Remote Utilization Management Nurse
University of Minnesota School of Nursing
UnitedHealth Group is seeking a Utilization Management Nurse to review medical records and craft defensible appeal letters. The role supports telecommuting from anywhere in the U.S. and requires a state RN license, 3+ years bedside nursing, and strong data extraction skills. You will collaborate with teams to meet quality expectations and stay current with licenses and training. The position emphasizes adherence to HIPAA, policy guidance, and efficient case processing within set time frames, #J-18808-Ljbffr
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...Remote workWork from home
$60.15 - $85.81 per hour
...Job Summary: The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions... ...rotating weekend coverage ~ Hybrid Position – Primarily remote/work-from-home, with an expectation to be on-site at least...Remote workFull timeWork experience placementWork from homeShift work- ...The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization management functions to promote... ...with rotating weekend coverage Hybrid Position – Primarily remote/work-from-home, with an expectation to be on-site at least...Remote workFull timeWork from homeShift work
$60.2k - $107.4k
...Optum is a global health services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company...Remote workFull timeMonday 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$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive...Remote workHourly payFull timeTemporary workWork from homeAfternoon shift- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
- ...Plan Holding Company, Inc. is seeking a UM Nurse to support network adequacy review and... ...for ACO, HMO, and EPO products. Remote role with occasional onsite meetings in... ...Requires MA RN license and 2–3 years of utilization review experience. You will review authorization...Remote work
- ...Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning and utilization review. Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective...Remote work
- ...UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases. The position offers a 40-hour...Remote workMonday to Friday
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
- ...Full Time 40 hours/week remote Summary: The Utilization Management Nurse is responsible for conducting medical necessity review to assure appropriate use of hospital resources and serving as a resource to the hospital staff on utilization management practices...Remote workFull time
$36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and... ...with members, providers, and regulatory organizations. #LI-Remote Pay ranges vary based on the candidate's work location....Remote workFull timeWork at officeImmediate startWork from homeFlexible hours$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,60... ...Friday, 0730–1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications U.S. Citizenship (required...Remote workContract workImmediate startMonday to Friday- ...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical... ...requirements, and a member's benefit coverage while working remotely. Primary Responsibilities: Performs clinical utilization...Remote workContract workWork at office
$71.1k - $97.8k
...About This Role The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication... ...care. Highlights Pay : $71,100 - $97,800/year Location : Remote, LA Department/Unit : Care Management Schedule : Full-time...Remote workFull timeTemporary workMonday to Friday$26.01 - $56.14 per hour
...something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | 24/7 Operations Are you an experienced Registered Nurse looking to apply your clinical...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | Central Time Zone Preferred Are you an experienced Registered Nurse looking to expand your...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization ManagementJoin a dynamic healthcare team where your clinical expertise... ...(RN) to support our Utilization Management team. In this role, you will review... ...and holidays (based on business needs).Remote/office-based environment with...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shift$32.01 - $68.55 per hour
...health care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule - 4x10's- Thursday, Saturday, Sunday, Monday 8A-...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$32.01 - $68.55 per hour
..., each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...Remote workHourly payFull timeLocal area10 hours per weekFlexible hours$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination... ...or Interqual. Experience working in a fully remote, metrics-focused role Experience as an MDS Coordinator...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office$60k
...LPN/LVN Utilization Management Nurse Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service... ...wellness programs ~ Career development opportunities Remote Opportunities We are actively seeking new colleagues in...Remote workTemporary workLocal area$26.35 - $39.53 per hour
...for all. Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time... ...services provided to members under a managed care health plan. This role involves... .... Corporate office preferred / remote may be considered Collaborative environment...Remote workHourly payWork at office$29.1 - $62.32 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual — shaping a more connected, convenient... ...Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shift- ...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 workImmediate startShift work
- ...offer medical and pharmacy benefit management solutions that run on the same platform... ...mindset. Job Summary: The Utilization Management (UM) Nurse will have well-developed knowledge and... .... NOTE: This is a Part-Time REMOTE position for 4 Hours on Friday Evening...Remote workPart timeWeekend workAfternoon shift
$83k - $99k
...find out more about us at: Role and Responsibilities The Utilization Management Nurse collaborates with external entities such as Brokers, Group... ...$500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program...Remote workFull timeWork at officeFlexible hours- ...defined patient population. This includes utilization management, patient advocacy, and monitoring... ...It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold... ...and administrative compliance. Unlike remote roles, this position relies heavily on...Remote workImmediate startShift work
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