Average salary: $72,771 /yearly
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$72.8k - $130k
...collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting proper...SuggestedMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workOptum
Boston, MA12 hours 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
Appworks
United States4 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 States4 days ago$143.1k - $165.05k
...Utilization Management Nurse Burlingame, CA 94010 Overview Salary Range $143,098.80 - $165,048.00 Salary Description Summary Of Position: The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and...SuggestedWork at officeRemote workNorth East Medical Services
Burlingame, CA3 days 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...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome officeHumana
Concord, NH1 day ago- ...Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization... ...Your knowledge and experience: ~ Associate Degree in Nursing required ~ Bachelor of Science in Nursing or advanced...SuggestedFull timeContract workPart timeWork at officeLocal areaWork from homeHome officeWeekend workAfternoon shift2 days per week
Blue Shield Of California
Woodland Hills, CA1 day ago $71.1k - $97.8k
...About This Role The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations. This role is ideal for experienced nurses who can work independently...SuggestedFull timeTemporary workRemote workMonday to FridayIntelliResume
Louisiana, MO3 days ago- ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while...SuggestedContract workWork at officeRemote work
Brighton Health Plan Solutions
Chapel Hill, NC1 day ago $58.66k - $142.45k
...opportunities, and much more. The UMCM will utilize clinical knowledge to analyze, assess,... ...(outpatient review) experience in a managed care setting with commercial health plan... ...Education: ~ Associate's Degree Nursing required or Bachelor's Degree Nursing preferred...SuggestedWork at officeRemote workFlexible hoursShift workMass General Brigham
Somerville, MA2 days ago- ...Full Time 40 hours/week remote Summary: The Utilization Management Nurse is responsible for conducting medical necessity review to assure appropriate use of hospital resources and serving as a resource to the hospital staff on utilization management...SuggestedFull timeRemote work
Akron Children's Hospital
Akron, OH2 days ago - ...Akron Children’s Hospital is seeking a Utilization Management Nurse to perform medical necessity reviews and ensure proper use of hospital resources. The role supports staff with utilization practices and collaborates across teams to authorize patient days and discharge...SuggestedRemote work
Akron Children's Hospital
Akron, OH2 days ago - ...Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization Management and collaborate with...SuggestedRemote work
Humana
United States1 day ago $29.1 - $62.32 per hour
...of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your...SuggestedHourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeAfternoon shiftCVS Health
United States1 day ago$60k
...LPN/LVN Utilization Management Nurse Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our...SuggestedTemporary workLocal areaRemote workIntegra Partners
United States3 days ago$68.89k - $92.14k
...Pay Plan Title: Utilization Management Nurse Working Title: Utilization Management Nurse – Physical Health FLSA Status: Exempt Posting Salary Range: $68,890 - $92,138 Office Location: Remote within North Carolina. POSTING DETAILS: Make an Impact...SuggestedFull timeWork at officeLocal areaImmediate startRemote workWork from homeFlexible hours$32.01 - $68.55 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team where your clinical expertise helps ensure members receive the right care at the right...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shiftCVS Health
Annapolis, MD1 day ago- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...Remote workWork from home
Santa Barbara Cottage Hospital
United States3 days ago - ...industry, and in people's lives. Work Shift Day (United States of America) Job Summary: As an on-site Hospital Utilization Management (UM) Nurse, you are the primary link between the clinical floor and administrative compliance. Unlike remote roles, this position...Immediate startRemote workShift work
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization ManagementRemote | Work from Home | Eastern Time Zone PreferredAre you an experienced RN looking to leverage... ...expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive the right care at the...Hourly payFull timeTemporary workRemote workWork from homeAfternoon shiftOak St. Health
Columbus, OH1 day ago$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | Central Time Zone Preferred Are you an experienced Registered Nurse looking to expand...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeAfternoon shiftCVS Health
Topeka, KS1 day ago$32.01 - $68.55 per hour
...simplify health care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule - 4x10's- Thursday, Saturday, Sunday...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeAfternoon shiftCVS Health
Springfield, IL4 days ago- UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases. The position offers a 40-hour...Remote jobMonday to Friday
- 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
- Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role requires an RN license, 3+ years bedside experience, and strong data extraction skills. You will work per diem with flexible start times and may telecommute...Remote jobDaily paidWork at officeFlexible hours
- The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization management functions to promote appropriate patient care, support regulatory and payer requirements, and ensure effective utilization of healthcare resources...Full timeRemote workWork from homeShift work
$60.2k - $107.4k
Optum is a global health services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company...Remote jobFull timeMonday to Friday- ...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 job
- nirvanaHealth is seeking a part-time Utilization Management (UM) Nurse to join our remote team. The UM Nurse will perform prospective, concurrent, and retrospective medical necessity reviews, determine level of care, and participate in initial clinical review to ensure...Remote jobPart timeWeekend workAfternoon shift
- ...pay range $45.00/yr - $52.00/yr Delivery Manager - Healthcare, Client Relationship Manager, VMS/MSPHiring Locums & Physicians/Nurses/Allied/Professional Coder Across with... ...explanation. Poor Computer Skills Summary : The Utilization Management team reviews the inpatient...Contract workTemporary workLocumWork at officeHome officeShift work
$83k - $99k
...balance, and the ability to contribute to something important, find out more about us at: Role and Responsibilities The Utilization Management Nurse collaborates with external entities such as Brokers, Group Contacts, and Stop Loss supports to provide updated...Full timeWork at officeRemote workFlexible hours
