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...SuggestedBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from home
Guidehealth
Chicago, IL1 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...SuggestedHourly payRemote workSanta Barbara Cottage Hospital
New York, NY3 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)...SuggestedBi-weekly payTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeWeekend workHumana
Washington DC4 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...SuggestedWork at officeRemote workFlexible hours
Clover Health
New York, NY3 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
Santa Barbara Cottage Hospital
New York, NY3 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...SuggestedRemote work
Santa Barbara Cottage Hospital
New York, NY3 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,...SuggestedContract workImmediate startRemote workMonday to FridayAfternoon shiftMindlance
New York, NY3 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...SuggestedRemote work
Brighton Health Plan Solutions
Chapel Hill, NC1 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...SuggestedRemote work
Appworkshub
New York, NY3 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...SuggestedRemote work
Curana Health, Inc.
New York, NY3 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...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeCenterwell
Austin, TX2 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, TX4 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
Columbus, OH2 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, CA5 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...SuggestedRemote work
Macpower Digital Assets Edge
United States4 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 timeContract workWork at officeRemote workBlue Shield Of California
Oakland, CA5 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 wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workOptum
Boston, MA2 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 payPermanent employmentTemporary workWork at officeRemote workMorgan Stephens
United States3 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 payTemporary workLive inImmediate startRemote workRelocationFlexible hoursShift workWeekend workDay shiftAfternoon shiftChildren's Hospital Colorado
Aurora, CO1 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 timeRemote workRady Children's Hospital
San Diego, CA5 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 payWork at officeRemote workMonday to FridayUniversity of California
United States2 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 workTemporary workRemote workActalent
Rancho Cordova, CA8 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 payContract workRemote workShift workZenex Partners
Los Angeles, CA5 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 payFull timeLocal areaRemote work10 hours per weekFlexible hoursThe Muse
Albany, NY1 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 workFlexible hours
Hispanic Alliance for Career Enhancement
Columbus, OH1 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 payRemote workCVS Health
Columbus, OH1 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 payFull timeRemote workWork from homeNeueHealth
California, MO3 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 officeRemote work
Santa Barbara Cottage Hospital
New York, NY3 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 workImmediate startRemote workMonday to FridayJ Edward Staffing LLC
Aurora, CO5 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 timeWork at officeLocal areaRemote workMonday to FridayAfternoon shiftOak St. Health
United States2 days ago
