73 Utilization Management Nurse jobs in United States

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Massachusetts, US (Hybrid)

$100–105K / year

Job Description: Candidates must live in Massachusetts and hold an active, unrestricted Massachusetts RN license at the time of hire.

Boston, Massachusetts, US (Hybrid)

$84.1–126.2K / year

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare.

Mission, Texas, US (Hybrid)

$36.00 – $65.00 / hour

Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of…

Roanoke, Virginia, US (Hybrid)

$89.5–136.5K / year

City/State Roanoke, VA Work Shift First (Days) Overview: Sentara Health is looking to hire an Integrated Case Manager, RN.

New Hampshire, US (Hybrid)

$31.00 – $55.00 / hour

Position Purpose: Provides expertise based on experience with identifying, overseeing, and managing the coordination of transition of members in the community.

Riverside, California, US (Hybrid)

Job Description Job Summary Provides support for clinical facility site reviews.

United States (Remote)

$71.1–97.8K / year

Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the…

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Lead a team dedicated to delivering high-quality,…

United States (Remote)

$36.00 – $38.00 / hour

Vida is looking for a licensed RN or LPN to manage clinical review requests, escalations, and member inquiries in a fully remote, virtual care setting.

United States (Remote)

$27.00 – $49.00 / hour

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance…

United States (Remote)

$27.00 – $49.00 / hour

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating…

United States (Remote)

$66.3–84K / year

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here .

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…

United States (Remote)

$78–83K / year

Our Story Imagine being part of a team that’s not just shaping the future but actively driving it.