Remote Utilization Management Nurse
Humana
Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization Management and collaborate with the One Home/Home Solutions UM team to ensure appropriate care in the right setting. The role requires a compact RN license, 1+ year of clinical RN experience, and a passion for improving member experiences. #J-18808-Ljbffr
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...Remote workWork from home
- ...Akron Children’s Hospital is seeking a Utilization Management Nurse to perform medical necessity reviews and ensure proper use of hospital resources. The role supports staff with utilization practices and collaborates across teams to authorize patient days and discharge...Remote work
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Full Time 40 hours/week remote Summary: The Utilization Management Nurse is responsible for conducting medical necessity review to assure appropriate use of hospital resources and serving as a resource to the hospital staff on utilization management practices...Remote workFull time
$29.1 - $62.32 per hour
...something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your clinical...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$68.89k - $92.14k
...Pay Plan Title: Utilization Management Nurse Working Title: Utilization Management Nurse – Physical Health FLSA Status: Exempt Posting Salary Range: $68,890 - $92,138 Office Location: Remote within North Carolina. POSTING DETAILS: Make an Impact...Remote workFull timeWork at officeLocal areaImmediate startWork from homeFlexible hours$71.1k - $97.8k
...About This Role The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication... ...care. Highlights Pay : $71,100 - $97,800/year Location : Remote, LA Department/Unit : Care Management Schedule : Full-time...Remote workFull timeTemporary workMonday to Friday$143.1k - $165.05k
...Utilization Management Nurse Burlingame, CA 94010 Overview Salary Range $143,098.80 - $165,048.00 Salary Description Summary Of Position... ..., or patient's home which may be in understaffed/remote areas, in the presence of pets or family members that are...Remote workWork at office$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | Central Time Zone Preferred Are you an experienced Registered Nurse looking to expand your...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$32.01 - $68.55 per hour
..., one family and one community at a time. Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team where your clinical expertise... ...), weekends, and holidays (based on business needs). Remote/office-based environment with extensive computer and...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization management functions to promote appropriate... ...rotating weekend coverage Hybrid Position - Primarily remote/work-from-home, with an expectation to be on-site at least...Remote workFull timeWork from homeShift work
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote jobWeekend work$32.01 - $68.55 per hour
...health care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule - 4x10's- Thursday, Saturday, Sunday, Monday 8A-...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$60.2k - $107.4k
Optum is a global health services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company...Remote jobFull timeMonday to Friday$72.8k - $130k
...and projects. We have collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- Harris Health System, Inc. is seeking a Utilization Management Review Nurse to evaluate medical necessity, appropriateness, and efficiency of services, ensuring care aligns with evidence-based guidelines. The role involves partnering with Care Management, Physician Advisors...Remote jobFlexible hours
- ...Plan Holding Company, Inc. is seeking a UM Nurse to support network adequacy review and... ...for ACO, HMO, and EPO products. Remote role with occasional onsite meetings in... ...Requires MA RN license and 2-3 years of utilization review experience. You will review authorization...Remote job
- UnitedHealth Group is seeking a Utilization Management Nurse to review medical records and craft defensible appeal letters. The role supports telecommuting from anywhere in the U.S. and requires a state RN license, 3+ years bedside nursing, and strong data extraction skills...Remote job
$58.66k - $142.45k
...much more. The UMCM will utilize clinical knowledge to analyze... ...outpatient review) experience in a managed care setting with commercial... ...: ~ Associate's Degree Nursing required or Bachelor's Degree... ...after hire. This is a remote role with occasional onsite team...Remote workWork at officeFlexible hoursShift work- Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical services and benefit determinations. This remote role may require occasional travel to Humana's offices for training or meetings. The...Remote job
- UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases. The position offers a 40-hour...Remote jobMonday to Friday
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination... ...or Interqual. Experience working in a fully remote, metrics-focused role Experience as an MDS Coordinator...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role requires an RN license, 3+ years bedside experience, and strong data extraction skills. You will work per diem with flexible start times and may telecommute...Remote jobDaily paidWork at officeFlexible hours
$60k
...a LPN/LVN experienced in the managed care payor environment to perform... ...pre-service and post-service utilization reviews and appeals for... ...KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include... ...opportunities Remote Opportunities We are actively...Remote workTemporary workLocal area- nirvanaHealth is seeking a part-time Utilization Management (UM) Nurse to join our remote team. The UM Nurse will perform prospective, concurrent, and retrospective medical necessity reviews, determine level of care, and participate in initial clinical review to ensure...Remote jobPart timeWeekend workAfternoon shift
- ...Day (United States of America) Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the clinical floor and administrative compliance. Unlike remote roles, this position relies heavily on real-time, face-to-face...Remote workImmediate startShift work
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
$32.01 - $68.55 per hour
...with heart, each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...Remote workHourly payFull timeLocal area10 hours per weekFlexible hours- ...defined patient population. This includes utilization management, patient advocacy, and monitoring... .... It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold... ...and administrative compliance. Unlike remote roles, this position relies heavily on...Remote workImmediate startShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse. Be the first to apply!
- supply chain analyst remote United States
- procurement specialist remote United States
- physician consultant remote United States
- remote insurance agent United States
- remote data manager United States
- training manager remote United States
- remote concierge United States
- remote ui developer United States
- remote customer service advisor United States
- it manager remote United States


