Remote Utilization Management Nurse: Impact Care Costs
Vālenz Health®
- Remote job
Vālenz Health® is seeking a Utilization Management Nurse for a fully remote role. You will oversee and manage UM processes to ensure appropriate, necessary, and cost-effective care for plan participants, reviewing prospective, concurrent, and retrospective reviews. You’ll collaborate with internal teams, apply UM criteria, and maintain HIPAA-compliant records while staying current with CMS and URAC guidance. Join a company that emphasizes innovation and patient-focused value. #J-18808-Ljbffr Vālenz Health®
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full... ...timely, safe, and appropriate care for members. In this role you will review... ...collaborate with providers, and support cost-effective care while meeting state and...Remote jobFull timeWork from home
$70k - $75k
...Guidehealth leverages remotely-embedded... ...and a centralized Managed Service Organization... ...Description The Utilization Management Registered Nurse is responsible for... ...services Quality of care concerns Interfacing... ...review of cases impacting performance metrics...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support our 24/7 Utilization Management operations. In this role, you...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered... ...clinically strong RN looking to expand your impact beyond direct patient care, we'd love to...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift- Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective care for plan participants. You will review prospective... ...and other regulators. This fully remote role requires a US-based location,...Remote job
- Valenz, a remote-first health services platform in the United States, seeks a Utilization Management Nurse to oversee the UM process for plan participants, ensuring appropriate, necessary, and cost-effective care. You will review prospective, concurrent, and retrospective...Remote job
$42 per hour
IntusCare is seeking a Contract Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. The role collaborates with interdisciplinary... ...care settings. The position is fully remote within the United States and offers a 1-...Remote jobHourly payContract work- CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates... ..., ensuring appropriate care levels within state and federal... ...with providers, and supporting cost-effective care. #J-18808-Ljbffr...Remote jobFull time
$39 - $40 per hour
...The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month... ...Contract W2 Location: Remote - but MUST reside... ..., coordinating care, and ensuring members... ...receive high-quality, cost-effective treatment.... ...make a meaningful impact—without sacrificing...Remote workDaily paidContract workTemporary workMonday to FridayShift workWeekend work- ...Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving... ...activities to ensure appropriate care while complying with state and federal... ...with providers, and supporting cost‑effective, high‑quality care. #J...Remote jobFull time
$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the right care at the right time. What You'll Do Review clinical...Remote workHourly payFull timeTemporary workAfternoon shift$92.3k - $120k
...Registered Nurse (RN), Home Health Utilization Management Remote - USA At Clover Health, we are committed to providing... .... We prioritize preventive care while leveraging data and technology... ...we ensure better care at a lower cost—delivering the highest value to those...Remote workWork at officeLocal areaFlexible hours- ...Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role available to... ...management, ensuring safe, effective care while meeting regulatory... ...providers, and supporting high-quality, cost-effective care with strong...Remote jobFull time
- CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to EST residents across the U.S. You... ...ensure members receive safe, appropriate and cost-effective care. Schedule: Monday-Friday, 8:00 AM-5:00 PM EST,...Remote jobFull timeMonday to FridayWeekend work
- ...providers and members to reduce costs, improve quality, and... ...patient journey – from care navigation and management to payment integrity,... ...Opportunity: As a Utilization Management Nurse, you’ll oversee and manage... ...Work This is a fully remote position, and we’ll provide...Remote workFull timeImmediate startMonday to FridayFlexible hours
$71.1k - $97.8k
...Become a Part of Our Caring Community and Help Us Put Health First The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...Use Your Skills to Make an Impact Required Qualifications... ...Friday Travel: While this is a remote position, occasional travel to...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$29.1 - $62.32 per hour
...Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your... ...receive the right care at the right time....Remote workHourly payFull timeTemporary workWork at officeMonday to FridayAfternoon shiftWeekday work$41.71 - $105.65 per hour
...Staff Nurse - Per Diem Rotating Day - BWH Utilization Management The Insurance Support Nurse participates... ...are received in the Care Coordination Department.... ...efforts to improve quality, cost and satisfaction... ...Details (if applicable) Remote Type Remote Work Location...Remote workHourly payDaily paidShift work$29.1 - $62.32 per hour
...by passionate colleagues who care deeply, innovate with... ...and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule... ...Registered Nurse ready to make an impact beyond the bedside? Join our...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work$42 per hour
...Programs of All-Inclusive Care for the Elderly (PACE)... ...health, and utilization management. IntusCare empowers teams... ...Utilization Management Nurse plays a critical role... ...ensuring high-quality, cost-effective, and compliant... ...location : This is a fully remote role based in the...Remote workContract work$85k - $105.34k
...UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3... ...-driven Coordinated Care Organization (CCO) dedicated... ...The Utilization Management Nurse evaluates clinical... ...necessary, cost-effective, and evidence... ...making a meaningful impact, empowering healthier...Remote workFull timeWork at officeLocal areaImmediate startMonday to Friday$29.1 - $62.32 per hour
...passionate colleagues who care deeply, innovate with purpose... ...one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home... ...our team. This is a fully remote role available to... ...and supporting high-quality, cost‑effective care. Key Responsibilities...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayShift workWeekend work$72.8k - $130k
...Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...opportunities. Come make an impact on the communities we serve... ...occasional opportunity for remote work based on business needs....Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area$26.35 - $39.53 per hour
...quality, coordinated care. By uniquely aligning... ...Summary: The Concurrent Utilization Review (UR) Nurse is responsible for... ...provided to members under a managed care health plan.... .... 4. Utilization & Cost Management Reduction... ...Corporate office preferred / remote may be considered...Remote workHourly payWork at office$26.01 - $56.14 per hour
...0pm EST Location: 100% Remote (U.S. only) About Us American... ...URAC-accredited medical management organization founded in... ...3. We provide flexible, cost-effective care management solutions... ...medical journeys. As a Utilization Management (UM) Nurse Consultant specializing...Remote jobHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work- ...Job Description Job Description Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like... ...stays, outpatient surgeries, outpatient tests, care, etc. Review requests and match up to an...Remote workFull timeWork at office
- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization... ...). These will be completely remote positions, working entirely... ...educating patients on appropriate care and managing health care costs for the dependents of our...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- PacificSource Utilization Management Clinician is sought to support members remotely from Florida, Tuesday through Saturday... ...with physicians, nurses, social workers and other... ...professionals to coordinate care, assess benefits, and promote cost-effective utilization. The...Remote job
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports... ..., coordinating with providers, and ensuring timely care while meeting state and federal requirements. Strong documentation...Remote jobWork from home
$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... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work
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