Remote Utilization Management RN
Guidehealth
Gary, IN
- Remote job
Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments, and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings, and are proficient with Microsoft 365. #J-18808-Ljbffr Guidehealth
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN in Gary, IN vacancy
- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: Full-Time Position Overview We are seeking an experienced Utilization...Remote workFull timeMonday to Friday
- ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
- ...Plan in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity,... ...discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual...Remote workFull time
$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
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% remote role available to CST Zone residents in the United States. You will... ...federal requirements. Requirements include an active RN license and 2+ years of acute hospital experience....Remote workFull time
- ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated manager, the Utilization Management RN performs telephonic review of hospital admissions and recommends alternative levels of care when appropriate. This role...Remote workPart timeMonday to Friday
$26 - $28 per hour
...are adhered to at all times. Qualifications MUST HAVE Utilization Management experience MUST BE a Registered Nurse Need at least 2-... ...Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated...Remote workContract workTemporary workWork from home- ...Overview This remote position in Utilization Management requires a Registered Nurse with 2 years of experience. Responsibilities include working with providers, managing reviews, and utilizing EMR systems. The role follows a Monday through Friday schedule with...Remote workWeekly payMonday to FridayWeekend work
- ...Utilization Management RN Remote I'm currently working on a Utilization Management RN opportunity with a health plan client, supporting a temporary assignment during their Epic Tapestry system implementation and optimization. This is a contract role starting 10/15/...Remote workContract workTemporary workMonday to FridayShift work
- ...Utilization Management RN There's no place like Liberty Health Come explore career opportunities with Liberty Health, a dynamic leader in... ...with all staff levels. Clearly communicates instructions to remote users. Visit for more information. Background checks...Remote workWork at office
- ...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...Remote work
$45 - $50 per hour
...organization in healthcare insurance, is seeking experienced Utilization Management RNs to play a vital role in reviewing prior authorization... ...an excellent opportunity to make an impact within a dynamic, remote environment where your expertise will support improved patient...Remote workContract workWork at office$39.83 - $59.74 per hour
...Utilization Management RN Robbinsdale, MN Posting Date: Sep 18 2026 Apply now ( Back to search Requisition Number: 514508 Why North Memorial... ...: Every Other Weekend Call Requirement: None Remote or On-site: Hybrid Remote- Must live in MN or WI FLSA Status...Remote workFull timeContract workPart timeFor contractorsFor subcontractorLive inWork at officeShift workWeekend work- ...Behavioral Health Utilization Manager Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned patients... ..., MS Excel, Outlook, and telephone systems Work Schedule: Remote Other Requirements: Able to work independently under general...Remote workContract workWork experience placement
- Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho or Utah, conducting prospective, concurrent and retrospective reviews to ensure medical necessity...Remote job
- A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr Healthcare...Remote job
- Humana is seeking an Utilization Management Registered Nurse to interpret and coordinate medical services... ...for post-acute care. You will work remotely, reporting to the Manager of Utilization... .... Requirements include an active RN license in your state and 1+ year of clinical...Remote job
- Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation...Remote job
- Mass General Brigham Health Plan Holding Company, Inc. is seeking an experienced nurse for utilization review in a remote-friendly setting with occasional onsite work in Somerville, MA. The role emphasizes clinical knowledge, medical necessity determinations, and collaboration...Remote jobCasual 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- Centene Corporation is seeking a senior utilization management supervisor to oversee Prior Authorization, Concurrent Review... ...Retrospective Review teams. The role requires RN licensure with CA license consideration, and remote work options are available for candidates...Remote work
- ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...5 pm with one hour for lunch This is an in-office, no remote work capability position Travel ~ Some travel may be...Remote workWork at office
- Guidehealth, a fully remote healthcare company, is seeking a Utilization Management Registered Nurse to perform reviews, apply medical necessity criteria, and document findings in support of determinations. You will collaborate with the Medical Director and peers to ensure...Remote job
- ...is seeking a Registered Nurse to conduct level of care medical necessity reviews within patient records. You will perform utilization management activities to assure compliance with accreditation and regulatory requirements, and support pre‑authorization processes, documentation...Remote job
- QuickCruit, Inc. is seeking a Utilization Management RN to collaborate with the Medical Director and Health Plan Manager. You will drive reductions... ...members to plan resources to meet care conditions. In this remote U.S. role, you will contribute to care management review...Remote job
$2,147 per week
...Travel RN - Case Management/Utilization Review American Traveler Somerville, Massachusetts, United States Position ID: P-762577 Position... ...weekly pay) Description American Traveler is hiring a remote RN for Utilization Management requiring an active MA RN...Remote workWeekly payLocal areaMonday to FridayShift work- ...Hospital Utilization Management (UM) Nurse How would you like to work in a place where your contributions... ...and administrative compliance. Unlike remote roles, this position relies heavily on... ...-site UM Nurse is a Registered Nurse (RN) responsible for performing admission...Remote workImmediate startShift work
- Evry Health is seeking an RN Integrated Care Coordinator (UM) to provide... ...to ensure high-quality care in a remote environment, with rotating weekend utilization review coverage. The candidate... ...should have 1-2 years in utilization management, 3-5 years clinical experience,...Remote job
- OU Health is seeking a Case Manager, RN for Utilization Review on a PRN basis. The role focuses on evaluating medical necessity, coordinating with... ...care while maintaining HIPAA compliance, even in a remote setup. The candidate will work with the Utilization Review...Remote jobRelief
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management RN. Be the first to apply!



