Despite the remote setup, collaboration is fostered through regular meetings, virtual team-building ... Collaborate with the Utilization Review Department to discuss patient progress, treatment ...
New
Despite the remote setup, collaboration is fostered through regular meetings, virtual team-building ... Collaborate with the Utilization Review Department to discuss patient progress, treatment ...
New
Despite the remote setup, collaboration is fostered through regular meetings, virtual team-building ... Collaborate with the Utilization Review Department to discuss patient progress, treatment ...
New
This full-time remote position invites a dedicated professional to play a vital role in providing ... Engage with insurance companies to manage pre-certification and utilization review, ensuring that ...
New
This full-time remote position invites a dedicated professional to play a vital role in providing ... Engage with insurance companies to manage pre-certification and utilization review, ensuring that ...
New
Sunnyvale, CA ยท On-site +1
$120K - $130K/yr
Work Environment This role primarily operates in a remote environment, allowing for flexible ... Serve as a point of contact with the Utilization Review Department and Business Department ...
New
Sunnyvale, CA ยท On-site +1
$120K - $130K/yr
Work Environment This role primarily operates in a remote environment, allowing for flexible ... Serve as a point of contact with the Utilization Review Department and Business Department ...
New
Oakland, CA ยท Remote
This full-time, remote position is tailored for professionals who are committed to delivering ... Maintain regular communication with the Utilization Review and Business Departments regarding ...
New
Oakland, CA ยท Remote
This full-time, remote position is tailored for professionals who are committed to delivering ... Maintain regular communication with the Utilization Review and Business Departments regarding ...
New
Oakland, CA ยท Remote
This full-time remote position offers an opportunity to provide essential mental health support and ... Collaborate closely with the Utilization Review and Business Departments to maintain clear ...
New
Oakland, CA ยท Remote
This full-time remote position offers an opportunity to provide essential mental health support and ... Collaborate closely with the Utilization Review and Business Departments to maintain clear ...
New
San Francisco, CA ยท Remote
$120K - $130K/yr
This full-time, remote position is ideal for professionals with a passion for providing quality ... Engage in collaboration with the Utilization Review Department to ensure timely authorization and ...
New
San Francisco, CA ยท Remote
$120K - $130K/yr
This full-time, remote position is ideal for professionals with a passion for providing quality ... Engage in collaboration with the Utilization Review Department to ensure timely authorization and ...
New
Vallejo, CA ยท On-site +1
Work Environment This position allows for remote work flexibility, supporting a work-life balance ... Collaborate with the Utilization Review Department and the Business Department to manage ...
New
Vallejo, CA ยท On-site +1
Work Environment This position allows for remote work flexibility, supporting a work-life balance ... Collaborate with the Utilization Review Department and the Business Department to manage ...
New
You will collaborate with healthcare professionals including psychiatrists, nurses, and counselors ... utilization reviews to optimize patient outcomes. * Advocate for patients by researching and ...
New
You will collaborate with healthcare professionals including psychiatrists, nurses, and counselors ... utilization reviews to optimize patient outcomes. * Advocate for patients by researching and ...
New
Fremont, CA ยท Remote
$70K - $100K/yr
... a full-time remote position based in Fremont, California. This role offers an exceptional ... utilization review processes are followed. * Coordinate support services for clients and families ...
New
Fremont, CA ยท Remote
$70K - $100K/yr
... a full-time remote position based in Fremont, California. This role offers an exceptional ... utilization review processes are followed. * Coordinate support services for clients and families ...
New
Oakland, CA ยท On-site +1
$400K/yr
With more than 50 programs and a clinical workforce that includes 30+ nurses and multiple ... Utilization Review. Complete documentation necessary for billing Medication Support Services for ...
Oakland, CA ยท On-site +1
$400K/yr
With more than 50 programs and a clinical workforce that includes 30+ nurses and multiple ... Utilization Review. Complete documentation necessary for billing Medication Support Services for ...
San Francisco, CA ยท Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
Quick apply
San Francisco, CA ยท Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
San Francisco, CA ยท Remote
$100/hr
Position: Registered Nurses Type: Contract Compensation: $60-$100/hour Location: Remote Role ... Our team reviews applications daily. Please complete your AI interview and application steps to be ...
Quick apply
San Francisco, CA ยท Remote
$100/hr
Position: Registered Nurses Type: Contract Compensation: $60-$100/hour Location: Remote Role ... Our team reviews applications daily. Please complete your AI interview and application steps to be ...
Oakland, CA ยท Remote
$120K - $130K/yr
In this full-time, remote position, you will conduct comprehensive clinical evaluations, provide ... utilization reviews to optimize care pathways. * Ensure meticulous documentation of all client ...
New
Oakland, CA ยท Remote
$120K - $130K/yr
In this full-time, remote position, you will conduct comprehensive clinical evaluations, provide ... utilization reviews to optimize care pathways. * Ensure meticulous documentation of all client ...
New
San Jose, CA ยท Remote
$90K - $105K/yr
This remote position calls for an experienced professional who is passionate about making a ... managing utilization reviews to facilitate client access to necessary services. * Engaging in ...
New
San Jose, CA ยท Remote
$90K - $105K/yr
This remote position calls for an experienced professional who is passionate about making a ... managing utilization reviews to facilitate client access to necessary services. * Engaging in ...
New
The utilization of remote therapy allows us to engage with clients from various backgrounds and ... Regular performance reviews and mentorship programs ensure that all team members are supported in ...
New
The utilization of remote therapy allows us to engage with clients from various backgrounds and ... Regular performance reviews and mentorship programs ensure that all team members are supported in ...
New
All clinical staff participate in weekly Rounds to review and learn from case situations and the ... This is a contract (1099), fully remote role with an expected commitment of approximately 10-15 ...
Quick apply
All clinical staff participate in weekly Rounds to review and learn from case situations and the ... This is a contract (1099), fully remote role with an expected commitment of approximately 10-15 ...
San Francisco, CA ยท On-site +1
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
San Francisco, CA ยท On-site +1
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
San Francisco, CA ยท Remote
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
Quick apply
San Francisco, CA ยท Remote
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
San Jose, CA ยท Remote
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
Quick apply
San Jose, CA ยท Remote
$140 - $150/hr
Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...
San Jose, CA ยท On-site +1
$25.25 - $32/hr
Maintain ongoing caseload of individuals through the utilization of evidence based approaches to ... reviews and consulting with nurse care manager, behavioral health care manager, and nurse ...
San Jose, CA ยท On-site +1
$25.25 - $32/hr
Maintain ongoing caseload of individuals through the utilization of evidence based approaches to ... reviews and consulting with nurse care manager, behavioral health care manager, and nurse ...
$23.91 - $28.74
2% of jobs
$28.74 - $33.58
9% of jobs
$36.89 is the 25th percentile. Wages below this are outliers.
$33.58 - $38.41
21% of jobs
The median wage is $42.33 / hr.
$38.41 - $43.25
23% of jobs
$43.25 - $48.09
13% of jobs
$51.85 is the 75th percentile. Wages above this are outliers.
$48.09 - $52.92
10% of jobs
$52.92 - $57.76
8% of jobs
$57.76 - $62.59
5% of jobs
$62.59 - $67.43
5% of jobs
$67.43 - $72.26
2% of jobs
$72.26 - $77.10
2% of jobs
$23
$47
$77
As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.
| Aspect | Remote Utilization Review Nurse | Remote Case Manager |
|---|---|---|
| Certifications | RN license, possibly CCM or UR certifications | RN license, CCM or case management certifications |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Insurance companies, healthcare organizations, telehealth |
| Job Focus | Review medical necessity, approve or deny services | Coordinate patient care, arrange services, discharge planning |
Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.
The top searched job categories for Remote Utilization Review Nurse jobs in San Ramon, CA are:
Cities near San Ramon, CA with the most Remote Utilization Review Nurse job openings:

San Jose, CA โข Remote
Full-time
Medical, Retirement, PTO
Posted 2 days ago
New
Horizon Mental Care Services is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our team in a full-time remote role. This position is centered around providing therapeutic support to individuals in a detox treatment center, ensuring both their mental and emotional well-being as they navigate through their recovery journey. The LCSW will play a pivotal role in conducting assessments, leading therapy sessions, and engaging in case management duties to promote client safety and recovery.
About the OrganizationHorizon Mental Care Services is a leading provider of mental health and substance abuse care in California, committed to enhancing the quality of life for individuals facing challenges related to addiction and mental health. Our detox center in San Jose is designed to provide a safe and supportive healing environment. We prioritize personalized care through evidence-based practices and a compassionate approach, empowering our clients to achieve lasting recovery. Becoming part of our team means joining a passionate community of mental health professionals dedicated to making a meaningful difference in the lives of those we serve.
Work EnvironmentThis position offers a unique opportunity to work remotely, providing flexibility while being part of a dynamic, interdisciplinary team focused on delivering exceptional care to our clients. Despite the remote setup, collaboration is fostered through regular meetings, virtual team-building events, and accessible communication channels, ensuring that all team members remain integrated and supported. The detox center is equipped with innovative tools and resources to facilitate patient engagement and enhance the overall treatment experience.
Key ResponsibilitiesThe primary patient population includes individuals experiencing substance abuse issues seeking detoxification. The LCSW will work closely with clients who may also present co-occurring mental health disorders, necessitating tailored interventions that address both addiction and underlying psychological issues. Through compassionate engagement, the LCSW will empower clients in actively participating in their recovery, improving their resilience and coping mechanisms.
QualificationsThe salary range for this position is between USD 120,000 and 130,000 per year, determined by experience and caseload. In addition to a competitive salary, Horizon Mental Care Services offers a comprehensive benefits package that includes health insurance, retirement savings plans, and paid time off. We believe in investing in our staff, providing opportunities for professional development, continuing education, and skill enhancement to promote career advancement.
Career Growth OpportunitiesAt Horizon Mental Care Services, we are committed to fostering an environment of growth and learning. Our staff have access to ongoing professional development programs, mentorship opportunities, and the potential for career advancement within the organization. Whether you aspire to specialize further in clinical practice or take on leadership roles, we provide the resources to help you achieve your professional goals.
Why Join Our TeamJoining our team means being part of an organization that values compassion, collaboration, and innovation. We emphasize a supportive work culture that recognizes the contributions of each team member and prioritizes client-centered care. Your work as an LCSW will directly impact the lives of individuals seeking recovery, giving you a profound sense of fulfillment and purpose. Together, we can help build healthier communities and empower individuals to reclaim their lives.
Application InformationIf you are excited about this opportunity and meet the qualifications outlined above, we encourage you to apply. Submit your resume and a cover letter detailing your experience and motivations for joining Horizon Mental Care Services. We look forward to hearing from you and potentially welcoming you to our dedicated team of professionals!