Remote Utilization Management Nurse Supervisor
Integra Partners
Troy, OH
- Remote job
Integra Partners in Michigan seeks an Utilization Management Nurse Supervisor to lead the UM nursing team, balancing hands-on operations with strategic leadership and ensuring compliance with CMS, NCQA, and state requirements. You will conduct regular 1:1s and performance reviews, lead daily huddles, manage case assignments and authorizations, and provide coaching to improve productivity, timeliness, and quality across the UM function. #J-18808-Ljbffr Integra Partners
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Supervisor in Troy, OH vacancy
$75k
The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team... ...and external stakeholder interactions as directed. Remote work environment with expectations for timely communication...Remote workTemporary workLocal area- ...Mass General Brigham is seeking an RN for a remote Utilization Management role in the United States. The position involves clinical review, triage, and escalation support to ensure medical necessity and regulatory compliance. The role requires 2–3 years in case management...Remote work
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job... ...Nurse” roles. Clinical Review Nurse- Prior Authorization Remote Registered Nurse (Remote Patient Monitoring & Chronic...Remote workFull timeWork at officeWork from homeNight shift- Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews for clients while working remotely in a fast-paced environment. The role requires current LPN licensure and strong knowledge of URAC and...Remote job
- Centene Management Company LLC is seeking a remote RN reviewer to perform concurrent reviews, determine appropriate level of care, and support discharge... ...with Medical Affairs, and educating providers on utilization processes to ensure high-quality care. #J-18808-Ljbffr...Remote job
- ...serve as the clinical expert for prospective utilization review. The role balances production reviews with lead duties, coaching nurses, and ensuring timely case flow in a fast-... ...organized and experienced in utilization management, with strong communication for cross-...Remote job
- ...Medical Group) is seeking a Case Manager to evaluate the necessity and... .... The role offers hybrid or remote work options and an... ...candidate will be a Registered Nurse with acute care experience and... ...to quality patient care and utilization review processes. #J-18808-Ljbffr...Remote job
- ...Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care across multiple states. The role emphasizes applying clinical criteria, ensuring medical necessity, and coordinating...Remote workWork from home
- Jobgether is seeking a Case Manager - Utilization Review Specialist to oversee admissions and concurrent... ...administrative appeals. You will work remotely from the United States alongside... ...have five or more years of acute care nursing and five to seven years in case management...Remote job
- ...Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote workWork from home
- ...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 workFull timeImmediate startShift work
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- Cambia Health is seeking an Utilization Management Nurse to support prospective, concurrent and retrospective reviews from a home-based role across multiple states. The position emphasizes quality, cost-effective care and appropriate payment for services while coordinating...Remote jobWork from home
- Cambia Health is seeking an Utilization Management Nurse to support care decisions from a home-based setup across several states, including Washington, Oregon, Idaho and Utah. The role emphasizes clinical judgment, cost-effective care, and policy-based reviews. The nurse...Remote jobWork from home
$26.01 - $68.55 per hour
CVS Health is seeking a Registered Nurse (RN) for Utilization Management. You will review clinical information to support coverage determinations, apply... ...to ensure appropriate care. This full-time role offers remote work from home in the United States, with a 40-hour...Remote jobHourly payFull timeWork from home- Cambia Health Solutions, Inc. is hiring a Utilization Management Nurse who will conduct reviews to ensure medical necessity and cost-effective outcomes. Working from home within the states of Oregon, Washington, Idaho or Utah, you will assess patient needs and collaborate...Remote jobWork from home
- CVS Health is seeking a Registered Nurse to join our Utilization Management team in a work-from-home weekend position. You will assess, plan, and coordinate care, applying clinical criteria to determine appropriate benefits and services for members. The role requires 3...Remote jobWork from homeWeekend work
- CVS Health is seeking a qualified Registered Nurse for a remote Utilization Management role. You will assess and coordinate care, apply clinical criteria, and collaborate with providers to ensure appropriate services for members. Responsibilities include reviewing cases...Remote jobFull timeWork from home
- ...an inpatient or hospital-based role. The best fit has a utilization management or case management foundation and has moved into payer-side... ...Comfortable managing multiple time-sensitive cases at once in a fully remote setting. Nice to haves BSN or MSN. Experience...Remote work
- Utilization Management Nurse at Cambia Health Solutions, Inc. works from home across Oregon, Washington, Idaho or Utah, with preference for Idaho/ Utah residents. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and appropriate...Remote jobWork from home
- HealthCare Strategies is seeking a Utilization Management RN to work from a HOME OFFICE. This full-time position runs Monday-Friday, 9am-6pm ET, offering a 40-hour workweek and remote work from anywhere in the United States. The role requires an active RN license, at least...Remote jobFull timeWork from homeHome officeMonday to Friday
- Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication of medical services and benefit determinations... ...position operates Monday-Friday, 8:00am-5:00pm ET, with remote/work-from-home options and occasional travel to Humana...Remote jobWork from homeMonday to Friday
- HealthCare Strategies, Inc. is seeking a Utilization Management RN to work from a home office. This full-time role runs Monday to Friday, 9am-6pm ET, offering 40 hours per week and a home-based schedule. The RN will perform telephonic clinical assessments, collect information...Remote jobFull timeWork from homeHome officeMonday to Friday
- CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a home...Remote jobWork from homeWeekend workAfternoon shift
- ...CVS Health is seeking an Utilization Management Nurse Consultant to assess and coordinate care for members across the continuum of care. This role... ..., and effective communication. A BSN is preferred; remote work is supported within the state(s) of residence. #J-1...Remote work
- ...Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. You will collaborate with the patient’s physician, facility case manager, discharge planner and contracted providers to ensure appropriate, cost-effective care at the...Remote work
$29.1 - $62.32 per hour
...UM Nurse Consultant Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. Fully Remote- WFH Schedule: Monday-Friday 10:30AM- 7:30PM Position Summary: UM Nurse Consultant Utilizes clinical experience...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$26.01 - $62.32 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time.RN Utilization Management Nurse Consultant (Medicare - Joint Procedures)Remote | Full-Time | Monday-Friday (9:00 am to 5:30 pm in your time zone, with occasional evenings/...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- ...Cambia Health is seeking an Utilization Management Nurse to work remotely within Oregon, Washington, Idaho or Utah. The role focuses on prospective, concurrent and retrospective reviews to ensure medical necessity and cost-effective care, applying expert clinical judgment...Remote work
- ...Cambia Health is seeking an Utilization Management Nurse who can work remotely within the U.S. states of Oregon, Washington, Idaho or Utah. The role focuses on prospective, concurrent and retrospective reviews to ensure medical necessity and cost-effective care. The...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse Supervisor. Be the first to apply!
Related searches
- clinical nurse Troy, OH
- nurse practitioner urology Troy, OH
- advanced nurse practitioner Troy, OH
- clinical informatics nurse Troy, OH
- clinical research nurse Troy, OH
- nurse practitioner Troy, OH
- nurse practitioner - telehealth Troy, OH
- matron Troy, OH
- nurse supervisor Troy, OH
- nurse practitioner director Troy, OH



