77 Utilization Management Nurse jobs

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,…

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…

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…

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.

Harrisburg, Pennsylvania, US (Hybrid)

Category: Health Care Location: Harrisburg Pennsylvania United States Are you a registered nurse ready to take your career in an exciting new…

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.

United States (Remote)

This is a remote position.

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

United States (Remote)

Kingman Healthcare Incorporated (KHI) Staff Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case…

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

United States (Remote)

$75.3–135.4K / year

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members.

United States (Remote)

$34.00 / hour

Overview Carenet Health is not authorized to hire in certain states due to internal business considerations: IL, AK, CA, MA, MI, MN, NY, NV, NJ, OR,…