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Entry Level Remote Um Nurse Jobs (NOW HIRING)

Vytwo

Epic Tapestry UM Analyst

Prosper, TX · Remote

$50/hr

^Remote Work **Must be authorized to work in USA. We are seeking an experienced Epic Tapestry ... Clinical background (e.g., RN) or strong experience partnering with clinical reviewers and Medical ...

Astrana Health

UM Review Nurse - LVN

Monterey Park, CA · Remote

$34 - $47/hr

This is a remote position for CA-licensed nurses. Candidates must live in California. We are ... Active and unrestricted LVN license in CA. * 1+ years of outpatient UM experience * Experience with ...

Mvphealthcare

Sub-Acute RN UM Reviewer - Medicare

OR · Remote

$69K - $92K/yr

Remote Pay Transparency MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith ...

Molina Healthcare

Care Review Clinician (RN)

Long Beach, CA · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

Molina Healthcare

Care Review Clinician (RN)

Chandler, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

Molina Healthcare

Care Review Clinician (RN)

Mesa, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Works with UM Manager and other clinical leadership to ensure that departmental and organizational ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Molina Healthcare

Care Review Clinician (RN)

Phoenix, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Works with UM Manager and other clinical leadership to ensure that departmental and organizational ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Molina Healthcare

Care Review Clinician (RN)

Scottsdale, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

Molina Healthcare

Care Review Clinician (RN)

Tucson, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Adheres to UM policies and procedures. * Occasional travel to other Molina offices or hospitals as ...

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All JobsEntry Level Remote Um Nurse Jobs

Entry Level Remote Um Nurse information

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$39K

$89.5K

$163K

How much do entry level remote um nurse jobs pay per year?

As of Jun 9, 2026, the average yearly pay for entry level remote um nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Entry Level Remote UM Nurse, and why are they important?

To thrive as an Entry Level Remote UM Nurse, you need a current RN license, a solid understanding of clinical guidelines, and foundational knowledge of utilization management processes. Familiarity with case management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is typically required. Strong communication, critical thinking, and organizational skills help you collaborate with providers and manage cases efficiently in a remote environment. These skills ensure accurate and compliant utilization reviews, support cost-effective patient care, and maintain quality standards in a virtual setting.

What is the difference between Entry Level Remote Um Nurse vs Entry Level Remote Medical Assistant?

AspectEntry Level Remote Um NurseEntry Level Remote Medical Assistant
Required CredentialsRN license, Basic Life Support (BLS)High school diploma, Certified Medical Assistant (CMA) or similar
Work EnvironmentRemote patient care, telehealth platformsRemote administrative support, scheduling, data entry
Employer & Industry UsageHospitals, clinics, telehealth companiesMedical offices, clinics, healthcare providers
Common Search & ComparisonPatient care, nursing duties, telehealthAdministrative tasks, patient scheduling, data management

Entry Level Remote Um Nurses primarily focus on patient care and nursing responsibilities via telehealth, requiring an RN license. In contrast, Entry Level Remote Medical Assistants handle administrative and support tasks, often with a CMA certification. Both roles are remote but serve different functions within healthcare organizations.

What are Entry Level Remote UM Nurses?

Entry Level Remote Utilization Management (UM) Nurses are registered nurses who work from home to review medical records and ensure that healthcare services are medically necessary and compliant with insurance policies. They typically assess treatment plans, coordinate with healthcare providers, and help determine coverage for procedures and hospital stays. These nurses use their clinical knowledge and understanding of insurance guidelines to make decisions that support quality patient care while controlling healthcare costs. Remote positions allow them to perform these duties virtually, offering flexibility and the ability to work from various locations. Entry-level roles usually require an active RN license and some clinical experience, but extensive UM experience may not be necessary.

What are some common challenges faced by entry level remote UM Nurses, and how can they be overcome?

Entry level remote Utilization Management (UM) Nurses often face challenges such as adapting to virtual communication, managing a high volume of case reviews, and mastering multiple digital platforms. Building strong organizational and time management skills is key, as is regularly collaborating with more experienced team members for guidance. Proactively seeking feedback and participating in ongoing training can also help new UM Nurses stay current with best practices and regulatory requirements. Establishing a dedicated and distraction-free workspace can further support productivity and focus in a remote environment.
More about Entry Level Remote Um Nurse jobs
What cities are hiring for Entry Level Remote Um Nurse jobs? Cities with the most Entry Level Remote Um Nurse job openings:
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Entry Level Remote Um Nurse jobs near you
Infographic showing various Entry Level Remote Um Nurse job openings in the United States as of May 2026, with employment types broken down into 1% Locum Tenens, 52% Full Time, 46% Part Time, and 1% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.
Utilization Management Nurse I, RN

Utilization Management Nurse I, RN

Clever Care Health Plan

Huntington Beach, CA • Remote

$34.98 - $42.85/hr

Full-time

Posted yesterday

Job description

Remote in California only

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.   

Who Are We?  

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. 

Why Join Us?  

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. 

Job Summary

The UM Nurse I - RN performs clinical review of authorization requests to determine medical necessity based on established criteria, regulatory requirements, and organizational policies. This role conducts utilization review activities under established guidelines and escalates complex or non-standard determinations to senior staff or the Medical Director.

Functions & Job Responsibilities

· Conduct clinical review of prior authorization requests using approved criteria (e.g., MCG, InterQual).

· Review outpatient and routine inpatient requests.

· Ensure compliance with CMS, state, and contractual turnaround time requirements.

· Document medical necessity determinations clearly and accurately.

· Communicate authorization decisions to providers, members and internal teams.

· Identify cases requiring physician or Medical Director review.

· Participate in concurrent review and discharge planning coordination as assigned.

· Ensure compliance with regulatory timelines.

· Support audit readiness and documentation integrity.

· Additional duties as assigned.

Qualifications

Education and Experience

· Active, unrestricted RN license.

· Minimum of three (3) years of clinical experience.

· At least one (1) year in utilization management or case management preferred.

Skills

· Knowledge of medical necessity criteria (MCG/InterQual).

· Understanding of CMS/state UM regulations.

· Strong clinical assessment and documentation skills

· Ability to manage caseload efficiently.

· Effective provider communication.

· Bilingual proficiency in Cantonese, Mandarin, Spanish, Vietnamese, or Korean preferred.

Wage Range: $34.98 to $42.85 per hour

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

• Must be able to travel when needed or required

• Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)

• Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs. Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly. Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business.

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. 

  

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency. 

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