Fertility Utilization Management RN - Remote
$60.2k - $107.4kUnitedHealth Group
About This Role As a Fertility Utilization Management RN at UnitedHealth Group, you will ensure health services are administered efficiently and effectively, assessing member needs and identifying solutions to help them live healthier lives. This remote position is ideal for those looking to make a significant impact in healthcare. Highlights Pay: $60,200 - $107,400/year Location: Des Moines, IA Schedule: Full Time, Day shift Residency: Must reside in the U.S. What You'll Do Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination Identify solutions to non-standard requests and problems Translate concepts into practice Act as a resource for others; provide explanations and information on difficult issues Generally, work is self-directed and not prescribed Work with less structured, more complex issues Serve as a resource to others Make decisions that directly impact members while leveraging technologies and resources Requirements Education: Current unrestricted RN licensure in state of residence Experience: 3+ years of Managed Care and/or Clinical experience 1+ years of fertility experience Licenses & Certifications: Compact license and/or willingness to obtain additional licenses in CA, NV, NM, OK, WA, and WY required Benefits Comprehensive benefits package Incentive and recognition programs Equity stock purchase and 401k contribution About UnitedHealth Group UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They harness technology and innovation to make healthcare simpler, more affordable, and more connected for the people they serve. The organization values inclusion and empowers employees to bring their authentic selves to work. #J-18808-Ljbffr
- ...UnitedHealth Group is seeking a Fertility Utilization Management RN in the United States. This remote role requires 3+ years in managed care and fertility experience, plus an unrestricted RN license in the resident state. The position is full-time with day shifts, based...Remote workFull timeDay shift
- ...Humana is seeking a dedicated Utilization Management Registered Nurse to interpret and support clinical and administrative determinations for post-acute care services including SNF, Home Health, and DME. You will work from home or hybrid, reporting to the Manager of...Remote workWork from home
- ...Arkansas Blue Cross and Blue Shield is seeking an RN Utilization Management Nurse to perform clinical reviews for medical necessity across various services. The role involves weekend coverage and work from home within Arkansas and several western states. The ideal candidate...Remote workWork from homeWeekend work
- ...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...Remote workWork from home
- ...HealthEdge in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity... ...experience, and 1+ year in Behavioral Health/utilization management; remote work across time zones as #J-18808-LjbffrRemote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...You will use clinical nursing skills to determine medical necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations for post-acute care (SNF, Home Health, DME). The role reports to the Manager of Utilization...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote work
- ...support patient care initiatives, the full-time Florida Licensed Utilization Management RN will monitor admissions, perform medical necessity reviews,... ...with the multidisciplinary care team in a fully remote setting. Key responsibilities Monitor admissions and perform...Remote workFull time
- ...CVS Health is seeking an experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on Medicare joint procedures.... ...care and utilization. The position requires 3+ years RN experience, an active RN license, an associate degree in nursing...Remote work
- ...Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance, auditing DRG classifications...Remote workContract work
- ...Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will coordinate with providers and members...Remote work
- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: Full-Time Position Overview We are seeking an experienced Utilization...Remote workFull timeMonday to Friday
- ...Humana is seeking a qualified Utilization Management Registered Nurse to join the One Home/Home Solutions UM team. This remote role focuses on interpreting medical criteria, coordinating documentation, and communicating determinations for post-acute care services including...Remote work
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and support the coordination, documentation, and communication of medical... ...Management team. The role requires an active Compact RN license, 1 year of RN experience, and a passion for improving...Remote work
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN), remote and full-time with a weekend schedule after training. You’ll review clinical information for coverage determinations, apply guidelines, and coordinate with care teams...Remote workFull timeWeekend workAfternoon shiftWeekday work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Services and Supports, the full-time Massachusetts Licensed Utilization Management RN will manage clinical determinations, authorization support, and appeals in a hybrid role that is approximately 75% remote and 25% onsite for meetings and training. Key responsibilities...Remote workFull time
$47.37 per hour
...Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care,... ...regulations. The role requires an active RN/LPN/LVN license and 2–4 years of clinical experience...Remote workHourly pay- ...Humana is seeking an Utilization Management Registered Nurse to interpret and support the coordination, documentation and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and support a team focused...Remote work
- ...Humana Inc. invites a qualified Utilization Management Registered Nurse to interpret and support coordination, documentation and communications... ...acute care services. Required qualifications include an active RN license in your state, over one year of clinical RN experience...Remote work
- ...Humana Inc. seeks a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical... ...report to the Manager of Utilization Management and work on a remote team focused on delivering appropriate care in the right setting...Remote work
- ...A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr...Remote work
- ...Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United States. Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state of...Remote work
- ...Hanker Systems Inc. is seeking a skilled Registered Nurse for Utilization Management/Utilization Review in a 100% remote role. California licensure is required, with 3+ years in acute hospital care management and recent utilization review experience. Epic proficiency...Remote work
- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant (RN) for remote work supporting prior authorization and utilization management. You will review requests, evaluate medical necessity, and collaborate with care teams to ensure timely, cost-effective...Remote work
- ...Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews for... ...cost containment. The role requires an RN with current licensure and a minimum of... ...in relevant areas. The position is remote within Arkansas and selected nearby...Remote workWork at office
- Mass General Brigham Health Plan Holding Company, Inc. is seeking an experienced nurse for utilization review in a remote-friendly setting with occasional onsite work in Somerville, MA. The role emphasizes clinical knowledge, medical necessity determinations, and collaboration...Remote workCasual work
- ...CVS Health is seeking an Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) for a remote, full-time role. You will review cases, determine coverage, and collaborate with care teams to ensure appropriate care timing and setting. The position...Remote workFull timeMonday to Friday
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
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