Average salary: $72,771 /yearly

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  •  ...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... 
    Suggested
    Bi-weekly pay
    Full time
    Temporary work
    For contractors
    Local area
    Remote work
    Work from home

    Guidehealth

    Chicago, IL
    1 day ago
  • $34.98 - $42.85 per hour

     ...Clever Care is hiring a UM Nurse I - RN to conduct clinical reviews of authorization requests in California. The role involves...  ...minimum of three years of clinical experience, preferably in utilization management. This remote position offers a wage range of $34.98 to $42.8... 
    Suggested
    Hourly pay
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    3 days ago
  • $71.1k - $97.8k

     ...Become a part of our caring community The Utilization Management RN will collaborate with other health care givers in reviewing medical care and...  ...a related field Active and unrestricted Compact Registered Nurse (RN) license with no disciplinary action (including Nevada)... 
    Suggested
    Bi-weekly pay
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office
    Weekend work

    Humana

    Washington DC
    4 days ago
  •  ...Utilization Management, Registered Nurse (RN) Remote - USA At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through... 
    Suggested
    Work at office
    Remote work
    Flexible hours

    Clover Health

    New York, NY
    3 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... 
    Suggested
    Contract work
    Work at office
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    3 days ago
  •  ...Mass General Brigham Health Plan is hiring for a role that utilizes clinical expertise for utilization management in a remote environment. Ideal candidates should hold an Associate's Degree in Nursing, possess strong decision-making and problem-solving skills, and have... 
    Suggested
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    3 days ago
  • $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,... 
    Suggested
    Contract work
    Immediate start
    Remote work
    Monday to Friday
    Afternoon shift

    Mindlance

    New York, NY
    3 days ago
  •  ...A healthcare administration company is seeking a Utilization Management Nurse to conduct clinical reviews and collaborate with healthcare partners while working remotely. The ideal candidate must be a current Licensed Practical Nurse, skilled in utilization review processes... 
    Suggested
    Remote work

    Brighton Health Plan Solutions

    Chapel Hill, NC
    1 day ago
  •  ...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... 
    Suggested
    Remote work

    Appworkshub

    New York, NY
    3 days ago
  •  ...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... 
    Suggested
    Remote work

    Curana Health, Inc.

    New York, NY
    3 days ago
  • $71.1k - $97.8k

     ...Become a part of our caring community The Utilization Management Nurse uses clinical nursing skills to support the coordination, documentation and communication of medical services and benefit administration determinations. The Utilization Management Nurse uses... 
    Suggested
    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office

    Centerwell

    Austin, TX
    2 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... 
    Suggested
    Work at office
    Remote work
    Weekend work

    Regency Group

    Austin, TX
    4 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... 
    Suggested
    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Home office

    Humana

    Columbus, OH
    2 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... 
    Suggested
    Hourly pay
    Work at office
    Remote work

    Clever Care Health Plan

    Huntington Beach, CA
    5 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... 
    Suggested
    Remote work

    Macpower Digital Assets Edge

    United States
    4 days ago
  • $90.86k - $136.29k

     ...Job Title Utilization Management Concurrent Review Nurse Job Description The Utilization Management Concurrent Review team reviews the inpatient stays for our members and correctly applies guidelines for nationally recognized levels of care. In this role you... 
    Full time
    Contract work
    Work at office
    Remote work

    Blue Shield Of California

    Oakland, CA
    5 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... 
    Minimum wage
    Full time
    Work experience placement
    Casual work
    Live in
    Work at office
    Local area
    Remote work

    Optum

    Boston, MA
    2 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... 
    Hourly pay
    Permanent employment
    Temporary work
    Work at office
    Remote work

    Morgan Stephens

    United States
    3 days ago
  • $50.68 per hour

     ...Email this Job Job Overview The Utilization Review RN participates as a member of a...  .... Department Name: Utilization Management Job Status: flex, not eligible for benefits...  ...* EDUCATION - Bachelor of Science in Nursing (BSN) * EXPERIENCE - Three years of... 
    Hourly pay
    Temporary work
    Live in
    Immediate start
    Remote work
    Relocation
    Flexible hours
    Shift work
    Weekend work
    Day shift
    Afternoon shift

    Children's Hospital Colorado

    Aurora, CO
    1 day ago
  • $45.75 - $62.9 per hour

     ...Note: This is a fulltime prior authorization nurse role; experience with health plan authorization process is strongly preferred...  ...Under the supervision of the Supervisor, UM Clinical, the Utilization/Case Manager Nurse coordinates the delivery of care through assessment,... 
    Full time
    Remote work

    Rady Children's Hospital

    San Diego, CA
    5 days ago
  • $74.16 - $107.75 per hour

     ...Utilization Review Nurse Work Location: Los Angeles, CA, USA Onsite or Remote Fully On-Site Work Schedule Monday-Friday 8am-4:30pm...  ...The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting... 
    Hourly pay
    Work at office
    Remote work
    Monday to Friday

    University of California

    United States
    2 days ago
  • $45 - $50 per hour

     ...Job Title: Utilization Management Nurse Location: Remote Position Overview The Utilization Management Nurse is responsible for reviewing inpatient admissions and applying nationally recognized medical necessity criteria to determine appropriate levels of care... 
    Contract work
    Temporary work
    Remote work

    Actalent

    Rancho Cordova, CA
    8 days ago
  • $8 per hour

     ...Description Job Opportunity: Registered Nurse - Utilization Review Facility: CSMN - 8714024 - MNS Quality Management Location: Los Angeles, CA Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00 17:00 Start Date: 2/24/2025 Job Duration: 13... 
    Hourly pay
    Contract work
    Remote work
    Shift work

    Zenex Partners

    Los Angeles, CA
    5 days ago
  • $32.01 - $68.55 per hour

     ...it all with heart, each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS...  ...remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days per week. This... 
    Hourly pay
    Full time
    Local area
    Remote work
    10 hours per week
    Flexible hours

    The Muse

    Albany, NY
    1 day ago
  •  ...Hispanic Alliance for Career Enhancement is seeking a Nurse Consultant to join their Utilization Management team. In this 100% remote role, you will apply your clinical judgement to review inpatient and outpatient services. Candidates should have an active RN license,... 
    Remote work
    Flexible hours

    Hispanic Alliance for Career Enhancement

    Columbus, OH
    1 day ago
  • $29.1 - $62.32 per hour

     ...CVS Health is hiring a Nurse Consultant for their Utilization Management team based in Columbus, Ohio. This fully remote position involves applying critical clinical judgement to assess and authorize inpatient and outpatient services. Qualified candidates should possess... 
    Hourly pay
    Remote work

    CVS Health

    Columbus, OH
    1 day ago
  • $27.1 - $40.65 per hour

     ...NeueHealth is seeking a full-time Utilization Management Nurse, LVN/LPN, to work from home in California. This role involves ensuring appropriate benefit coverage through prior authorizations. Key responsibilities include evaluating requests based on clinical guidelines... 
    Hourly pay
    Full time
    Remote work
    Work from home

    NeueHealth

    California, MO
    3 days ago
  •  ...A healthcare provider in the United States is seeking a Utilization Management Nurse to work remotely. This role involves performing clinical utilization reviews, collaborating with healthcare partners, and adhering to national standards and regulations. Candidates must... 
    Work at office
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    3 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 ends 11/30/27) Schedule... 
    Contract work
    Immediate start
    Remote work
    Monday to Friday

    J Edward Staffing LLC

    Aurora, CO
    5 days ago
  • $26.01 - $68.55 per hour

     ...Medicare Precertification Utilization Management Nurse Consultant (Remote) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues... 
    Full time
    Work at office
    Local area
    Remote work
    Monday to Friday
    Afternoon shift

    Oak St. Health

    United States
    2 days ago