Utilization Management Nurse
MaziCTools
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 and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating with providers, and ensuring quality healthcare delivery.
The ideal candidate should have proficiency in Microsoft Office and the ability to multitask in a fast-paced environment. The position operates Monday to Friday from 8 am to 5 pm CST, with potential weekend and holiday rotations.
#J-18808-LjbffrVacancy posted 15 hours ago
Similar jobs that could be interesting for youBased on the Utilization Management Nurse in United States vacancy
- ...additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals. JOB PURPOSE The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various...SuggestedContract workTemporary workWork at officeImmediate startFlexible hoursNight shift
HealthOne Alliance
Dalton, GA2 days ago - ...the state of South Carolina. Conducts utilization reviews to determine if patients are receiving... ...as needed.Bachelor's degree in Nursing from an accredited school of nursing and... ...experience preferred. One year of case management and/or utilization management work experience...SuggestedWork experience placementShift work
Medical University of South Carolina
Murrells Inlet, SC4 days ago - ...Optum is seeking an experienced Utilization Review Nurse (RN) to support inpatient care management in a remote-capable role. You will review admissions and preauthorizations using evidence-based criteria and collaborate with Medical Directors. The position requires an...SuggestedRemote work
Palo Verde Community College District
Sacramento, CA15 hours ago - ...Northwestern Medicine is seeking a Utilization Management RN located in Winfield, Illinois. The position involves reviewing patient clinical... ...healthcare providers, and managing denials. A Bachelor's degree in Nursing and RN licensure are required with preference for those...SuggestedRelocation package
Northwestern Medicine
Winfield, IL15 hours ago $80k - $95k
...Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated...SuggestedRemote workIntus Care
United States2 days ago- ...Utilization Management Registered NurseAt Duly Health and Care, you are supported to do your best work and make a meaningful impact every day.... ...every patient we serve.The Utilization Management Registered Nurse is responsible for conducting utilization management reviews...Shift work
Duly Health and Care
Downers Grove, IL3 days ago - ...Texas Children’s Hospital is seeking a Utilization Management Clinical Registered Nurse to support precertification of inpatient hospitalizations and outpatient procedures requiring authorization. You will perform telephonic and concurrent review of hospital stays and...
Texas Children's Hospital
Bellaire, TX1 day ago - ...coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective... ...Education & Experience: Three (3) years of critical care nursing experience, or Five (5) years of medical-surgical nursing...
UF Health Central Florida
The Villages, FL1 day ago $29 - $52 per hour
...Requisition number:** 2379019 **Job category:** Nursing Optum is a global organization that... .... Connecting. Growing together.** The Utilization Review Nurse, RN is responsible for... ...efficient and effective Inpatient utilization management. Reviews inpatient criteria for acute...Hourly payMinimum wageFull timeWork experience placementLocal areaRemote workMonday to FridayShift workUnitedHealth Group
Sacramento, CA1 day ago$35.5 - $53.25 per hour
...Department 11229 Carolinas Medical Center - Care Management Status Part time Benefits Eligible No Hours Per Week 0 Schedule... ...for staffing needs. Pay Range $35.50 - $53.25 Utilization Management Registered Nurse PRN Our CommitmenttoYou Advocate Health offers a comprehensive...Daily paidFull timeTemporary workPart timeReliefFlexible hoursShift workAtrium Health
Charlotte, NC3 hours ago$2,274 - $2,302 per week
...Overview Registered Nurse, Utilization Management. This travel assignment is in Franklin, New Hampshire, United States. Start date: 09/01/2026. Duration: approximately 11 weeks. Weekly pay: $2,274–$2,302 per week. Guaranteed hours: 40 per week. Shift: 5x8 days with hours...Weekly payDaily paidOngoing contractContract workTemporary workLocal areaFlexible hoursShift workHealth Force
Franklin, NH2 days ago$70k - $75k
...Utilization Management Registered Nurse (RN) - RemoteThe 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 established...Bi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from homeGuidehealth
Gary, IN15 hours ago$72.8k - $130k
...Sr Utilization Management NurseOptum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...work based on business needs.As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring...Minimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workGenoa Telepsychiatry
Boston, MA15 hours ago- ...pay range $45.00/yr - $52.00/yr Delivery Manager - Healthcare, Client Relationship Manager, VMS/MSPHiring Locums & Physicians/Nurses/Allied/Professional Coder Across with Best... .... Poor Computer Skills Summary : The Utilization Management team reviews the inpatient stays...Contract workTemporary workLocumWork at officeHome officeShift work
Pacer Staffing
Rancho Cordova, CA2 days ago $30.37 - $59.21 per hour
...multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required... ...combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of...Hourly payWork experience placementWork at officeMolina Healthcare
Lemon Grove, CA2 days ago- ...UnitedHealth Group is seeking a Utilization Management Nurse to help ensure high-quality, cost-efficient care across the continuum. You will assess member needs, interpret medical guidelines, and determine appropriate levels of care in collaboration with care teams. This...Remote work
Texas Health Institute
Sacramento, CA4 days ago - ...Utilization Management Nurse - Prior AuthorizationBHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews on prior authorization requests in accordance with national standards...Contract workWork at officeRemote work
Brighton Health Plan Solutions
Chapel Hill, NC2 days ago - ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
SHR (Spectrum Healthcare Resources)
Honolulu, HI15 hours ago - ...industry. Join us! We Are Currently Seeking An Experienced UTILIZATION MANAGEMENT RN Job Summary Day-to-day management of Utilization Management... ...Department meetings Job Requirements Licensed Registered Nurse credentialed from an accredited school/college with 3–5 years...Work at officeRemote work
LibertyHealth System
Wilmington, NC3 hours ago - ...Spectrum Healthcare Resources is seeking a Registered Nurse for Utilization Management at Lackland AFB in San Antonio, TX. This contract position offers a Monday-Friday schedule from 7:30am to 4:30pm in an outpatient clinic with no nights, weekends, or on-call requirements...Contract workMonday to FridayWeekend work
Spectrum Healthcare Resources
San Antonio, TX2 days ago $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, documentation and communication of medical services and benefit administration determinations. You will report to the...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome officeHumana
Jackson, MS3 days ago- ...Utilization Management Registered Nurse (UM RN)We are seeking an experienced and detail-oriented Utilization Management Registered Nurse (UM RN) to join our hospital team. The UM RN is responsible for reviewing patient cases to ensure appropriate utilization of healthcare...
Central Business Solutions
Milford, NH2 days ago - ...Humana Inc. is seeking a Part C Grievance & Appeals Nurse (Utilization Management Nurse 2) to support case preparation, evidence review, and collaboration with multidisciplinary teams. Remote position in Hawaii requiring RN with compact license, 3+ years of clinical experience...Remote work
Humana
Honolulu, HI3 days ago - ...Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments to...Remote workWork from home
Humana
Frankfort, KY3 days ago - ...General Brigham Health Plan Holding Company, Inc. is seeking a UM Nurse to support network adequacy review and prior authorization for... ...in Somerville, MA. Requires MA RN license and 2–3 years of utilization review experience. You will review authorization requests, determine...Remote work
Mass General Brigham Health Plan Holding Company, Inc.
Somerville, MA1 day ago - ...A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive...
HealthCare Support
Troy, MI15 hours ago $26.01 - $68.55 per hour
...time. Fully remote with requirement to work the following schedule: Monday-Friday 8:00am-4:30pm EST. Position Summary As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/...Hourly payFull timeTemporary workWork at officeLocal areaRemote workMonday to FridayWeekend workCVS Health
Lincoln, NE3 days ago- ...Utilization Management ProgramsUnder broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide... ...resources. Performs highly responsible professional nursing and administrative work in accordance with established standards...
Franciscan Missionaries of Our Lady Health System
Jackson, MS2 days ago $38.82 - $47.44 per hour
...true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating... ...using clinical skills, principles of managed care, nationally recognized medical necessity... ...Massachusetts license: Registered Nurse, LICSW, LMHC, BCBA 3-5 years of clinical...Hourly payFull timeShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA4 days ago$29 - $52 per hour
...Utilization Management NurseFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to... ...health care services are delivered. As a Utilization Management Nurse at UnitedHealth Group, you will make sure our health...Hourly payMinimum wageFull timeWork experience placementLocal areaRemote workIntelyCare
Sacramento, CA4 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Management Nurse. Be the first to apply!
Related searches
- internship event management company United States
- materials management associate United States
- entry level emergency management United States
- sbm management services United States
- pest management United States
- identity management United States
- threat and vulnerability management engineer United States
- director of inventory management United States
- managing broker United States
- management fast track program United States