Utilization Management RN

1 week ago Be among the first 25 applicants This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $39.00/hr - $40.00/hr Direct message the job poster from The Judge Group Lead Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the following states: IL, TX, NM, OK, MT, TN Schedule: Monday–Friday, 8:00 AM–5:00 PM EST or CST. No nights or weekends required! Compensation: $40/hour Summary: We are seeking a Utilization Management RN to join our team on a remote, contract basis. This role is ideal for a nurse with recent experience in health plan operations and utilization review. You will be responsible for evaluating healthcare services, coordinating care, and ensuring members receive high-quality, cost-effective treatment. Responsibilities Perform delegated tasks within the Nurse Case Management job family Collaborate with physicians to plan, implement, and evaluate healthcare services Use clinical expertise to assess, coordinate, and monitor care options for optimal outcomes Conduct utilization reviews (prospective, concurrent, retrospective) for inpatient, outpatient, and rehabilitation services Provide health education and clinical assessments to members Independently manage caseloads and coordinate assigned cases Resolve escalated issues and support junior team members Evaluate alternative care services to ensure program goals and cost-effective care Maintain compliance with clinical guidelines and regulatory standards Qualifications Active, unrestricted RN license in the U.S. Minimum 2 years of Utilization Management RN experience, including Prior Authorization and Concurrent Review Experience working for a health plan (payer) within the last 3 years Proficiency with Milliman Care Guidelines (MCG) or InterQual Criteria Strong computer literacy and comfort with digital tools Ready to make a meaningful impact—without sacrificing work-life balance? If you're a passionate RN with a sharp eye for clinical detail and a heart for patient advocacy, we’d love to hear from you. This is your chance to bring your expertise to a dynamic team, work remotely, and help shape better healthcare outcomes across the country. Apply now and let’s do great work together! By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Seniority level Seniority level Mid-Senior level Employment type Employment type Contract Job function Job function Health Care Provider Industries Business Consulting and Services Referrals increase your chances of interviewing at The Judge Group by 2x Get notified about new Registered Nurse jobs in Chicago, IL . Streeterville, IL $76,960.00-$126,984.00 2 days ago Chicago, IL $25,000.00-$200,000.00 3 weeks ago Registered Nurse - RN / Step Down Unit - TELE-P Downers Grove, IL $76,207.00-$117,662.00 3 months ago IQVIA - Per Diem - RN Clinical Nurse Educator - Chicago Chicago, IL Clinical Educator - Registered Nurse Chicago, IL $120,000.00-$150,000.00 1 month ago Chicago, IL $146,730.00-$204,532.00 2 days ago Greater Chicago Area $75,000.00-$95,000.00 2 weeks ago Orland Park, IL $2,300.00-$11,500.00 2 weeks ago Arlington Heights, IL $79,885.00-$99,856.00 1 week ago Chicago, IL $75,000.00-$95,000.00 2 weeks ago Psychiatric Mental Health Nurse Practitioner Chicago, IL $130,000.00-$200,000.00 2 days ago Palliative Oncology Nurse Navigator (8:30AM - 5PM EST Shift) East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago East Chicago, IN $1,800.00-$9,000.00 5 days ago Chicago, IL $110,000.00-$125,000.00 1 month ago Psychiatric Mental Health Nurse Practitioner (PMHNP) Psychiatric Mental Health Nurse Practitioner (PMHNP) Psychiatric Mental Health Nurse Practitioner (PMHNP) We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr