Remote Utilization Management Nurse (PACE)
$42 per hourSanta Barbara Cottage Hospital
- Remote job
IntusCare is seeking a Contract Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. The role collaborates with interdisciplinary teams to review utilization, guide care decisions, and support transitions across care settings. The position is fully remote within the United States and offers a 1-year contract with potential extension. Compensation is $42.00 per hour, with sponsorship not available. #J-18808-Ljbffr Santa Barbara Cottage Hospital
- ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity... ...benefit coverage while working remotely. Primary Responsibilities... .... • Adaptive to a high pace and changing environment- flexibility...Remote workContract workWork at office
$29.1 - $62.32 per hour
...determined in collaboration with management to ensure adequate weekend... .... Position Summary Utilize your clinical experience and... ...adapt effectively to a fast-paced, changing environment. Capacity... ...Qualifications Registered Nurse Education: Diploma RN...Remote workHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend work$71.1k - $97.8k
...The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing skills... ...holiday rotation. This is a remote position. This role is responsible... ...oversight with team support in a fast-paced environment. Work at Home Requirements...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work- Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the... ..., and other regulators. This fully remote role requires a US-based location, strong... ..., and ability to work in a fast-paced environment #J-18808-Ljbffr Vālenz HealthRemote job
$80k - $95k
...Inclusive Care for the Elderly (PACE) programs deliver... ...adjustment, population health, and utilization management. IntusCare empowers teams to... ...The Utilization Management Nurse plays a critical role in ensuring... ...location: This is a fully remote role based in the United...Remote work$26.01 - $56.14 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual... ...and effectively adapt to a fast paced changing environment. Position requires... ...2+ years of experience as a Registered Nurse in adult acute care/critical care setting...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$29.1 - $62.32 per hour
...Join Our Utilization Management Team We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ..., and multitasking skills ~ Comfort working in a fast-paced, technology-driven environment Preferred...Remote workFull timeShift workAfternoon shift- ...Job Description The Utilization Review Case Manager is responsible for assessing the... ...collaboratively in a fast-paced, multidisciplinary environment... ...clinical knowledge and nursing expertise to conduct initial... ...Los Angeles, CA, 90048, US (Remote) Overtime Status...Remote workShift workNight shift
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure... ...Office and the ability to multitask in a fast-paced environment. The position operates Monday to Friday...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
$32.01 - $68.55 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual... ...and effectively adapt to a fast paced changing environment. Position requires... ...2+ years of experience as a Registered Nurse in adult acute care/critical care setting...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shift$83k - $99k
...us at: Role and Responsibilities The Utilization Management Nurse collaborates with external entities such... ...and self-directed Enjoys the pace and rhythm of a deadline-oriented environment... ...incentive and a $600 wellness reimbursement Remote work and continuing education...Remote workFull timeWork at officeFlexible hours- ...- from care navigation and management to payment integrity, plan... ...About This Opportunity: As a Utilization Management Nurse, you’ll oversee and manage... ...Ability to work in a fast-paced, detailed, deadline-driven... ...You’ll Work: This is a fully remote position, and we’ll provide...Remote workFull timeImmediate startMonday to FridayFlexible hours
$26.01 - $68.55 per hour
Utilization Management Nurse - Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking... ...while managing a high-volume workload in a fast-paced environment WHAT YOU BRING - REQUIRED Required Qualifications...Remote workHourly payFull timeTemporary workLocal areaWeekday work- CVS Health is seeking a Registered Nurse for Utilization Management on a work-from-home schedule with weekend coverage. You will assess, plan, implement, coordinate, monitor, and evaluate options to facilitate healthcare services and member benefits. Responsibilities include...Remote jobWork from home
- CVS Health seeks a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations through clinical review, care coordination, and evidence-based decision-making. This remote role requires an active RN license, NICU nursing experience, and familiarity...Remote jobWork from home
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate...Remote jobFull timeWork from home
- ...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
- ...Utilization Management – Care Management Shift options: 8:00–16:30 PST or 9:00–17:30 PST. Every third weekend rotation required. Must commit... ...Eve, New Year's Day. Assignment Details This is a 100% remote position. Requirements ~3 years of acute medical...Remote workShift workWeekend work
$70k - $75k
...analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build... ...Job Description The Utilization Management Registered Nurseis responsible... ...education consistent with current nursing practice standards and the...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$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$29.1 - $62.32 per hour
...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: Monday, Tuesday, Thursday, Friday and Saturday...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- UnitedHealth Group is seeking a Utilization Management Nurse to ensure efficient and effective health services delivery across care settings. You... ...decisions to help members live healthier lives. This role offers remote work with time-zone requirements in Pacific or Mountain...Remote job
- UnitedHealth Group's Optum is seeking a Utilization Management Nurse to review patient records and craft defensible appeal letters in accordance with OPAS guidelines. This role supports 40 hours per week, Monday-Friday, with telecommuting flexibility across the U.S. and...Remote jobMonday to Friday
$58.66k - $142.45k
...Utilization Management Clinical Reviewer Mass General Brigham Health Plan is an exciting place... ...Education ~ Associate's Degree Nursing required or Bachelor's Degree Nursing... ...Approximately 6 months after hire. This is a remote role with occasional onsite team...Remote workWork at officeFlexible hours- UnitedHealth Group is seeking a remote Utilization Management Nurse located in the Pacific or Mountain Time Zones. The role focuses on prior authorization review across skilled facilities and rehabilitation settings, ensuring efficient, appropriate care decisions. Requires...Remote job
- ...Utilization Management Specialist Shift: Monday through Friday 8:00 AM to 4:30 PM, with every fifth... ...~ Must be computer literate and have remote working experience. Compliance... ...City Fort Myers State FL TLC Nursing Associates, Inc. is an equal-opportunity...Remote workContract workWork experience placementLocal areaMonday to FridayShift workWeekend work
$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 jobWeekend work- Harris Health System, Inc. is seeking a Utilization Management Review Nurse to evaluate medical necessity, appropriateness, and efficiency of services, ensuring care aligns with evidence-based guidelines. The role involves partnering with Care Management, Physician Advisors...Remote jobFlexible hours
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and compliance. You will support OPAS and enterprise goals while collaborating across teams to deliver high-quality reviews. Requirements...Remote jobWork at officeFlexible hours
- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications...Remote jobWork at office
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