Remote Utilization Management Nurse — Health Care Innovator
ISHE
- Remote job
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 compact RN license, 3+ years in Managed Care or clinical settings, and prior Utilization Management experience. Strong computer skills and experience with major EMRs are preferred. #J-18808-Ljbffr ISHE
$29.1 - $62.32 per hour
...re building a world of health around every individual... ...passionate colleagues who care deeply, innovate with purpose, hold... ...community at a time. Utilization Management is a 24/7 operation and... ...and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule: Monday...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$26.01 - $56.14 per hour
...Utilization Management Position We're building a world of health around every individual — shaping a more connected, convenient... ...by passionate colleagues who care deeply, innovate with purpose, hold ourselves... ...experience as a Registered Nurse in adult acute care/critical...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift- UnitedHealth Group is hiring a Utilization Management Nurse for a remote role open to those in Pacific or Mountain Time zones. You will assess member needs... ...include a compact RN license and 3+ years in managed care or clinical settings. Strong MS Office skills and EMR...Remote jobFlexible hours
- UnitedHealth Group's OptumCare seeks a Utilization Management Nurse to oversee utilization management,... ...inpatient rehab, and long-term acute care. The role emphasizes autonomy in a fast... ..., production-driven environment. This remote position requires a Compact RN license...Remote job
$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 health... ...ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and...Remote workFull timeShift workAfternoon shift$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse... ...outpatient services, Quality of care concerns. Interfacing... ...or population health programs to support continuity... .... With Collaborative Innovation, we solve problems...Remote jobBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$26.01 - $68.55 per hour
...We're building a world of health around every individual -... ...colleagues who care deeply, innovate with purpose, hold ourselves... ...community at a time. Fully remote with requirement to work... ...EST. Position Summary As a Utilization Management Nurse Consultant, you will utilize...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayWeekend work- Vŏlenz® Health is the platform to simplify... ...mindset and culture of innovation combine to create... ...journey - from care navigation and management to payment integrity... ...Opportunity: As a Utilization Management Nurse, you’ll oversee... ...: This is a fully remote position, and we’ll...Remote workFull timeImmediate startMonday to FridayFlexible hours
- CVS Health Corporation is seeking a Utilization Management Nurse Consultant for a fully remote, 100% work-from-home role in the CST zone. The position supports utilization and benefit management with a 40-hour work week, Monday-Friday, and occasional after-hours coverage...Remote jobWork from homeMonday to Friday
- 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... ...information, communicating with providers, and coordinating care. Requires active RN licensure, 3+ years RN...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
$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 workWeekend work- 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... ..., ensuring timely, safe, and appropriate care for members. In this role you will review medical...Remote jobFull timeWork from home
- ...Role BHPS provides Utilization Management services to its clients... ...Management Nurse performs medical necessity... ...coverage while working remotely. Primary Responsibilities... ...of services and care. • Provides referrals... ...including Behavioral Health, DME, Genetic Testing,...Remote workContract workWork at office
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management... ...while supporting transitions of care and ensuring patients receive... ...(LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy...Remote work
- ...seeks a Medical Director of Clinical AI Innovation and Performance. This senior physician... ..., testing, and surveillance for utilization management criteria, leveraging InterQual and custom... ...decision support to ensure safe, effective care at scale. The role reports to UCS and...Remote job
$71.1k - $97.8k
...Become a part of our caring community The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing... ...holiday rotation. This is a remote position. This role is... ...serve to achieve their best health - delivering the care and service...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work- ...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
$80k - $95k
...Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically... ...Programs of All-Inclusive Care for the Elderly (PACE)... ...adjustment, population health, and utilization management... ...location: This is a fully remote role based in the United States...Remote work- 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
- 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... ...live healthier lives. This role offers remote work with time-zone requirements in Pacific...Remote job
- Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters according to process instructions. You will extract pertinent details, reference clinical guidelines, and ensure compliance with HIPAA and policies. Position...Remote job
- Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective care for plan participants. You will review prospective,... ...other regulators. This fully remote role requires a US-based location...Remote job
$42 per hour
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... ...care settings. The position is fully remote within the United States and offers a 1-...Remote jobHourly payContract work- Harris Health is seeking a Utilization Management Review Nurse to assess medical service necessity and optimize care across a large network in Texas. The role partners with Care Management, physician advisors, and payers to ensure appropriate care levels and cost-efficient...Remote jobFlexible hours
- System One is seeking an Utilization Management Specialist (RN) for a contract-... ...Baltimore, MD. The position is remote-offsite with... ...necessity and coordinating care. You will analyze clinical information... ...across medical and behavioral health services. #J-18808-Ljbffr System...Remote jobContract work
- Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical... ...independent decisions aligned with organizational strategy. Remote-friendly, standard hours, with occasional travel. #J-1880...Remote job
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret... ...Skilled Nursing Facility (SNF), Home Health, and Durable Medical Equipment... ...Experience working in a fully remote, metrics-focused role...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and compliance... ...include an RN license, 3+ years bedside nursing in acute care, and proficiency with Microsoft Office plus 45 wpm typing....Remote jobWork at officeFlexible hours
- 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
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