Average salary: $72,771 /yearly
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- ...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...SuggestedFull timeImmediate startRemote workShift work
Wellstar Health Systems, Inc.
Augusta, GA21 days ago $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 Springfield MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting...SuggestedMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workOptum
Amherst, MA2 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 States3 days ago- ...based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary... ...CuranaHealth.com. Summary The primary role of the Utilization Management Nurse is to review and monitor members' utilization of...SuggestedContract workWork at officeRemote workWeekend work
Curana Health, Inc.
United States2 days ago - ...Mass General Brigham Health Plan is seeking a Clinical Utilization Management Nurse to provide escalation support, triage inquiries, and determine medical necessity and adherence to guidelines. You will collaborate with Nurse Reviewers, Medical Directors, and providers...SuggestedRemote work
Mass General Brigham Health Plan, Inc.
United States20 hours ago $65.52k - $118.56k
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and candidates who reside in Idaho and Utah Build a career with purpose. Join our Cause to create a person-focused and economically...SuggestedFull timeWork at officeImmediate startRemote workWork from homeFlexible hours- ...Overview NaphCare is hiring an experienced Utilization Management Registered Nurse just like you to join our Remote based, Arizona team . NaphCare is a family owned, healthcare technology company that has been delivering high quality healthcare to correctional...SuggestedFull timeRemote workShift work
- ...Job Summary: Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating medical services, treatments, and procedures. This role...SuggestedFull time
$71.1k - $97.8k
...Become a part of our caring communityThe 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 the...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome officeHumana
Olympia, WA10 hours agonew- ...Curana Health seeks an experienced Utilization Management Nurse to review and monitor members’ use of healthcare services, ensuring high-quality, cost-effective care. The role emphasizes concurrent review, discharge planning, and high-dollar claims analysis, with remote...SuggestedRemote work
Curana Health
New York, NY10 hours agonew - ...considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply. Utilization Management Nurse RN - Utilization Management - UH Truman Medical Center (7:00a-4:00p, varied days per week)101 Truman Medical Center Job...SuggestedFull timeWork from home
- ...Arkansas Blue Cross Blue Shield is seeking a qualified Utilization Management Nurse to perform clinical review of prior approvals, network exceptions, and benefit inquiries. You will assess medical necessity and promote quality care while controlling costs using evidence...SuggestedRemote work
Arkansas Blue Cross
United States2 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, NC20 hours ago - ...Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care across multiple states. The role emphasizes applying clinical criteria, ensuring medical necessity, and coordinating...SuggestedRemote workWork from home
Cambia Health Solutions
United States4 days ago - ...Utilization Management NurseBurlingame, CA 94010OverviewSalary Range $143,098.80 - $165,048.00 SalaryDescriptionSummary Of Position:The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities...SuggestedWork at officeRemote work
North East Medical Services
Burlingame, CA1 day ago - ...Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating and documenting medical services and benefit determinations. The role involves independent interpretation of actions, collaborating with internal and external stakeholders...Remote work
Humana
Helena, MT2 days ago - ...Cambia Health Solutions, Inc. is seeking an experienced Utilization Management Nurse to conduct prospective, concurrent, and retrospective reviews and apply clinical criteria to determine medical necessity. You will collaborate with physician advisors to support appropriate...Remote work
Cambia Health Solutions
Union Gap, WA3 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...Contract workTemporary workLocumWork at officeHome officeShift work
Pacer Staffing
Rancho Cordova, CA10 hours agonew $90k - $107k
...range of professionals, including doctors, nurses, business people, tech experts,... ...total compensation package. The UMCM will utilize clinical knowledge to analyze, assess, and... ...authorization (outpatient review) experience in a managed care setting with commercial health plan...Remote workFlexible hoursShift workMass General Brigham Health Plan Holding Company, Inc.
Somerville, MA2 days ago- ...Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is preferred, with at least...Remote workWork from home
Arkansas Blue Cross
Bismarck, ND2 days ago - ...Job DescriptionJob DescriptionJob Title: Registered Nurse - Utilization ReviewREMOTE POSITION Utilization Management: Shift: Monday through Friday 8A to 4:30P, with every fifth weekend rotation. 2 years of experience required. Must have experience with providers and not...Permanent employmentRemote workMonday to FridayShift workWeekend work
Enterprise Solutions-Healthcare
Fort Myers, FL4 days ago - ...Job DescriptionJob DescriptionJob Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:" Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:" Reviews admissions...Remote work
3B Healthcare, Inc
Austin, TX4 days ago $26.01 - $74.78 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 Location: Remote (Preference for candidates in CST or EST time zones) Schedule: 24/7 operation requiring...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeWeekend workAfternoon shiftCVS Health
United States20 hours ago- ...CVS Health is seeking an Utilization Management Nurse Consultant to assess and coordinate care for members across the continuum of care. This role requires RN licensure, 2+ years in acute/critical care, and EST/CST residency with 24/7 schedule expectations. The position...Remote work
CVS Health
United States4 days ago $29.1 - $62.32 per hour
...schedules will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary Utilize your clinical experience and skills in a... .... Required Qualifications Registered Nurse Education: Diploma RN acceptable; Associate...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeShift workWeekend workCVS Corporation
United States4 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 Corporation
United States6 hours agonew- ...CVS Health is seeking a Utilization Management Nurse Consultant (Remote) to support Florida Medicare home-care requests. You will review cases, determine coverage, and coordinate with providers to ensure timely, appropriate care. The role emphasizes clinical judgment,...Full timeRemote work
CVS Health
United States1 day ago - ...CVS Health is seeking a qualified Registered Nurse for Utilization Management to ensure appropriate healthcare services and benefits for members. This role supports a 24/7 operation, including weekends and evenings, and requires strong clinical judgment and collaboration...Remote workAfternoon shift
Anacalifornia
United States3 days ago $26.01 - $62.32 per hour
...be part of something bigger - helping to simplify health care one person, one family and one community at a time. RN Utilization Management Nurse Consultant (Medicare - Joint Procedures) Remote | Full-Time | Monday-Friday (9:00 am to 5:30 pm in your time zone, with...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shiftWeekday workCVS Health
Guin, AL3 days ago$26.01 - $62.32 per hour
...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 Schedule Are you a Registered Nurse...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shiftWeekday workCVS Health
Sioux Center, IA4 days ago
