Remote RN, Utilization Management & Care Coordination
$71.1k - $97.8kHumana
- Remote job
Humana seeks a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communications for medical services and benefit determinations. You will report to the Manager of Utilization Management and support post-acute care services including SNF, Home Health, and DME to ensure members receive appropriate care. The role can be fully remote with a 40-hour work week, offering a pay range of $71,100 to $97,800 annually plus a performance-based bonus plan. #J-18808-Ljbffr Humana
$71.1k - $97.8k
...solutions company is looking for a Utilization Management Registered Nurse to interpret and coordinate medical services. This fully remote position requires a Compact RN license and over a year of... ...criteria and collaborating with care providers. The position offers a...Remote work$71.1k - $97.8k
...healthcare organization is seeking a Utilization Management Registered Nurse to support the coordination and documentation of medical services. This remote position requires a valid RN license and clinical... ...information and ensuring appropriate care delivery. The role offers a...Remote work$71.1k - $97.8k
...United States is seeking a Utilization Management Registered Nurse to... ...clinical skills in coordinating medical services and ensure appropriate care levels for members. This... ...possess a Compact RN license and at least one... ...The position offers a remote work option and includes...Remote work- ...organization is looking for a Utilization Management Registered Nurse to work remotely in Cheyenne, Wyoming. You... ...nursing skills to coordinate medical services and ensure appropriate care levels. The ideal candidate will hold a Compact RN license and have over one...Remote work
- ...The Carle Foundation in Illinois is seeking an Illinois Licensed Utilization Management RN to work remotely full-time, coordinating patient care, ensuring cost-effective services, and verifying medical necessity criteria during concurrent reviews and documentation. You...Remote workFull time
$54.38 - $73.41 per hour
ENL Utilization Management Compensation range: $54.38 - $73.41 Your rate of pay... ...hiring the right team to care for our patients and their... ...our team. **This position is remote.** POSITION SUMMARY: The... ...Enloe Medical Center Transfer Coordinator (TC) provides clinical...Remote workDaily paidWork at officeImmediate startFlexible hoursShift work- CVS Health is seeking a Utilization Management Nurse Consultant for a remote, full-time role. You will coordinate, document and communicate coverage... ...to ensure appropriate care in a timely manner while adhering... .... Required: 3+ years of RN experience with active licensure...Remote jobFull timeWeekend work
- ...recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an... ...include evaluating healthcare services and coordinating care for members. Join a dynamic team and make a meaningful...Remote workContract work
$71.1k - $97.8k
...Humana Inc is seeking a dedicated Utilization Management Nurse to join their team in Topeka,... ...clinical knowledge to provide appropriate care for members and coordinate with various stakeholders to ensure... .... Candidates must have an active RN license, at least 3 years of...Remote workFull timeWork at office- ...California is seeking a Supervisor of Utilization Management to oversee operations of the... .... You'll manage staffing, coordinate referrals, and facilitate team meetings. A California RN license is required. This... ...focuses on improving patient care and operational efficiency....Remote work
$60.52k - $129.62k
4062 Aetna Resources, LLC is looking for a Remote Case Manager RN to utilize a collaborative process in assessing and advocating for patients' health... .... You will perform comprehensive assessments, coordinate care, and actively engage with members to promote healthy lifestyle...Remote workFull time- ...is designated as a regional Coordinated Care Organization (CCO) for... ...Communities Together. This is a remote position in which we are... ...experience: ~ ~ Health plan utilization management ~ Medicare and Medicaid... ...unencumbered Oregon RN License required within 90...Remote work
- ...Health in Portland, Oregon, is hiring a Care Coordinator to manage treatment plans and ensure timely care... ...position requiring a valid Oregon RN license and at least 3 years of relevant... ...interacting with members and providers, utilizing internal systems to assess eligibility...Remote jobFull timeWork from home
- ...Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified...Remote work
- ...Job Title: Care Management Coordinator Location: 100% Remote Duration: 6+ Months (Possible FT conversion) Would... ...Management and Coordination PA RN license (only) required! Job Summary... ...medical knowledge to cases utilizing specified resources and guidelines...Remote work
$39 - $40 per hour
...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... ...responsible for evaluating healthcare services, coordinating care, and ensuring members receive high-...Remote workDaily paidContract workMonday to FridayShift workWeekend work- ...Performs care coordination services for assigned recipients who are eligible for home health services (Home Health Visits, PPEC, Personal... ...validate UR or forward to 2nd level reviewer. Provides first level utilization review for all inpatient and outpatient services requiring...Remote workContract work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for... ...outpatient services Quality of care concerns Interfacing routinely... ...reliable and user-friendly. Care Coordination & Quality Support Initiating...Remote jobBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$75k - $100k
Description Our Utilization Management RN (Registered Nurse) evaluates efficiency... ...Location We are open to remote work in the following... ...Services objectives of quality care and reasonable cost.... ...Demonstrated experience managing and coordinating care effectively for case...Remote workFor contractorsWork at officeLocal areaImmediate start- ...skilled Registered Nurse (RN) Care Coordinator to join our healthcare team... ...centered care to individuals managing multiple chronic and... ...up for high-risk patients, utilizing monthly reports to monitor... ...entitlement programs. Oversee remote patient monitoring and chronic...Remote work
- ...YEAR COMMITMENT**JOB TITLE: UTILIZATION REVIEW/CASE MANAGEMENT – NurseDEPARTMENT: CASE... ...combination of in person and remote considered)GENERAL... ...ensures safe transitions of care.GIBSON AREA HOSPITAL & HEALTH... ...DUTIES AND RESPONSIBILITIES1. Coordinate and facilitate patient...Remote workFull timeSecond jobWork at officeRelocation packageShift work
$26.01 - $62.32 per hour
...Enhancement is seeking a full-time Utilization Management Nurse Consultant to support... ...for complex spine cases. This remote position requires an active RN license and a minimum of 3 years... ...responsibilities including evaluating care and coordinating services. Candidates should...Remote jobHourly payFull timeWork at office$40 - $45 per hour
...Immediate need for a talented RN Care Management Coordinator . This is a 03 months Contract opportunity with long-term potential and is Remote , but the candidate must be in PA, DE, NJ... ...advanced medical knowledge to cases, utilizing specified resources and guidelines to...Remote workContract workLocal areaImmediate start$45 - $45.5 per hour
...Title: Nurse Case Management Senior Analyst Location: REMOTE Duration: 5-6 Months... ...appropriate health care services in conjunction... ...treatment plan. Utilizes clinical skills to... ..., plan, implement, coordinate, monitor and evaluate... ...team members. RN and current unrestricted...Remote workContract workImmediate startMonday to FridayAfternoon shift- ...Humana is seeking a Utilization Management Administration Coordinator to provide non-clinical support for optimal treatment and care of members. This role works fully remote within the Home Solutions organization, and requires managing various administrative tasks including...Remote workWork at office
- ...have an active, unrestricted RN license in the state of... ...requests or provides health management program interventions. Utilizes clinical proficiency and... ...implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options,...Remote jobContract workLive inMonday to Friday
$39.83 - $59.74 per hour
...Utilization Management RN Robbinsdale, MN Posting Date: Jul 10 2026 Apply... ...Create Impact. Empathy and care are at the heart of North’s... ...information to assist with care coordination and support the delivery of... ...Call Requirement: None Remote or On-site: Hybrid Remote-...Remote workFull timeContract workPart timeFor contractorsFor subcontractorLive inWork at officeShift workWeekend work- ...Plan Group is seeking a Clinical Program Manager RN for a full-time evening shift. This... ...a liaison with providers and Ministry Care Coordination teams, ensuring patients are transitioned... ..., along with a strong background in Utilization Management. A comprehensive benefits...Remote jobFull timeAfternoon shift
$63.5k - $90.72k
...providing a variety of Care Coordination services within the... ...empowering member’s self-management skills and... ...population management, utilizes behavioral health screening... ...assigned. Qualifications RN with valid license in... ...HIPAA compliant for all remote or telecommuting positions...Remote workHome office- ...A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities include... ...service eligibility and facilitating care. This remote role requires an RN license and clinical experience....Remote workWork from home
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