RN Remote Utilization Management Supervisor
TriWest Healthcare Alliance
- Remote job
TriWest Healthcare Alliance is seeking a Nurse Manager for Utilization Management to supervise daily UM operations under the TRICARE contract. You will coordinate across teams to meet contractual metrics, ensure standardized clinical care, and supervise staff performance and reporting. Requirements include RN license, 3+ years in healthcare, and 3+ years supervisory leadership with UR/case management. Remote work options with occasional travel and DoD background eligibility are included. #J-18808-Ljbffr TriWest Healthcare Alliance
- Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote jobFlexible hours
$75.3k - $135.4k
...professional on our Medical Management/Health Services team. Centene... ...Supervises day-to-day activities of utilization management team. Monitors... .... License/Certification RN - Registered Nurse - State Licensure... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours$77.96k - $120.37k
...Utilization Review Supervisor RN The Utilization Review Supervisor RN is responsible for directing the operations of their designated... ...human resources, customer service, and limited sales management. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift- ...Managing the daily operations of the Utilization Management Coordinator team, the full-time remote Utilization Management Supervisor will ensure timely processing of prior authorization requests, provide staff coaching, and maintain compliance with regulatory requirements...Remote workFull time
$85k - $95k
...RN SupervisorCohere's Service Operations team... ...the platform. The RN Supervisor, Clinical Operations position... ...to the Director/Manager of Clinical Operations... ...guidelinesPrior Authorization or Utilization Management... ...supervising and training in a remote work environment.Pay &...Remote workHourly payFlexible hours- TriWest Healthcare Alliance seeks a Nurse to supervise daily Utilization Management operations under the TRICARE contract. You will coordinate across teams to meet contractual metrics and ensure quality, efficient care delivery. The role builds staff capability and supports...Remote jobContract work
$53.46 - $79.52 per hour
...RN Supervisor Um Prior Auth Inspired by faith. Driven by innovation. Powered by humankindness... ...by law. As our Supervisor of Utilization Management (UM), under the guidance and... ...for high-quality patient care. As a remote employee, we will provide you with the...Remote workWork at office- ...classified as hybrid, onsite or remote. While the majority of our... .... PURPOSE OF THE JOB The Utilization Review Supervisor coordinates the activities... ...as a Registered Nurse (RN) Required Certifications... ...Work Experience 1 year of managed care/health plan experience...Remote workFull timeWork experience placement2 days per week1 day per week
- Blue Cross Blue Shield of Arizona is seeking a Utilization Review Supervisor in Phoenix, AZ. This hybrid role requires coordination of medical necessity... ...must have 2 years of clinical experience and an active RN license in Arizona. The position entails evaluating department...
- Cambia Health Solutions is seeking a Supervisor Utilization Management to lead a team dedicated to improving health care delivery. This hybrid role requires leadership skills and clinical expertise to ensure quality care through effective utilization management programs...
- ...RN Supervisor, Utilization Management Responsible for supervising/ coaching/ mentoring STAR/ CHIP/ or STAR Kids workgroups (Pods) comprised of UM/ECM RN and support staff to achieve department goals and objectives. Acts as process owner and subject matter expert for...Work at office
$102.18k
...income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of the UM department, and monitoring the Care Management...Full time- ...communities in Minnesota and surrounding states. This role leads the Utilization Management team, supervising clinical staff, managing performance, and... ...compliance with Medicare/Medicaid regulations. The Supervisor collaborates with managers and vendor partners to...Work at office3 days per week
- ## RN - Supervisor, Utilization MgmtApplylocations: Fort Worth, TXtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR-118390... ...Additional Information:**The **RN Supervisor, Utilization Management** is responsible for supervising/ coaching/ mentoring...Shift workDay shift
- L.A. Care Health Plan seeks a Supervisor of Utilization Management, RN, to oversee daily UM operations and staff performance. You will ensure staffing adequacy, monitor compliance with policies, and drive process improvements across the CM/UM teams in a large public health...
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include...Remote jobWork from home
- Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews,... ...with providers and members. The role is remote/work-from-home with weekend shifts and... ...few times annually; requires Kentucky RN license, 2+ years clinical experience,...Remote jobWork at officeWork from homeShift work
- Cincinnati Children's is seeking a Remote Utilization Management leader (RN) to guide the MU team, coordinate with Health Partners, Care Managers and Discharge Planners, and ensure compliance with federal, state and payor requirements. The role requires a BSN, 5+ years...Remote job
$75.3k - $135.4k
Centene Corporation is seeking a Clinical Supervisor to oversee the utilization management team ensuring appropriate care for members. The ideal candidate will... ...experience in a related field, along with an active RN license in California. This position offers a salary range...Remote job- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
$44.34 - $66.51 per hour
...Description: The acute care supervisor will perform responsibilities... ...nurse leadership. Assess, direct, manage and evaluate the delivery of... ...Minimum of 2 years previous RN experience Be a part of a... ...month FTE: 1 Possible Remote/Hybrid Option: Shift Rotation...Remote workLocal areaWork from homeFlexible hoursShift workWeekend work- 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
- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract... ...using evidence-based literature and coding guidelines. This remote role supports telecommuting from anywhere in the U.S. with...Remote jobFlexible hours
$52.26 - $81.13 per hour
...day-to-day clinical and administrative operations of the care management team. Supervises Care Management (CM) staff to include nursing,... ...Swedish Metropolitan Park East-Seattle Workplace Type: Remote Pay Range: $52.26 - $81.13 The amounts listed are the...Remote workMinimum wageFull timeLocal areaShift work- ...to help millions of people live healthier lives. The Utilization Management and Clinical Validation RN will review patient medical records, extract pertinent... ...process instructions and guidelines. This role is remote from anywhere in the U.S. with an unrestricted RN license...Remote job
- ...Inc. seeks a Registered Nurse to coordinate and manage utilization management for behavioral health services across remote settings in the US. The role emphasizes medical... ...planning, and care coordination. The position requires RN license, 2+ years acute clinical experience, and...Remote job
- ...seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior... ...care programs. Required are an active CA RN license and at least five years in patient... ...substitute for experience. Hybrid work and remote- interview options are offered. #J-188...Remote jobTemporary work
- Molina Healthcare seeks an experienced RN to support Arizona Plan clinical member services... ...active AZ RN license and experience with utilization management, prior authorization, and both inpatient and outpatient settings. Remote position, must reside in Arizona, with...Remote job
- Elevance Health is seeking a Wound Care Utilization Management RN for a virtual, full-time role. The position focuses on pre-certification and authorization for Home Health wound care services and coordinating care across providers. Hybrid work is available with some in...Remote jobFull time
- CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within...Remote jobFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Remote Utilization Management Supervisor. Be the first to apply!

