Remote Utilization Management RN
Guidehealth
Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments, and ensuring timely decisions in a remote work environment.
Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings, and are proficient with Microsoft 365.
#J-18808-LjbffrVacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN in United States vacancy
- ...RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide... ...Registered Nurse (UMRN) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$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 workWeekend work- ...A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Remote workHourly payDaily paidDay shift
$70k - $75k
...AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections... ...a better path!! Job Description The Utilization Management Registered Nurseis responsible for...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- CVS Health is seeking a Utilization Management Nurse Consultant (RN) for a remote role. You will perform concurrent reviews for acute inpatient admissions and support timely transitions of care. Required RN license, 5+ years acute care, 2+ years UM/Case Management experience...Remote job
- UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient and effective health services administration. The... ...appropriate care levels to support healthier outcomes. This remote position is restricted to applicants located in Pacific or Mountain...Remote job
$101.72k - $198.36k
...Location: California - Ability to work remote, but selected candidate must reside in... ...This position requires California RN Licensure. Candidates must have significant... ...some or all of the following functions: utilization management, care management, behavioral health and...Remote workContract workWork experience placementWork at officeLocal area- ...Utilization Management RN There's no place like Liberty Health Come explore career opportunities with Liberty Health, a dynamic leader in... ...with all staff levels. Clearly communicates instructions to remote users. Visit for more information. Background checks...Remote workWork at office
- Optum is seeking a Utilization Review Nurse, RN to perform inpatient utilization management, applying evidence-based guidelines and medical necessity criteria. The role involves day-to-day clinical reviews, documentation, and collaboration with Medical Leadership across...Remote job
- ...This role is part of a multidisciplinary team focused on member care within a managed care framework. The position requires R.N. licensure in NC, five years of clinical experience, including acute care and utilization management experience. #J-18808-Ljbffr Vaya HealthRemote job
- 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 Healthcare...Remote job
- ...Utilization Management Specialist Shift: Monday through Friday 8:00 AM to 4:30 PM, with every fifth weekend rotation. Contract Length: 1... ...experience necessary. ~ Must be computer literate and have remote working experience. Compliance / Notes: Must provide...Remote workContract workWork experience placementLocal areaMonday to FridayShift workWeekend work
- Optum is seeking a Utilization Review Nurse (RN) to perform inpatient utilization management, applying evidence-based guidelines to admissions and preauthorization requests... ...offer a Monday-Friday schedule with potential remote work for those in PST or MST and weekend...Remote jobMonday to FridayWeekend work
- UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient, evidence-based care across the continuum. This... ...translating guidelines into practical decisions. You will work remotely within Pacific or Mountain Time Zones, enjoy autonomy, and...Remote job
- UnitedHealth Group is seeking a Utilization Management Nurse to ensure efficient and effective administration of health... ...level of care, and guide care decisions in a remote setting. Baseline requirements include Compact RN license and 3+ years in managed care or clinical...Remote job
- Optum is seeking a Utilization Review Nurse (RN) to perform inpatient utilization management, applying evidence-based guidelines to determine medical necessity for admissions... ..., and collaboration with physician leadership. Remote work is available for those in PST/MST with...Remote workWeekend work
- Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with...Remote job
- UnitedHealth Group is seeking a Utilization Management Nurse to ensure efficient administration of health services. You will assess member needs,... ...responsibilities affecting patient care. Requirements include RN license, 3+ years in managed care or clinical settings, and...Remote job
- UnitedHealth Group's Optum is seeking a Utilization Management Nurse to review patient records and craft defensible appeal letters in accordance... ...on data-driven, compliant reviews. The position requires an RN license and an associate degree, plus 3+ years of bedside nursing...Remote jobMonday to Friday
- UnitedHealth Group is hiring a Utilization Management Nurse for a remote role open to those in Pacific or Mountain Time zones. You will assess member needs... ...-driven environment. Requirements include a compact RN license and 3+ years in managed care or clinical settings...Remote jobFlexible hours
- UnitedHealth Group's OptumCare seeks a Utilization Management Nurse to oversee utilization management, including prior authorization... ...a fast-paced, production-driven environment. This remote position requires a Compact RN license, 3+ years in Managed Care or clinical...Remote job
- Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical... ...independent decisions aligned with organizational strategy. Remote-friendly, standard hours, with occasional travel. #J-18808-...Remote job
- Optum, part of UnitedHealth Group, is seeking a Utilization Review Nurse, RN, to perform inpatient utilization management. The role requires clinical expertise,... ..., and adherence to medical necessity criteria. Remote work is available for PST/MST while weekend shifts...Remote jobShift workWeekend work
$39 - $40 per hour
...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:...Remote workDaily paidContract workMonday to FridayShift workWeekend work- ...Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services by assessing member... ...Based in Phoenix, AZ with a fully remote work style, the role requires 3+... ...nursing in acute settings and an active RN license. You will perform reviews...Remote job
- ...seeking a Clinical Guide Part A to support inpatient, behavioral health, and post-acute utilization review in alignment with CMS guidelines. This remote, full-time role requires a licensed RN with several years of UR experience and familiarity with Medicare Advantage...Remote jobFull time
- American Traveler Staffing Professionals is recruiting an RN for a remote Utilization Management role in Austin, TX. Requires TX or multistate license and 2+ years acute care UM experience, with Cerner/Careport EMR and InterQual knowledge. The assignment runs 13 weeks...Remote jobLocal area
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and... ...teams to deliver high-quality reviews. Requirements include an RN license, 3+ years bedside nursing in acute care, and...Remote jobWork at officeFlexible hours
- A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote jobFlexible hoursWeekend workDay shift
- SSM Health is seeking a Manager of RN Utilization Management to oversee system-wide UM activities and lead a high-performing team. The role blends... ...across the continuum of care. The position is fully remote with a preference for candidates in MO, IL, WI, or OK, and...Remote jobWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN. Be the first to apply!


