Registered Nurse, Government Intel Customer - Washington DC/Metro Area
Remote VA Mc Lean 22101, United States

Magellan Health Remote-first

Health counseling Preventative care Laboratory procedures Medical Surveillance First aid Occupational Health Community Health Triage Counseling +13

USD 58K+

Utilization Management Clinical Care Reviewer II - MUST be Multi-State Licensed
Mississippi WFH, United States

Clinical care review Proper grammar usage Medical Necessity Review Registered Nursing Phone Etiquette Provider engagement Discharge planning Accreditation Certification +33

USD 55K+

RN, Admissions - Home Based - DC
CAP DC Resource Center, United States

Capital Caring Health

Patient health information systems Med surg Hospice Home Care Community Health Public health Conflict Resolution Nursing Oncology +6

USD 73K+

Maternity Clinical Practice Advisor
Remote-NV, United States

Centene Corporation

Maternal care Utilization metrics Clinical Practice Guidelines RN licensure Community partnerships Clinical Initiatives Quality performance Billing practices Clinical Standards +43

USD 68K+

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