Utilization Management RN
$39 - $40 per hourThe Judge Group Inc
1 week ago Be among the first 25 applicants This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $39.00/hr - $40.00/hr Direct message the job poster from The Judge Group Lead Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the following states: IL, TX, NM, OK, MT, TN Schedule: Monday–Friday, 8:00 AM–5:00 PM EST or CST. No nights or weekends required! Compensation: $40/hour Summary: We are seeking a Utilization Management RN to join our team on a remote, contract basis. This role is ideal for a nurse with recent experience in health plan operations and utilization review. You will be responsible for evaluating healthcare services, coordinating care, and ensuring members receive high-quality, cost-effective treatment. Responsibilities Perform delegated tasks within the Nurse Case Management job family Collaborate with physicians to plan, implement, and evaluate healthcare services Use clinical expertise to assess, coordinate, and monitor care options for optimal outcomes Conduct utilization reviews (prospective, concurrent, retrospective) for inpatient, outpatient, and rehabilitation services Provide health education and clinical assessments to members Independently manage caseloads and coordinate assigned cases Resolve escalated issues and support junior team members Evaluate alternative care services to ensure program goals and cost-effective care Maintain compliance with clinical guidelines and regulatory standards Qualifications Active, unrestricted RN license in the U.S. Minimum 2 years of Utilization Management RN experience, including Prior Authorization and Concurrent Review Experience working for a health plan (payer) within the last 3 years Proficiency with Milliman Care Guidelines (MCG) or InterQual Criteria Strong computer literacy and comfort with digital tools Ready to make a meaningful impact—without sacrificing work-life balance? If you're a passionate RN with a sharp eye for clinical detail and a heart for patient advocacy, we’d love to hear from you. This is your chance to bring your expertise to a dynamic team, work remotely, and help shape better healthcare outcomes across the country. Apply now and let’s do great work together! By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Seniority level Seniority level Mid-Senior level Employment type Employment type Contract Job function Job function Health Care Provider Industries Business Consulting and Services Referrals increase your chances of interviewing at The Judge Group by 2x Get notified about new Registered Nurse jobs in Chicago, IL . Streeterville, IL $76,960.00-$126,984.00 2 days ago Chicago, IL $25,000.00-$200,000.00 3 weeks ago Registered Nurse - RN / Step Down Unit - TELE-P Downers Grove, IL $76,207.00-$117,662.00 3 months ago IQVIA - Per Diem - RN Clinical Nurse Educator - Chicago Chicago, IL Clinical Educator - Registered Nurse Chicago, IL $120,000.00-$150,000.00 1 month ago Chicago, IL $146,730.00-$204,532.00 2 days ago Greater Chicago Area $75,000.00-$95,000.00 2 weeks ago Orland Park, IL $2,300.00-$11,500.00 2 weeks ago Arlington Heights, IL $79,885.00-$99,856.00 1 week ago Chicago, IL $75,000.00-$95,000.00 2 weeks ago Psychiatric Mental Health Nurse Practitioner Chicago, IL $130,000.00-$200,000.00 2 days ago Palliative Oncology Nurse Navigator (8:30AM - 5PM EST Shift) East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago Chicago, IL $110,000.00-$125,000.00 1 month ago Psychiatric Mental Health Nurse Practitioner (PMHNP) Psychiatric Mental Health Nurse Practitioner (PMHNP) Psychiatric Mental Health Nurse Practitioner (PMHNP) We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr The Judge Group
- A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...SuggestedRemote jobContract work
- A healthcare provider in Chicago seeks an experienced ED Utilization Review/Case Manager to ensure effective use of hospital resources and manage patient... ...and Excel. Candidates should possess a valid Illinois RN License and have experience in utilization management....Suggested
$50 - $85 per hour
Description Under the general direction of the Director of Behavioral Health, the Case Manager - Utilization Review RN provides clinically based case management and utilization review services to support the delivery of high-quality, cost-effective patient care. The RN...SuggestedFull timeTemporary workPart time- ...Job Title Utilization case review and application of criteria to approve initial and continued... ...criteria as well as defined disease management guidelines Work with CPHO team,... ...Qualifications Bachelors or better RN License Equal Opportunity Employer This...Suggested
- ...Work closely with Utilization Management (UM), Case Management (CM), and Customer Service (CS) to ensure the appeal process meets established guidelines. Adhere to accreditation and regulatory requirements to improve customer service and achieve organizational goals related...Suggested
Innovative Systems Group
Chicago, IL2 hours ago - ...Quality Management Position Participates in the development and ongoing implementation of... ...Experience: ~3+ years of experience as an RN ~ Registered Nurse in state of residence ~ Must have prior authorization utilization experience ~ Experience with Medcompass...
- Norwegian American Hospital seeks a Utilization Management and Population Health Nurse to review inpatient services, coordinate outreach, and develop... ...self-management with education and referrals. Requires RN license and a bachelor’s degree, with full-time on-site duties...Full time
- ...We have an innovative organization looking to add a Lead Utilization Management Nurse to its team. Their main purpose is to enable physicians... ...MSO settings and quality chart reviews Registered Nurse (RN) with a current and active nursing license to practice in the...Work from home
First Match Services, Inc.
Oak Brook, IL11 days ago - ...Job Description Job Description JOB SUMMARY – The RN Case Manager carries out activities related to utilization management, discharge planning, and care coordination. Participates in patient care rounds and promotes interdisciplinary collaboration with all team members...Full timeWeekend work
Humboldt Park Health
Chicago, IL11 days ago - ...data in Cerner, and facilitating timely resolutions regarding transfers. Candidates must be registered nurses with strong organizational and communication skills. Preferred experience includes transfer center and utilization review. #J-18808-Ljbffr Insight Health SystemsFull time
- ...GENERAL SUMMARY/BASIC PURPOSE OF JOB: The Registered Nurse (RN) Case Manager supports and provides expertise through comprehensive... ...physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care...
Sinai Health System
Chicago, ILa month ago $36.41 - $55.19 per hour
...established by the Medical Director and/or management of the SANE program for which the SANE is... ...for the delivery of safe patient care utilizing the nursing process of assessment, planning... ..., TRAINING 1. Current and valid state RN license. 2. Unrestricted State DL 3....Hourly payFull timeLocal areaShift work$43.6 - $78.04 per hour
...and Vascular Screening Program Coordinator RN works closely with leaders from across the... ...inpatient and outpatient settings. Assists management team in strategy development and implementation of program initiatives. Utilizes internal and external resources and systems...Hourly payFull timeWork at officeShift work$47.09 - $84.29 per hour
...case. Summary The Supervisor, Ambulatory RN assists the departmental and clinic... ...during shifts. The Supervisor plans and manages team members and resources to provide the... ...Supervisor oversees operational efficiency and utilization of labor resources of the assigned shift...Hourly payFull timeShift work$66.23 - $77.91 per hour
Job Title: RN - OR Manager Location: Evergreen Park, Illinois Schedule: Full-Time | Day Shift | Monday-Friday | Typical Start as Early as... ..., and staff retention Monitor surgical workflow, room utilization, patient throughput, and operational efficiency Maintain high...Hourly payFull timeRelocation packageMonday to FridayDay shift$80k - $100k
...Assistant Manager (RN) Chicago, Illinois, United States $ 80,000.00 - 100,000.00 (US Dollar) The role of RN in Telemetry/Medical-... ...and treatment of cardiac and other medical conditions. You will utilize advanced practice skills, critical thinking, and problem-...Permanent employmentWork visaRelocation packageShift work- ...Description Job Description A Enhanced Care Management Registered Nurse Care Team Manager (ECM... ...RNCTM enhances the reputation of AHF by utilizing core principles of nursing to meet... ...healthcare. Licenses and Certifications: CA RN License required; BSN preferred Acute...RelocationRelocation package
AIDS Healthcare Foundation
Chicago, IL4 days ago $38.2 - $57.3 per hour
...learning needs of patients and families. Utilizes appropriate resources to meet those needs... ...per year Licensure: Nurse, Registered (RN) A valid driver’s license issued by the... ...documentation skills. Computer skills Good time management and organizational skills Familiarity...Daily paidFull timeTemporary workPart timeFlexible hoursShift workWeekend work$72k - $92k
# Orthopedic Case Manager, RNCare Coordination & Case ManagementChicagoAugust 10, 2026$72,... ...hiring for a **Orthopedic Case Manager, RN** with a top-ranked orthopedic and spine... ...medical-surgical, acute case management, or utilization review preferred.* Complete BSN; MSN or...Hourly payFull timeMonday to FridayDay shift- The Team Manager is the leader of the Patient Care Team and that member of the team whose function is to supervise, evaluate and coordinate... ...the Outcomes Management and annual program review. Persforms utilization review of continuous care and inpatient levels of care for all...Contract workLocal area
- ...settings. Frequency of patient / family contacts will be at the discretion of the Case Manager and his/her assessment of need, but will be a minimum of every 15 days. The Case Manager utilizes teaching, assessment, and intervention skills to provide comfort care at end of...
$40 - $42 per hour
...Description Now Hiring: Wound Care Coordinator (RN or LPN) – Elevate Care! $40-42 – RN $... ...: Provide guidance on wound care management, prevention strategies, and self-care... ...regulatory standards. Quality Improvement: Utilize data and best practices to optimize wound...Immediate startElevate Care Windsor Park
Chicago, IL10 days ago- Humboldt Park Health in Chicago, IL is seeking an RN Case Manager to lead utilization management, discharge planning and care coordination. You will assess, plan, implement, coordinate and evaluate options to meet patient needs and optimize outcomes across the care continuum...
$80k - $95k
A healthcare organization in Chicago is seeking an experienced RN Case Manager to oversee inpatient utilization management, ensure effective care coordination, and support safe discharge planning. The role involves working closely with physicians and interdisciplinary...- Humboldt Park Health in Chicago, IL is seeking an RN Case Manager to lead utilization management, discharge planning, and care coordination across the continuum of care. You will work with the interdisciplinary team to ensure patient needs are met and care is delivered...
- ...continuous monitoring and life-support interventions. They perform comprehensive assessments, manage ventilators and complex equipment, and administer medications with precision. The RN collaborates with multidisciplinary teams to create and adjust individualized care plans....Contract workLocal areaShift workNight shiftWeekend workDay shift
Staffing the Universe
Chicago, IL4 days ago - ...Registered Nurse (RN) – Leadership Under New Nursing Direction Complete Care at Margate is elevating clinical standards under the... ...pathways for every Registered Nurse (RN) interested in unit management or clinical education. Modern Environment: Practice in a state...Daily paidImmediate start
Complete Care at Margate Park
Chicago, IL4 days ago - ...Position / Specialty: RN Pain Management / Interventional Radiology Shift: 5x8s, 8a-430p. No block scheduling Call Requirements: On call rotation assigned on week basis M-F, 12am-8am. Weekends and holidays 24Hrs. On call is rotated through all nurses. No holidays...Local areaShift work
Accede Solutions Inc.
Chicago, IL19 hours ago - Community First Medical Center is seeking a Case Manager - Utilization Review RN to deliver clinically based case management and utilization review across the patient care continuum in Chicago, IL. You will collaborate with physicians, social workers, revenue cycle staff...
- ...RN Pain Management / Interventional Radiology Position / Specialty: RN Pain Management / Interventional Radiology Shift: 5x8s, 8a-4:30p. No block scheduling Call Requirements: On call rotation assigned on week basis M-F, 12am-8am. Weekends and holidays 24hrs. On call...Local areaShift work
Staffing the Universe
Chicago, IL2 days ago
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