Remote UM RN with CM Growth Path
WPS—A health solutions company
- Remote job
WPS—A health solutions company is seeking a Utilization Management Registered Nurse to evaluate medical necessity and ensure appropriate services for our Health Plan. The UM RN will refer cases to medical directors when criteria are not met and may cross-train in Case Management for future growth. The role supports remote work within approved states, with a base salary range noted and a start date of 01/10/2027, offering opportunities to expand responsibilities and impact on medical loss ratio. #J-18808-Ljbffr WPS—A health solutions company
- ...hiring an Utilization Management RN to evaluate medical necessity and... ...of services. You will collaborate with Medical Directors to support... ...Case Management, with potential growth into a combined UM/CM role. The position supports remote work in approved states across the...Remote jobCms
$75k - $100k
...seeking an experienced Utilization Management RN to evaluate the necessity and... ...authorizing needed care and collaborating with medical directors. The role offers remote work with quotas and potential growth into CM. Start date is 01/10/2027 and salary ranges...Remote jobCms$75k - $100k
...Solutions is seeking a Utilization Management RN to evaluate medical necessity and approve appropriate... ...cross-training potential into Case Management with future growth into CM and a broader UM/CM path. The position offers remote work in approved states, with a start date of...Remote jobCms$75k - $100k
...seeks a Utilization Management RN to evaluate medical necessity for... ...appropriate care, and coordinate with medical directors. The role... ...training in Case Management and growth into a combined UM/CM position. Start Date: 01/10/2027. Remote work option available in approved...Remote jobCms$75k - $100k
...Health Solutions is seeking an Utilization Management RN to evaluate medical services for appropriateness... ..., and potential cross-training in Case Management with growth into a combined UM/CM position. The position is remote with approved states including GA; starts 01/10/20...Remote jobCms- ...seeking an Utilization Management RN who evaluates efficiency,... ...Plan. This role collaborates with Medical Directors and Health... ...cases that do not meet criteria. Remote work is allowed for specified states, with potential growth into combined UM/CM roles. A strong background in...Remote jobCms
- ...an experienced Utilization Management Registered Nurse (UM RN) to evaluate efficiency, appropriateness, and medical... ...Plan. The role includes cross-training in Case Management with potential growth into a combined UM/CM position and future CM opportunities. The candidate...Remote jobCms
$75k - $100k
...care and referring cases when needed. The role includes cross-training in Case Management and potential growth into a combined UM/CM position. The position offers remote work in approved states, a salary range of $75,000-$100,000, and benefits. #J-18808-Ljbffr WPS Health...Remote jobCms$75k - $100k
...solutions company, seeks an Utilization Management RN to evaluate medical necessity and authorize... .... Cross-training in Case Management offers growth toward a combined UM/CM role in the future. Start date is 01/10/2027 with a salary range of $75,000 to $100,000. #J-188...Remote jobCms$75k - $100k
...company, seeks an Utilization Management RN to evaluate medical necessity and... ...involves cross-training in Case Management with potential growth into a combined UM/CM position or CM in the future. Start Date: 01/10/2027. Remote work options available in a defined set...Remote jobCms- ...seeking an experienced Utilization Management RN to evaluate efficiency, appropriateness, and... ...role includes cross-training in Case Management with potential growth into a combined UM/CM position. Start Date: 01/10/2027. Remote work options available in multiple states...Remote jobCms
- ...Health Solutions seeks an Utilization Management RN to evaluate medical necessity and... ...procedures and extended hospital stays. We support remote work in multiple states and offer opportunities to grow into a combined UM/CM role. #J-18808-Ljbffr WPS Health SolutionsRemote jobCms
- ...is seeking an Utilization Management RN to evaluate medical necessity and... ...evidence-based review, collaboration with medical directors, and opportunities... ...Management with potential for a blended UM/CM position. This position offers remote work options within approved states...Remote jobCms
- ...Registered Nurse to evaluate medical necessity for services, coordinate care, and collaborate with Medical Directors. The role offers remote work within approved states and potential growth into Case Management. Experience in managed care and strong analytical skills are...Remote jobCms
$75k - $100k
...Solutions is seeking an Utilization Management RN to evaluate medical necessity and... ...role may cross-train in Case Management with potential growth into a combined UM/CM position or CM in the future. The position offers remote work options across approved states and a...Remote jobCms- ...seeks an Utilization Management RN to evaluate efficiency,... ...knowledge to review services with evidence-based criteria and... ...questionable cases. We offer remote work in numerous states and... ...Management, with potential growth into a combined UM/CM role in the future. #J-1880...Remote jobCms
$75k - $100k
...seeks an Utilization Management RN to evaluate medical necessity... ...based criteria and coordinates with medical directors to prevent unnecessary... .... The position offers remote work options in approved states... ...Case Management and grow toward CM leadership. #J-18808-Ljbffr WPS...Remote jobCms$75k - $100k
...necessity of medical services for our Health Plan. This role may cross-train in Case Management with potential growth into a combined UM/CM position. The position offers remote work options in multiple states, including Texas, with a salary range of $75,000 to $100,000....Remote jobCms- ...an Utilization Management RN to evaluate medical necessity... ...judgment, collaboration with Medical Directors, and potential... .... The position offers remote/hybrid options across multiple states with growth opportunities toward a combined UM/CM role in the future. #J-188...Remote jobCms
- ...company, is seeking an Utilization Management RN to assess medical necessity, authorize services, and coordinate care with medical directors. The role offers remote work in multiple states and a potential path toward combined UM/CM responsibilities. There is a strong...Remote jobCms
- ...solutions company, seeks an Utilization Management RN to assess efficiency, medical necessity, and authorize... ...cross-training in Case Management and potential growth into a combined UM/CM position. Remote-friendly with growth opportunities, the role requires Wisconsin RN...Remote jobCms
$75k - $100k
...necessity and appropriateness of services. The role may cross-train into Case Management and grow into a combined UM/CM position with potential future advancement. Remote work is available for qualified states, including FL. The position starts 01/10/2027 with a base pay range...Remote jobCms$75k - $100k
...WI seeks an Utilization Management RN to evaluate medical necessity and authorize... ...criteria. The role collaborates with medical directors and may cross-... ...with potential to grow into a combined UM/CM position. The position offers remote/hybrid options across approved...Remote jobCms- ...Minnesota is seeking a Utilization Management RN to evaluate efficiency, appropriateness,... ...when appropriate. This position offers remote work options with potential to cross-train in Case Management and grow into a combined UM/CM role or CM in the future. Start date is 0...Remote jobCms
$75k - $100k
...Health Solutions is seeking an Utilization Management RN to evaluate efficiency and medical necessity for... ...The role includes cross-training in Case Management with potential growth into CM. Start date 01/10/2027. Remote work is available in multiple states, including...Remote jobCms- Phaxis is hiring a Remote UM / Grievance & Appeals RN (NY License) for a contract role with a New York health plan. If you have owned appeals from intake to final decision letter, we want to talk to you. You will review medical necessity for outpatient and community-based...Remote jobCmsContract work
$52 - $56 per hour
Now hiring: Remote UM / Grievance & Appeals RN (NY License) | Contract | $52-56/hr Are you an RN who has owned appeals cases from intake to final decision... ...health plan, needs a clinical Grievance & Appeals nurse with a utilization management or case management background....Remote jobCmsContract workImmediate start$45 per hour
Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’smanaged care health plan client based out of Fairfield... ...in a fully remote managed care setting. The UM RN Nurse Coordinator reviews outpatient authorization...Remote jobCmsContract workTemporary workMonday to FridayWeekend work$68.4k
...JOB SUMMARY This is a full-time REMOTE position requiring weekend... ...processes that are consistent with established industry and corporate... ...clinical setting Preferred3 years RN experience RN Case Management, Care Management Experience in UM/CM/QA/Managed Care Experience with...Remote jobCmsFull timeFor contractorsWork at officeLocal areaFlexible hoursWeekend workWeekday work- WPS is seeking an Utilization Management RN to evaluate medical necessity for... ...potential to cross-train in Case Management with growth into UM/CM roles. The position offers... ..., documentation of case summaries, and remote work options in approved states. #J-18...Remote jobCms
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