Remote Utilization Management Lead (RN)
Santa Barbara Cottage Hospital
- Remote job
IntusCare is seeking a Utilization Management (UM) Manager to lead the UM nurse team supporting a PACE program. You will own end-to-end UM delivery, ensure SLA compliance, and apply clinical decision support criteria across cases to optimize care and efficiency. The role blends hands-on UM work (approx. 25%) with 75% focused on staffing, coaching, QA, and cross-functional coordination with clients and the contracted physician, ensuring high-quality service delivery. #J-18808-Ljbffr Santa Barbara Cottage Hospital
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BerryDunn is seeking a Utility Billing/Customer Information System Implementation Project Manager to join our Local Government Practice Group. In this role, you will guide client and vendor teams in implementing utility billing systems across departments with up to 50%...Remote jobLocal area- ...Cynwyd, PA is seeking an Interconnection Manager to oversee gas and electrical interconnection... ...experience in renewable energy and utility interface. Strong communication and negotiation... ...opportunities and the possibility of remote arrangements for exceptional candidates,...Remote work
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...are seeking a Compliance Field Lead to support our growing renewables and utilities practice. This role is ideal for... ...blending time in the office with remote work as business needs evolve. We... ...liaison with contractors, project managers, and agency representatives regarding...Remote workFull timeContract workTemporary workFor contractorsSecond jobWork at officeLocal area- 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... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include...Remote jobWork from home
- ...healthcare provider in California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-Authorization team. This role... ...referrals, and facilitate team meetings. A California RN license is required. This position offers a hybrid work environment...Remote job
- ...RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties... ...Nurse (UMRN) . These will be completely remote positions, working entirely from the... ...and VA Health Systems. SHR is a leading organization that provides physician...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$89.07k - $162.8k
About the Job In-patient Utilization Review RN experience highly preferred. Candidate must live in the DC/Baltimore region General Summary of... ...Supervises the daily activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed each...Live in$75.3k - $135.4k
...professional on our Medical Management/Health Services team.... ...-to-day activities of utilization management team.... ...management team members Leads and champions change within... ...preferred. RN - Registered Nurse - State... ...approach to work with remote, hybrid, field or office...Remote workFull timePart timeWork at officeFlexible hours- Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote jobFlexible hours
- CorVel Corporation is looking for a Utilization Review Supervisor RN to direct operations in Rancho Cucamonga. The role includes managing day-to-day operations, ensuring quality service, and handling HR matters. This remote position requires strong communication skills,...Remote job
- careers-centralhealth seeks a Clinical Quality and Utilization Review Specialist to oversee utilization management and peer review. You will coordinate reviews, ensure medical necessity, and lead quality improvement initiatives across inpatient and outpatient settings,...
$38 - $43 per hour
Join Personify Health as an RN Utilization Management Team Lead, where you will provide clinical and operational leadership in a dynamic environment. With a strong emphasis on compliance and quality, you will support timely coverage determinations and enhance team performance...Hourly pay- ...Healthcare Alliance is seeking a Nurse Manager for Utilization Management to supervise daily UM operations... ...and reporting. Requirements include RN license, 3+ years in healthcare, and 3+... ...leadership with UR/case management. Remote work options with occasional travel and...Remote jobContract work
- Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews,... ...with providers and members. The role is remote/work-from-home with weekend shifts and... ...few times annually; requires Kentucky RN license, 2+ years clinical experience,...Remote jobWork at officeWork from homeShift work
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