Average salary: $94,139 /yearly

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  • $34 - $55 per hour

     ...for clinical, financial, and resource utilization information. Provides intervention and...  ...records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns...  ...initiatives Participates in nursing unit and department clinical outcome projects... 
    Suggested
    Full time

    Luminis Health

    Annapolis, MD
    6 hours ago
  •  ..., or DE for permanent conversion) Position Type: Contract (6-12+ months) with potential for full-time conversion As a Utilization Management Nurse, you will: Review medical records to determine medical necessity for services Apply clinical guidelines such as InterQual... 
    Suggested
    Remote job
    Hourly pay
    Permanent employment
    Full time
    Contract work

    IntePros

    Trenton, NJ
    4 days ago
  • $23.79 - $38.86 per hour

    Job Summary Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care Management/Coordination...  ...\'s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master\'s of Science in Nursing (MSN) preferred... 
    Suggested
    Temporary work
    Work experience placement
    Relief
    Shift work

    Norman Regional Health System

    Norman, OK
    1 day ago
  • A leading healthcare staffing firm is seeking a Utilization Management Nurse for a fully remote position. The role involves reviewing medical records, applying clinical guidelines, and communicating with providers. Candidates must have an active RN license and at least... 
    Suggested
    Remote job
    Hourly pay
    Full time
    Contract work

    IntePros

    Trenton, NJ
    4 days ago
  • A leading healthcare organization in Florida seeks a Utilization Management Staff RN to oversee the Utilization Management program for inpatient...  ...teams. Candidates should be graduates from an accredited nursing program with a valid RN license and at least five years of... 
    Suggested

    Case Management Society of America (CMSA) ®

    Florida, NY
    1 day ago
  •  ...Clinical Research, Rehabilitation Therapy, and Nursing. Job Description Location: Downers Grove...  ...successful and timely return to work. Manage services, strategies, policies, and...  ...management, clinical coverage, and policies. Utilize clinical skills to coordinate, document,... 
    Suggested
    Work at office
    Weekend work

    Integrated Resources Inc.

    Downers Grove, IL
    2 days ago
  • $72.8k - $130k

     ...to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results...  ...for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring... 
    Suggested
    Minimum wage
    Full time
    Work experience placement
    Casual work
    Live in
    Work at office
    Local area
    Remote work

    Optum

    Boston, MA
    20 hours ago
  • Utility Management Nurses (Insurance Coding & Revenue Management) We are seeking a dedicated Utility Management Nurse specializing in Insurance Coding & Revenue Management in Oklahoma City, OK. Responsibilities Accurately code insurance claims and manage revenue cycles... 
    Suggested
    Full time

    CARIN Alliance

    Oklahoma City, OK
    5 days ago
  • $54.1k - $116.76k

     ...be a 12.5% differential for this shift. Utilizes clinical skills to coordinate, document...  ...all aspects of the utilization/benefit management program for preauthorization for mental...  ...Education If RN, Bachelor's degree in nursing required with emphasis on Behavioral Health... 
    Suggested
    Hourly pay
    Full time
    Temporary work
    Local area
    Work from home
    Flexible hours
    Shift work
    Weekend work

    Hispanic Alliance for Career Enhancement

    Salt Lake City, UT
    1 day 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... 
    Suggested
    Work at office
    Relocation package
    Flexible hours

    Presidential Staffing Solutions, LLC

    Los Angeles, CA
    5 days ago
  • A healthcare organization is seeking a Registered Nurse-Utilization Management to ensure effective nursing practices and quality improvement. The role involves educating internal and external clients on clinical standards, collaborating with interdisciplinary teams, and... 
    Suggested

    Case Management Society of America (CMSA) ®

    Oklahoma City, OK
    4 days ago
  •  ...Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits... 
    Suggested
    Contract work

    Integrated Resources Inc.

    Denver, CO
    2 days ago
  • $100k - $110k

    A leading correctional healthcare provider is seeking a Utilization Management RN to serve as a Regional Office Case Manager. Responsibilities...  ...coordinating patient care plans. Applicants should have a Registered Nurse Licensure and at least one year of experience. This full-... 
    Suggested
    Full time
    Work at office

    VitalCore Health Strategies

    Hopkinton, MA
    4 days ago
  •  ...healthcare organization in Atlanta seeks an experienced registered nurse to oversee acute hospital admissions and ensure appropriate...  ...hold a current RN license in Georgia, with a master's degree and utilization review experience preferred. The role offers a flexible... 
    Suggested
    Flexible hours

    Piedmont Healthcare Inc.

    Atlanta, GA
    4 days ago
  • A leading staffing firm in Miami seeks a Registered Nurse for Utilization Management. The ideal candidate will have at least 3 years of nursing experience in a critical care setting and be skilled in medical necessity reviews and authorization processes. Responsibilities... 
    Suggested

    Integrated Resources Inc.

    Miami, FL
    2 days ago
  • $60.2k - $107.4k

     ...scale. Join us to start Caring. Connecting. Growing together. Utilization Management RN Coder will accurately and efficiently review and extract...  ...while providing high quality reviews. The Appeals nurse will perform their job functions, adhering to both Optum and... 
    Minimum wage
    Full time
    Work experience placement
    Local area
    Remote work

    Optum

    Newtown Square, PA
    1 day ago
  • A health management organization located in Tulsa, Oklahoma, is looking for a clinical reviewer to join their Utilization Management Team. The role involves assessing utilization requests and implementing care coordination for high-risk members. Candidates must have a... 

    CommunityCare HMO, Inc.

    Tulsa, OK
    1 day ago
  • $89.07k - $162.8k

     ...Coordinates negotiates procures and manages care of our members/enrollees to facilitate...  ...Columbia Contract for the population served. Utilizes standards/ guidelines to manage and...  ...Graduate of an accredited School of Nursing required and Bachelor's degree preferred... 
    Full time
    Contract work
    Work at office
    Relocation

    MedStar Health

    Washington DC
    2 days ago
  • $71.61k - $111k

    Overview Department/Unit: Care Management/Social Work Work Shift: Day (United States of America...  ...999.20 Responsibilities Responsible for Utilization Management, Quality Screening and Delay...  ...team. Minimum Qualifications Registered nurse with a New York State current license.... 
    Shift work

    Albany Med Health System

    Albany, NY
    5 days ago
  • $26.01 - $62.32 per hour

     ...through Friday, 9:00am to 5:30pm in the candidate’s time zone. Utilization Management is a 24/7 operation and work schedules will include holidays...  ...hours. Medicare Precertification Utilization Management Nurse Consultant Position Utilizes clinical experience and skills... 
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Monday to Friday
    Flexible hours
    Afternoon shift

    CVS Health

    Austin, TX
    2 days ago
  • $26.01 - $68.55 per hour

    A healthcare organization is seeking a Remote Registered Nurse for Utilization Management. This role requires 3+ years of RN experience and an active license. Responsibilities include assessing healthcare services, coordinating treatments, and working closely with providers... 
    Remote job
    Hourly pay
    Full time

    CVS Health Corporation

    Chicago, IL
    3 days ago
  •  ...IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Location : Downers Grove, IL Responsibilities...  ..., policies and programs are comprised of network management, clinical coverage, and policies. · Utilizes clinical skills to coordinate, document and... 
    Work at office
    Weekend work

    Integrated Resources Inc.

    Downers Grove, IL
    2 days ago
  • A healthcare organization is hiring a Registered Nurse to support Utilization Management. Candidates should have a minimum of 2 years of acute care experience, active RN licensure, and be willing to work flexible hours including weekends. Key responsibilities include coordinating... 
    Flexible hours

    Wisconsin Psychiatric Association Inc

    Madison, WI
    5 days ago
  • A leading healthcare provider in Wisconsin seeks an experienced Registered Nurse for a full-time role in Utilization Management. The position involves assessing and coordinating healthcare services for members, requiring a minimum of 2 years of experience in acute care... 
    Full time

    Wisconsin Psychiatric Association Inc

    Madison, WI
    1 day ago
  • A leading healthcare organization seeks a Registered Nurse for a remote position in Utilization Management. The role involves evaluating healthcare services, collaborating with providers, and requires 3+ years of nursing experience. Candidates should possess an active RN... 
    Remote job
    Full time
    Work at office

    Hispanic Alliance for Career Enhancement

    Oklahoma City, OK
    1 day ago
  • A leading healthcare company is seeking a remote Utilization Management Nurse Consultant to coordinate healthcare services for members. The role requires an active RN license and at least 3 years of acute clinical experience, preferably in medical-surgical and ICU units... 
    Remote job

    Hispanic Alliance for Career Enhancement

    Albuquerque, NM
    1 day ago
  • $66.58k - $142.58k

    Behavioral Health Utilization Management Clinician We’re building a world of health around every individual — shaping a more connected, convenient...  ...independent clinical behavioral health or registered nurse license in the state of residence; accepted licenses include... 
    Hourly pay
    Full time
    Temporary work
    Local area
    Flexible hours

    CVS Health

    Sacramento, CA
    5 days ago
  • $26.01 - $68.55 per hour

     ...healthcare organization based in the United States is seeking a Utilization Manager to work remotely, ideally from the EST or CST regions. The...  ...package, including a 401(k) plan, medical options, and wellness programs. #J-18808-Ljbffr Association of California Nurse Leaders
    Remote job
    Hourly pay
    Work at office

    Association of California Nurse Leaders

    Chicago, IL
    20 hours ago
  • $71.61k - $111k

    A healthcare organization in Albany is seeking a Registered Nurse to manage Utilization and Quality Screening for patients. The ideal candidate will have a Bachelor's degree and a minimum of three years clinical experience, preferably in case management. Responsibilities... 

    Albany Med Health System

    Albany, NY
    5 days ago
  • $26.01 - $62.32 per hour

    A national healthcare provider is seeking a Medicare Precertification Utilization Management Nurse Consultant in Austin, TX. The role requires a Registered Nurse with 3+ years of experience and an active RN license. Responsibilities include assessing and coordinating healthcare... 
    Hourly pay

    CVS Health

    Austin, TX
    2 days ago