Average salary: $72,771 /yearly
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- ...Ascension St. John's Medical Center Department/Specialty: Utilization Management Schedule: PRN, 8am-4:30pm, Minimum 2 weekends per month,... ...Licensure / Certification / Registration: ~ Registered Nurse credentialed from the Oklahoma Board of Nursing obtained prior...SuggestedReliefLocal areaRemote workShift workWeekend workWeekday work
Ascension
Tulsa, OK20 hours ago - ...A healthcare company is looking for a Utilization Management Nurse 2 to leverage clinical knowledge and skills to enhance patient care. The role focuses on interpreting criteria, coordinating treatment, and communicating with providers and members. Candidates must have...SuggestedRemote work
Humana
Sacramento, CA10 hours ago $71.1k - $97.8k
...Unrestricted RN license Possession of or ability to obtain Compact Nursing License 3+ years of clinical RN experience; Prior clinical experience, managed care experience, DME, Florida Medicaid OR utilization management experience Ability to work independently and within a...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeWeekend workHumana
Little Rock, AR5 days ago- ...A healthcare organization is seeking a Utilization Management Nurse 2 to leverage clinical knowledge and communication skills for optimal member treatment. This role includes coordinating care, interpreting policies, and collaborating with various stakeholders. Candidates...SuggestedRemote work
Humana
Montpelier, VT10 hours ago - ...A leading healthcare organization is seeking a Utilization Management Nurse 2 in New Hampshire. The role involves using clinical expertise to ensure appropriate treatment and care for members while coordinating with providers. Applicants should have an RN license and...SuggestedRemote work
Humana
Concord, NH22 hours 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...SuggestedMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workUnitedHealth Group
Boston, MA2 days ago$71.1k - $97.8k
...A leading healthcare organization is seeking a Utilization Management Nurse 2 to coordinate and provide the best treatment for members. Responsibilities include using clinical knowledge to interpret treatment criteria and facilitating care with providers. Candidates must...SuggestedRemote workHumana
Augusta, ME10 hours ago- ...A leading health services organization is seeking a Utilization Management Nurse 2 to provide optimal treatment and care coordination. The ideal candidate has a strong background in nursing, particularly in critical care, and is proficient in utilizing Microsoft tools...SuggestedRemote workWeekend work
Humana
Providence, RI10 hours ago - ...Are you a bedside nurse looking for a career change? If you answered, yes, this may be the role for you! Alliant Health Solutions... ...", seeks a Review Nurse for its Prior Authorization & Utilization Management (PA/UM) team. The Review Nurse, PA/UM,conducts prior...SuggestedContract work
Alliant Health Group
Atlanta, GA2 days ago $71.1k - $97.8k
...A leading healthcare organization is seeking a Utilization Management Nurse 2 who will utilize clinical knowledge and communication skills to provide optimal care to members. This role involves coordinating with providers and understanding organizational strategies. Candidates...SuggestedRemote workHumana
Little Rock, AR22 hours ago$71.1k - $97.8k
...A leading healthcare organization is seeking a Utilization Management Nurse 2 to provide optimal care and treatment through effective communication with healthcare providers and members. This role requires a valid nursing license and extensive experience in critical care...SuggestedRemote workHumana
Lincoln, NE22 hours ago- ...Job Description Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews... ...review, transplant and NICU/HROB. The Utilization Management Nurse, Consultant will report to the Manager, Utilization and Medical...SuggestedFull timeContract workPart timeWork at officeLocal areaRemote workWork from homeHome office2 days per week
Blue Shield Of California
Rancho Cordova, CA2 days ago $90k - $107k
...relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts... ...package. Job Summary The Medicare UM Nurse performs utilization management activities primarily for Medicare Advantage, including...SuggestedWork at officeLocal areaRemote workFlexible hoursShift workMass General Brigham
United States2 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
Lincoln, NE4 days ago$88.36k - $100k
...innovation. Job Summary The UM Nurse II - RN performs advanced clinical... ...resource for UM Nurse I staff. This role manages high-acuity, specialty, and escalated cases... .... • At least three (3) years of utilization management experience preferred. Skills...SuggestedWork at officeRemote workClever Care Health Plan
Huntington Beach, CA4 days ago- ...Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating Healthcare Services clinical policies, guidelines...Remote work
Macpower Digital Assets Edge
United States1 day ago - ...The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions... ...authorization (outpatient review) experience in a managed care setting with commercial health plan... ...Education ~ Associate's Degree Nursing required or Bachelor's Degree Nursing...Remote work
Mass General Brigham Health Plan
Somerville, MA1 day ago - ...The Medicare UM Nurse performs utilization management activities primarily for Medicare Advantage, including review of authorizations for home care, high tech radiology, outpatient, inpatient, and post-acute services. The Medicare UM Nurse reviews the medical necessity...Work at officeLocal areaRemote work
Mass General Brigham Health Plan
Somerville, MA2 days ago $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...Contract workImmediate startRemote workMonday to FridayVarite
Aurora, CO4 days ago- Summary The VA Portland Health Care System in Portland, Oregon is hiring a Registered Nurse (RN) Utilization Management (UM) to execute position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization processes...Permanent employmentTemporary workLocal areaRemote workRelocation packageFlexible hours
- ...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...Bi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from home
- 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...Contract workWork at officeRemote workFlexible hours
- ...Utilization Management Nurse - Prior Authorization BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews on prior authorization requests in accordance with national standards...Contract workWork at officeRemote work
$71.1k - $97.8k
...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...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...A leading healthcare company is seeking a registered nurse (RN) to join their team in Concord, NH. The RN will review medical care, collaborate with healthcare providers, and ensure compliance with established guidelines. Candidates must have an active RN license and at...Remote work
Humana
Concord, NH1 day ago - A leading healthcare organization is seeking a dedicated RN to join their dynamic team in Boston, Massachusetts. The ideal candidate will have an active RN license, 3+ years of clinical experience, and the ability to collaborate with healthcare professionals. This role...Remote work
Humana
Boston, MA1 day ago - ...A healthcare solutions provider is seeking a Registered Nurse in Sacramento, California. This role involves collaborating with health care providers and reviewing medical care against established guidelines. Candidates should have an active RN license and at least 3 years...Remote work
Humana
Sacramento, CA22 hours ago $71.1k - $97.8k
...A leading health care company is seeking a Registered Nurse (RN) in Providence, Rhode Island. The ideal candidate will have a strong clinical background, excellent communication skills, and the ability to work in a collaborative team environment. Responsibilities include...Remote workHumana
Providence, RI22 hours ago- ...A leading healthcare provider is seeking a Registered Nurse (RN) to join their team. The ideal candidate will collaborate with health care professionals to ensure quality medical care, adhere to CMS coverage guidelines, and provide outstanding service. Key qualifications...Remote work
Humana
Montpelier, VT22 hours ago - ...A leading health care organization is seeking a Registered Nurse (RN) to join their team and collaborate with health care providers to ensure high-quality patient care. The ideal candidate will possess a strong clinical background, active RN license, and excellent communication...Remote work
Humana
Lincoln, NE22 hours ago
