Utilization Management Nurse
Santa Barbara Cottage Hospital
Santa Barbara Cottage Hospital is seeking an experienced Utilization Management Nurse Consultant for a remote role with the Spine Team. You will review spine-related authorizations, apply criteria, and collaborate with providers and Medical Directors to ensure medically necessary care.
The position requires an active RN license, 3–5+ years of nursing experience, and strong analytic, communication, and documentation skills.
#J-18808-LjbffrVacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Utilization Management Nurse in United States vacancy
$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...SuggestedWeekly payDaily paidOngoing contractContract workTemporary workLocal areaFlexible hoursShift workHealth Force
Franklin, NH2 days ago$60.2k - $107.4k
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Broomall, PA5 days ago- ...Hospital Utilization Management (UM) NurseHow would you like to work in a place where your contributions and ideas are valued? A place where you... ...Summary:As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the clinical floor and administrative...SuggestedImmediate startRemote workShift work
WellStar Health System
Augusta, GA2 days ago - ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient utilization reviews while supporting...SuggestedRemote work
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United States5 days ago $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...SuggestedBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from homeGuidehealth
United States5 days ago- ...& development Vision insurance Location: Outpatient Case Management West Los Angeles VAMC, 11301 Wilshire Blvd, Los Angeles,... ...Angeles VA Medical Center. Job Summary: We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse, you...Work at officeRelocation packageFlexible hours
Presidential Staffing Solutions, LLC
Los Angeles, CA2 days ago - ...Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC1 day ago - ...ChenMed LLC is seeking a Physician Reviewer to lead Utilization Management (UM) cases across multiple markets. The role includes coordinating with health plans and local teams, attending daily calls, and guiding other physician reviewers in a growing delegated UM program...Local area
ChenMed
New York, NY2 days ago - ...UnitedHealth Group is seeking a Utilization Management Nurse to ensure efficient and effective health services delivery across care settings. You will assess member needs, determine medical appropriateness, and support clinical decisions to help members live healthier...Remote work
University of Minnesota School of Nursing
Brooklyn, NY4 days 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$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 workUnitedHealthcare At Home
Boston, MA3 days ago- ...qualified health services professional with nursing or behavioral health experience to coordinate care and ensure appropriate utilization for members. The role requires an active... ...credential and may involve case management across inpatient, residential, and outpatient...
PacificSource
Kansas City, MO3 days ago - ...Community Health Plan of Washington is seeking a Level I Utilization Management Clinician to perform utilization review for medical or behavioral health requests, coordinating with care teams to ensure timely access to appropriate services. The role requires an RN or...Local area
Community Health Plan of Washington
Seattle, WA2 days 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- ...Clinical Resource Management AssociateLocation Detail: 1290 Silas Deane Hwy Wethrsfld (101... ...on providing support and coordination of utilization management services for the utilization... ...Provides the Clinical Resource Management Nurse with support for denials, appeals, and...Work experience placementWork at officeRemote workMonday to FridayShift work
Hartford Healthcare
Wethersfield, CT1 day 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 - ...Utilization Management Clinical ReviewerMass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member... ...phone system.QualificationsEducationAssociate's Degree Nursing required or Bachelor's Degree Nursing preferredLicenses and...Work at officeRemote workFlexible hours
IntelyCare
Somerville, MA5 days ago - ...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...Work at officeRemote work
Brighton Health Plan Solutions
New York, NY1 day ago $80k - $95k
...care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations... ...healthcare system. Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-...Remote workINTUS INC
United States4 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- ...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 - ...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 - A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote work
The Judge Group, LLC
New York, NY1 day 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 - ...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 $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- ...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 - ...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, MI12 hours ago - ...SUMMARY: Responsible for clinical review of utilization requests and assessment and... ...active team member of the Utilization Management Team. KEY RESPONSIBILITIES: Performs utilization... ...: Graduation from accredited School of Nursing. Current, active, unrestrictive license...
CommUnityCare
Brooklyn, NY3 days ago
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