Acute Care, Home Health, and Medical Surgery experience preferred. * Strong technical acumen and ... Work Environment This 100% remote role involves working primarily on prior approval reviews. Our ...
Acute Care, Home Health, and Medical Surgery experience preferred. * Strong technical acumen and ... Work Environment This 100% remote role involves working primarily on prior approval reviews. Our ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
If selected for this role, you will be required to be screened for TB. Work at Home Requirements ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Utilization Management Nurse
$80K - $95K/yr
Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management Remote | Utilization Management | Work from Home Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management Remote | Utilization Management | Work from Home Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our ...
Utilization Management Nurse
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... Eligible for consideration of partial work from home status upon completion of probationary period ...
Quick apply
Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... Eligible for consideration of partial work from home status upon completion of probationary period ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
This is a remote position supporting members and providers throughout Illinois with periodic in ... Monday through Friday, 8am to 5pm CST. Work at Home Requirements: To ensure Home or Hybrid Home ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
From Home Remote Utilization Management Nurse information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do from home remote utilization management nurse jobs pay per year?
As of Aug 25, 2026, the average yearly pay for from home remote utilization management 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 is the difference between From Home Remote Utilization Management Nurse vs From Home Remote Case Manager?
| Aspect | From Home Remote Utilization Management Nurse | From Home Remote Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, case management certification (e.g., CCM) |
| Work Environment | Home-based, healthcare setting | Home-based, healthcare setting |
| Employer & Industry | Insurance companies, healthcare providers | Insurance companies, healthcare providers |
| Primary Focus | Reviewing medical necessity, authorizations | Coordinating patient care, discharge planning |
Both roles are remote healthcare positions requiring RN licensure. The main difference is that Utilization Management Nurses focus on reviewing medical necessity and authorizations, while Case Managers coordinate patient care and discharge planning. Both roles are essential in healthcare management and often overlap in skills and work environment.
What cities are hiring for From Home Remote Utilization Management Nurse jobs?
Cities with the most From Home Remote Utilization Management Nurse job openings:
What are the most commonly searched types of Remote Utilization Management Nurse jobs?
The most popular types of Remote Utilization Management Nurse jobs are:
What states have the most From Home Remote Utilization Management Nurse jobs?
States with the most job openings for From Home Remote Utilization Management Nurse jobs include:
Utilization Management Nurse
Remote
Actalent •Â
5 - 10K employees5,001 - 10,000 employees
$40/hr
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 9 days ago
Job description
Utilization Management Nurse
We are seeking a dedicated Utilization Management Nurse to provide timely and appropriate prior approval services to members and healthcare providers. The role involves making clinical determinations based on medical policies and criteria, completing post-service reviews, and supporting members throughout their healthcare journey. The position requires collaboration with healthcare staff and other team members to ensure accurate documentation and effective discharge planning.
Responsibilities- Provide timely prior approval for services, procedures, and out-of-network referrals by obtaining necessary medical information.
- Conduct post-service reviews for medical necessity and experimental/investigational services.
- Offer precertification and continued stay reviews to members in various healthcare settings.
- Assist in developing and facilitating discharge plans and refer cases to Case Management as needed.
- Collaborate with healthcare provider staff to gather medical information and facilitate discharge planning.
- Process utilization management requests by interpreting medical policy, criteria, and benefit information.
- Engage with Medical Directors and Physician Reviewers for services not meeting medical criteria.
- Document review processes and decisions accurately and consistently within the review documentation system.
- Communicate approval and denial decisions to members and providers according to regulatory standards.
- Meet quality assurance and production metrics established for the utilization management unit.
- Registered Nurse (RN) or Licensed Practical Nurse (LPN) with active and unrestricted license in Iowa or South Dakota.
- 4+ years of diverse clinical experience, including critical care, acute care, and outpatient settings.
- Experience in utilization management, utilization review, and case management.
- Strong verbal and written communication skills.
- Ability to apply analytical and critical thinking skills to make independent decisions.
- Proficient in diagnosis and procedure coding systems (e.g., ICD-10, HCPCS, CPT).
- Completion of an accredited nursing program.
- Acute Care, Home Health, and Medical Surgery experience preferred.
- Strong technical acumen and ability to learn new systems quickly, including Microsoft Office and clinical documentation platforms.
- Demonstrated commitment to service excellence and patient/member advocacy.
This 100% remote role involves working primarily on prior approval reviews. Our team consists of high achievers who are collaborative and self-motivated. The work hours are from 8 AM to 5 PM CST, with a contract length of 6-8 months and a possibility for extension. A compact license is required for individuals residing outside of Iowa or South Dakota. The role includes a 2-3 week training period with a buddy system for support. The team is friendly and team-focused, emphasizing continuous improvement and efficient resource utilization.
Job Type & LocationThis is a Contract position based out of DES MOINES, IA.
Pay and BenefitsThe pay range for this position is $40.00 - $40.00/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
This is a fully remote position.
Application DeadlineThis position is anticipated to close on Aug 21, 2026.
About Actalent
Sourced by ZipRecruiter
Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We're supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.
Company size
5,001 - 10,000 Employees
Headquarters location
Hanover, MD, US
Year founded
1983