Average salary: $72,771 /yearly
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- ...The Peer-to-Peer (P2P) Utilization Review Nurse is an integral member of the MGB Central Utilization Management team, specializing in identifying, preparing, and clinically reviewing cases requiring peer-to-peer engagement with payers. This role focuses on concurrent...SuggestedRemote workWork from home
Mass General Brigham (Enterprise Services)
Somerville, MA4 days ago $40 per hour
...Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through Saturday, 8:00 AM - 5:00 PM PST Compensation: $40 per hour...SuggestedHourly payPermanent employmentTemporary workWork at officeRemote workMorgan Stephens
United States3 days ago$34.98 - $42.85 per hour
...innovation. Job Summary The UM Nurse I - RN performs clinical review of... ...organizational policies. This role conducts utilization review activities under established... ...• At least one (1) year in utilization management or case management preferred. Skills...SuggestedHourly payWork at officeRemote workClever Care Health Plan
Huntington Beach, CA19 hours ago- ...RN - Utilization Management RN - Utilization Management needed at Mountain Home Air Force Base in Mountain Home, Idaho. Duties include,... ..., coordinates with TRICARE Regional Office Clinical Liaison Nurse or reviews TRICARE Operations Manual. Receives and makes...SuggestedFor contractorsWork at officeLocal areaWork from homeMonday to Friday
Vantage Search Group Inc
Mountain Home, ID3 days ago - ...Primary Responsibilities The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations. Essential Functions...SuggestedWork at officeRemote workWeekend work
Regency Group
Austin, TX1 day ago $50.1 - $75.1 per hour
...Registered Nurse - Utilization and Care Transitions Community health is about more than just vaccines and checkups. It's about giving people... ...are Better Together. Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a...SuggestedHourly payLocal areaMonday to FridayNeighborhood Healthcare
Riverside, CA4 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
Nashville, TN7 days ago$74.16 - $107.75 per hour
...Primary Duties and Responsibilities Press space or enter keys to toggle section visibility The Utilization Management (UM) Nurse supports appropriate level-of-care determination, patient flow, and revenue cycle integrity across inpatient, partial...SuggestedHourly payWork at officeRemote workMonday to FridayUCLA Health
Los Angeles, CA4 days ago$27.1 - $40.65 per hour
...Utilization Management Nurse, LVN/LPN (Work from Home) California, United States NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of...SuggestedHourly payFull timeContract workWork at officeRemote workWork from homeNeueHealth
United States1 day ago$50.68 per hour
Job Overview The Utilization Review RN participates as a member of a multidisciplinary team... ...payors. Department Name : Utilization Management Job Status : flex, not eligible for... ...Qualifications Education: Bachelor of Science in Nursing (BSN) Experience: Three years of...SuggestedHourly payLive inRemote workRelocationFlexible hoursShift workWeekend workDay shiftAfternoon shift- A healthcare company is seeking a Utilization Management Registered Nurse in Denver, Colorado. This remote position involves using clinical nursing skills to manage post-acute care services, determine appropriate medical services, and communicate with healthcare providers...SuggestedRemote job
- 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 working...SuggestedContract workWork at officeRemote work
- ...embedded Healthguides™ and a centralized Managed Service Organization to build stronger... ...centered care through precise and timely Utilization Review. In this role, you will apply clinical... ...and growth aligned with Illinois nursing regulations and contemporary clinical practice...SuggestedBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from home
$71.1k - $97.8k
A leading health services organization is seeking a Utilization Management Registered Nurse in Austin, Texas. This remote position involves using clinical nursing skills to evaluate medical services, ensuring members receive appropriate care. The ideal candidate will have...SuggestedRemote job- 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 transitions of care and ensuring patients receive...SuggestedRemote work
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 – $1,800/week (based on experience) Contract Length: 1-year minimum (Current POP ends 11/30/25, TO POP ends 11/30/27) Schedule...Contract workImmediate startRemote workMonday to FridayJ Edward Staffing LLC
Aurora, CO19 hours ago$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers...Hourly payWork at officeRemote workNeueHealth
Encino, CA1 day ago$71.1k - $97.8k
A leading health services company is looking for a Utilization Management Registered Nurse based in Ohio. The role involves using clinical skills to support the coordination and documentation of medical services. Candidates should possess a Compact RN license and at least...Remote job$71.1k - $97.8k
A healthcare company is seeking a Utilization Management Registered Nurse to support coordination and communication of medical services. The role requires a Compact RN license and over a year of clinical experience in relevant settings. Responsibilities include interpreting...Remote job$69.8k - $96.2k
Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization...Remote jobBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome office- Summary This position is located within the Nursing Service at the James A. Haley Veterans' Hospital in Tampa - Florida. The Utilization Management (UM) Nurse within the Quality Management Service Line. The incumbent provides clinical review - utilization oversight - and...Permanent employmentTemporary workWork at officeImmediate startRemote workRelocation packageMonday to Friday
- Curana Health, Inc. is seeking a Utilization Management Nurse to join their remote team. In this role, you will review healthcare services' utilization to ensure cost-effective care while actively coordinating transitions and discharges for patients. You will engage closely...Remote job
- Registered Nurse - Utilization Review (Nursing) Aurora, CO — 6 Months Location: Colorado Military Health System - Buckley AFB and Peterson AFB. Labor Category: Registered Nurse - Utilization Management Current POP ends 11/30/25. TO POP ends 11/30/27. This assignment...Contract workRemote workWork from homeMonday to FridayNight shift
- A health insurance company is seeking a Utilization Management Registered Nurse to leverage clinical skills for coordinating medical services within a remote setting. The role involves interpreting medical documentation and collaborating with healthcare providers. Ideal...Remote job
$71.1k - $97.8k
A leading healthcare organization seeks a Utilization Management Registered Nurse to utilize clinical skills for coordinating medical services. This remote position involves assessing care needs, communicating effectively with providers, and serving as part of a team ensuring...Remote job$71.1k - $97.8k
A healthcare organization is seeking a Utilization Management Registered Nurse. This role requires clinical nursing skills to manage medical services and benefit determinations. Responsibilities include reviewing physician information and facilitating member care coordination...Remote job- yourcommission is seeking a PRN Utilization Management Review Nurse in Bellaire, Texas to perform evaluations on medical services for necessity and efficiency. Responsibilities include handling appeals, conducting peer reviews, and ensuring quality outcomes through collaboration...Remote jobReliefFlexible hours
$45 - $45.5 per hour
Overview Job Title: Nurse Case Management Senior Analyst Location: REMOTE Duration: 5-6 Months (Contract possibly Extension) Schedule: Monday... ...services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate,...Contract workImmediate startRemote workMonday to FridayAfternoon shift$60k
...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... ...: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include but are not limited...Temporary workLocal areaRemote work$26.01 - $62.32 per hour
Utilization Management Nurse Consultant (Medicare / Spine) Remote | Full-Time | Mon‑Fri, 9:00 AM‑6:00 PM (local time) May include evenings, holidays, and occasional 24/7 operational coverage needs. About the Role Join a collaborative healthcare team as a Utilization...Hourly payFull timeTemporary workWork at officeLocal areaRemote workAfternoon shift
