Average salary: $72,771 /yearly
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$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
Providence, RI5 days 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, CA3 days ago - ...Full Time Days 7am-4:30pm 40 Hours/Week Utilization management and pediatric nursing experience preferred Summary: The Utilization Management Nurse is responsible for conducting medical necessity review to assure appropriate use of hospital resources...SuggestedFull timeRemote work
Akron Children's Hospital
Akron, OH5 days ago - ...pay range $45.00/yr - $52.00/yr Delivery Manager - Healthcare, Client Relationship Manager, VMS/MSPHiring Locums & Physicians/Nurses/Allied/Professional Coder Across with Best... .... Poor Computer Skills Summary : The Utilization Management team reviews the inpatient stays...SuggestedContract workTemporary workLocumWork at officeHome officeShift work
Pacer Staffing
Rancho Cordova, CA3 days ago - ...Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...SuggestedRemote work
Santa Barbara Cottage Hospital
New York, NY3 days ago - ...Utilization Management Nurse Des Moines, Iowa, United States Utilization Management Nurse Location: Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys...SuggestedFull timeWork at officeRemote work
Cottingham & Butler
Des Moines, IA2 days ago - ...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
Guidehealth
Chicago, IL4 days ago $70k - $75k
...embedded Healthguides™ and a centralized Managed Service Organization to build stronger... ...path!! Job Description The Utilization Management Registered Nurseis responsible... ...and education consistent with current nursing practice standards and the Illinois Nurse...SuggestedBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from homeGuidehealth
United States4 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, NC3 days ago $26.01 - $62.32 per hour
...us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.Utilization Management Nurse Consultant Clinical Precertification RN (Medicare)Remote | Full-Time | Weekday ScheduleAre you a Registered Nurse ready...SuggestedHourly payFull timeTemporary workWork at officeLocal areaRemote workMonday to FridayAfternoon shiftWeekday workCVS Health
Alabama, NY3 days ago$26.01 - $68.55 per hour
...Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring...SuggestedHourly payFull timeTemporary workRemote workWeekday workOak St. Health
United States1 day ago$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided...SuggestedHourly payWork at officeRemote workNeueHealth
Encino, CA4 days ago- ...CVS Health is seeking a Utilization Management Nurse Consultant specializing in Medical Review. This fully remote role requires an active RN license, 3+ years clinical experience, and 1+ year in Utilization Review/Medical Management. You will apply criteria to determine...SuggestedRemote work
4062 Aetna Resources, LLC
Kansas City, MO3 days ago $26.01 - $56.14 per hour
...division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-... ...lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a...SuggestedHourly payFull timeTemporary workLocal areaRemote workMonday to FridayFlexible hoursShift workCVS Health
United States2 hours ago$32.01 - $68.55 per hour
...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....SuggestedHourly payFull timeLocal areaRemote work10 hours per weekFlexible hoursThe Muse
Albany, NY4 days ago$26.01 - $56.14 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual — shaping a more connected, convenient... ...Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have...Hourly payFull timeTemporary workWork at officeLocal areaRemote workAfternoon shiftCVS Health
United States5 days ago$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend workkozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ2 days 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 receive...Remote 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, CO3 days ago$26.35 - $39.53 per hour
...better care experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews... ...appropriateness of healthcare services provided to members under a managed care health plan. This role involves assessing inpatient...Hourly payWork at officeRemote work- CVS Health is seeking an RN Utilization Management Nurse Consultant specialized in Medical Review. This fully remote role (U.S. only) requires a valid RN license and clinical experience to ensure medically necessary care through thoughtful review and collaboration with...Remote job
- ...candidate will have the following experience: ~ ~ Health plan utilization management ~ Medicare and Medicaid rules and regulations and health... ...in a related field preferred. ~ One (1) year clinical nursing experience plus four (4) years health plan utilization...Remote work
Samaritan Health Services
Eugene, OR2 hours ago $34 - $51 per hour
...leadership to ensure effective resource management for patient care delivery across the... ...practice, improved care outcomes, efficient utilization of health services, and appropriate... ...agencies. Responsible for utilizing the nursing process (assessment, diagnosis,...Full timePart timeWork experience placementWork from homeShift workDay shiftSanford Health
Fargo, ND5 days ago$39 - $40 per hour
...$40.00/hr Direct message the job poster from The Judge Group Lead Healthcare Recruiter at The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract W2 Location: Remote - but MUST reside in one of the following states: IL, TX,...Daily paidContract workRemote workMonday to FridayShift workWeekend workThe Judge Group
Chicago, IL3 days ago- A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and regulations. Candidates...Hourly payDaily paidRemote workDay shift
Providence Swedish Medical Center
Seattle, WA4 days ago - ...UTILIZATION MANAGEMENT RN Job Summary: Day-to-day management of Utilization Management queues, dashboards, members, ensuring all Utilization Management... ...Department meetings. Job Requirements Licensed Registered Nurse credentialed from an accredited school/college with 3–5...Work at officeRemote work
LibertyHealth System
Wilmington, NC2 days ago $68.13k - $119.52k
...guidelines and regulatory requirements and manages concurrent and pre-bill denials to... ...concurrent authorizations for in-house patients, utilizing daily commercial authorization reports.... .... Education: Associate's of Nursing [Required] Bachelor's of Nursing [...Full timeWork experience placementLocal areaRemote workMonday to FridayShift workAdventHealth
United States3 days ago$57.37 - $85.33 per hour
...Job Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will be responsible for ensuring the integrity of the adverse determination processes and accuracy of clinical decision-making, as it relates to the application of criteria...Local areaRemote workWork from homeShift workWeekend workDignity Health
Bakersfield, CA2 days ago$99.31k - $131.09k
...Utilization Management RN California, USA Position is FULLY REMOTE; CA RESIDENTS PREFFERED At WelbeHealth, we are transforming the... ...Requirements: Minimum of three (3) years of relevant clinical nursing experience Strong preference for prior PACE experience...Remote workWelbeHealth
United States1 day ago- ...Syra Health is seeking a Medical Management Nurse to manage a case load focusing on medical necessity reviews and case management in a remote role based in Indiana. The ideal candidate will have acute care, ICU, and Med/Surg experience, along with proficiency in IT applications...Remote work
Syra Health
Indianapolis, IN3 days ago
