Remote UM RN — Path to Case Management
WPS Health Solutions
- Remote job
WPS Health Solutions is seeking an experienced Utilization Management RN to evaluate efficiency, appropriateness, and medical necessity for health plan services. The role includes cross-training in Case Management with potential growth into a combined UM/CM position. Start Date: 01/10/2027. Remote work options available in multiple states with a strong emphasis on quality care and cost-effective utilization. This position offers a competitive salary range and comprehensive benefits. #J-18808-Ljbffr WPS Health Solutions
- ...solutions company, is hiring an Utilization Management RN to evaluate medical necessity and... ...decision-making and may cross-train for Case Management, with potential growth into a combined UM/CM role. The position supports remote work in approved states across the U.S.,...Remote job
$75k - $100k
...Solutions is seeking an Utilization Management RN to evaluate medical services for... ...involves authorizing services, referring cases to medical directors, and potential... ...with growth into a combined UM/CM position. The position is remote with approved states including GA;...Remote job- ...solutions company is seeking a Utilization Management Registered Nurse to evaluate medical... ...services for our Health Plan. The UM RN will refer cases to medical directors when criteria are... ...for future growth. The role supports remote work within approved states, with a base...Remote job
$75k - $100k
...Madison, Wisconsin, seeks a Utilization Management RN to evaluate medical necessity for services... ...directors. The role supports cross-training in Case Management and growth into a combined UM/CM position. Start Date: 01/10/2027. Remote work option available in approved states...Remote job$75k - $100k
...Health Solutions is seeking a Utilization Management RN to evaluate medical necessity and... ...includes cross-training potential into Case Management with future growth into CM and a broader UM/CM path. The position offers remote work in approved states, with a start date...Remote job- ...company, is seeking an Utilization Management RN to assess medical necessity,... ...directors. The role offers remote work in multiple states and a potential path toward combined UM/CM responsibilities. There is... ...colleagues, and cross-training in Case Management to support quality,...Remote job
- WPS Health Solutions is seeking a Utilization Management Registered Nurse to evaluate medical necessity for... ...collaborate with Medical Directors. The role offers remote work within approved states and potential growth into Case Management. Experience in managed care and...Remote job
- ...on-site Hospital Utilization Management (UM) Nurse, you are the primary link... ...compliance. Unlike remote roles, this position relies heavily... ...Nurse is a Registered Nurse (RN) responsible for performing admission... ...providers to discuss cases where documentation does not...Remote workFull timeImmediate startShift work
- ...for oversight of staff UM RNs to ensure coordination... ...includes utilization management, patient advocacy, and monitoring... ...It is expected that all RN Clinical Nurses are... ...compliance. Unlike remote roles, this position relies... ...admitting providers to discuss cases where documentation does...Remote workFull timeImmediate startShift work
- ...for oversight of staff UM RNs to ensure coordination... ...includes utilization management, patient advocacy, and monitoring... ...It is expected that all RN Clinical Nurses are... ...compliance. Unlike remote roles, this position relies... ...admitting providers to discuss cases where documentation does...Remote workImmediate startShift work
$65k - $85k
...UM RN - Behavioral Health Job Locations: US-Remote ID: 2026-8743 Category: Utilization Management Position Type: Full-Time Overview HealthEdge® offers AI-powered operational infrastructure... ...Nurse license required. Certification in Case Management may be preferred based upon...Remote workPermanent employmentFull timeWork at officeLocal area$75k - $100k
...seeking a Registered Nurse for Utilization Management to evaluate medical necessity and... ...services. The role may cross-train into Case Management and grow into a combined UM/CM position with potential future advancement. Remote work is available for qualified states,...Remote job- ...on-site Hospital Utilization Management (UM) Nurse, you are the primary link... ...compliance. Unlike remote roles, this position relies heavily... ...Nurse is a Registered Nurse (RN) responsible for performing admission... ...providers to discuss cases where documentation does not...Remote workImmediate startShift work
- ...Solutions seeks an Utilization Management RN to evaluate medical necessity... ...care when appropriate, and refer cases to medical directors to avoid... ...hospital stays. We support remote work in multiple states and offer... ...to grow into a combined UM/CM role. #J-18808-Ljbffr WPS...Remote job
$75k - $100k
...Solutions in Madison, WI seeks an Utilization Management RN to evaluate medical necessity and... ...directors and may cross-train into Case Management, with potential to grow into a combined UM/CM position. The position offers remote/hybrid options across approved states and...Remote job- ...solutions company, is seeking an Utilization Management RN to evaluate medical necessity and support... ..., and opportunities to cross-train in Case Management with potential for a blended UM/CM position. This position offers remote work options within approved states...Remote job
$75k - $100k
...Health Solutions is seeking an Utilization Management RN to evaluate medical necessity and... ...emphasizes evidence-based decision-making, case reviews, and referral when criteria aren’... ...Management and for progression into a combined UM/CM position in the future, with a start...Remote job$75k - $100k
...Solutions is seeking an Utilization Management RN to evaluate medical necessity and... ...Plan. The role may cross-train in Case Management with potential growth into a combined UM/CM position or CM in the future. The position offers remote work options across approved...Remote job$75k - $100k
...Health Solutions is seeking a Utilization Management Registered Nurse to evaluate efficiency,... ...Plan. This role may cross-train in Case Management with potential growth into a combined UM/CM position. The position offers remote work options in multiple states, including...Remote job- ...company is seeking an Utilization Management RN who evaluates efficiency, appropriateness... ...appropriate care and refer cases that do not meet criteria. Remote work is allowed for specified states... ...with potential growth into combined UM/CM roles. A strong background in managed...Remote job
$75k - $100k
...solutions company, seeks an Utilization Management RN to evaluate medical necessity and... ...role involves cross-training in Case Management with potential growth into a combined UM/CM position or CM in the future. Start Date: 01/10/2027. Remote work options available in a...Remote job$75k - $100k
...solutions company, seeks an Utilization Management RN to evaluate medical necessity and authorize... ...Health Plan. You will refer questionable cases to medical directors to prevent... ...Management offers growth toward a combined UM/CM role in the future. Start date is 01/1...Remote job- WPS Health Solutions seeks an experienced Utilization Management Registered Nurse (UM RN) to evaluate efficiency, appropriateness, and medical necessity... ...our Health Plan. The role includes cross-training in Case Management with potential growth into a combined UM/CM position...Remote job
- ...Solutions is seeking an Utilization Management RN to evaluate medical necessity and... ..., and potential cross-training in Case Management. The position offers remote/hybrid options across multiple... ...growth opportunities toward a combined UM/CM role in the future. #J-18808-...Remote job
$52 - $56 per hour
Now hiring: Remote UM / Grievance & Appeals RN (NY License) | Contract | $52-56/hr Are you an RN who has owned appeals cases from intake to final decision letter? We want to talk to you... ...& Appeals nurse with a utilization management or case management background. You’ll...Remote jobContract workImmediate start$97.76k - $104k
...Develop, implement, and standardize UM/UR workflows, best practices,... ...Collaborate with physicians, case management, and hospital leadership to... ...This job operates in a remote home office environment. This... ...unrestricted Registered Nurse (RN) license. · 3-5 years of hospital...Remote workFull timeWork at officeHome officeMonday to FridayWeekend work$45 per hour
Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’smanaged care health... ...remote managed care setting. The UM RN Nurse Coordinator reviews... ...Management, Prior Authorization, Case Management, or Managed Care...Remote jobContract workTemporary workMonday to FridayWeekend work$68.4k
...SUMMARY This is a full-time REMOTE position requiring... ...implements effective utilization management strategies including:... ...to a Health Coach/case management, and identification... ...Preferred3 years RN experience RN Case Management... ...Experience in UM/CM/QA/Managed Care Experience...Remote jobFull timeFor contractorsWork at officeLocal areaFlexible hoursWeekend workWeekday work- ...ESSENTIAL JOB FUNCTIONS Reviews cases and applies medical criteria... ...standards. Reviews UM reports for outstanding and expiring... ...one year of utilization case management preferred. REQUIREMENTS ~... ...active and unencumbered LPN or RN license PHYSICAL DEMANDS...Remote workFull time
$75k - $100k
...health solutions company is seeking an experienced Utilization Management RN to evaluate the necessity and appropriateness of medical... ...care and collaborating with medical directors. The role offers remote work with quotas and potential growth into CM. Start date is 0...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote UM RN — Path to Case Management. Be the first to apply!
- outpatient rn Charleston, SC
- sedation rn Charleston, SC
- ed rn Charleston, SC
- registered nurse office Charleston, SC
- labor & delivery rn Charleston, SC
- registered nurse remote Charleston, SC
- injection rn Charleston, SC
- gastroenterology rn Charleston, SC
- rn iv therapy Charleston, SC
- registered nurse healthcare Charleston, SC




