Utilization Management Nurse
$80K - $95K/yr
... by contracted providers. Employ effective use of knowledge, critical thinking, and skills to ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
... by contracted providers. Employ effective use of knowledge, critical thinking, and skills to ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Utilization Management Nurse
$80K - $95K/yr
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Ability to apply analytical and critical thinking skills to make independent decisions ... Work Environment This 100% remote role involves working primarily on prior approval reviews. Our ...
Ability to apply analytical and critical thinking skills to make independent decisions ... Work Environment This 100% remote role involves working primarily on prior approval reviews. Our ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
... and independent determination of the appropriate courses of action. Reports to the UM Nurse ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse 2 uses clinical knowledge and independent critical thinking skills ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...
The Utilization Management Nurse performs medical necessity and benefit review requests in ... Must be able to work independently. * Must be detail oriented and have strong organizational and ...
Quick apply
The Utilization Management Nurse performs medical necessity and benefit review requests in ... Must be able to work independently. * Must be detail oriented and have strong organizational and ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
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
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in ... independently. • Must be detail oriented and have strong organizational and time management ...
Utilization Management Nurse
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in ... independently. • Must be detail oriented and have strong organizational and time management ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Working independently while collaborating with providers, members, and interdisciplinary teams, you ... This is a remote position supporting members and providers throughout Illinois with periodic in ...
Independent Contractor Remote Utilization Management Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do independent contractor remote utilization management nurse jobs pay per hour?
As of Aug 25, 2026, the average hourly pay for independent contractor remote utilization management nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.
What is an independent contractor remote utilization management nurse?
An Independent Contractor Remote Utilization Management Nurse is a licensed nurse, typically a registered nurse (RN), who works remotely as a contractor rather than a full-time employee. Their primary responsibilities include reviewing medical records, evaluating the necessity and efficiency of healthcare services, and ensuring that patient care aligns with established guidelines and insurance requirements. These nurses communicate with healthcare providers to facilitate approvals or denials of medical services, often for insurance companies or third-party administrators. Working remotely allows for schedule flexibility and the ability to serve multiple clients, but also requires strong organizational and communication skills.
What are the key skills and qualifications needed to thrive as an independent contractor remote utilization management nurse?
To thrive as an Independent Contractor Remote Utilization Management Nurse, you need a current RN license, clinical experience (often in acute care), and strong knowledge of utilization review processes. Familiarity with case management software, electronic medical records (EMRs), and industry-standard guidelines like Milliman or InterQual is typically required. Exceptional time management, critical thinking, and effective communication skills help you excel when working independently and collaborating virtually with healthcare teams. These competencies ensure accurate utilization reviews, regulatory compliance, and optimal patient care outcomes in a remote setting.
How does an independent contractor remote utilization management nurse typically collaborate with healthcare teams while working remotely?
As an Independent Contractor Remote Utilization Management Nurse, you will regularly communicate and collaborate with physicians, case managers, and other healthcare professionals through secure digital platforms, email, and conference calls. Despite working remotely, strong teamwork is essential for reviewing patient cases, discussing complex situations, and ensuring appropriate care decisions. Maintaining clear and timely communication, as well as building professional relationships with both internal and external stakeholders, helps facilitate efficient utilization reviews and high-quality patient care. You may also attend virtual team meetings and contribute to interdisciplinary discussions to stay aligned with organizational goals.
What is the difference between Independent Contractor Remote Utilization Management Nurse vs Utilization Review Nurse?
| Aspect | Independent Contractor Remote Utilization Management Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, certification in case management or utilization review often preferred | RN license, certification in case management or utilization review often required |
| Work Environment | Remote, independent contractor basis, flexible schedule | Typically employed by healthcare organizations, may be remote or onsite |
| Employer & Industry Usage | Contract basis, used by insurance companies, healthcare providers, or third-party administrators | Full-time or part-time employee, used within hospitals, insurance companies, or managed care organizations |
The main difference is that the Independent Contractor Remote Utilization Management Nurse works on a contract basis, often remotely, providing specialized review services independently. In contrast, the Utilization Review Nurse is usually employed directly by healthcare organizations or insurers, with a more structured work environment. Both roles require similar credentials and focus on evaluating medical necessity and appropriateness of care.
More about Independent Contractor Remote Utilization Management Nurse jobs
What cities are hiring for Independent Contractor Remote Utilization Management Nurse jobs?
Cities with the most Independent Contractor 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 Independent Contractor Remote Utilization Management Nurse jobs?
States with the most job openings for Independent Contractor Remote Utilization Management Nurse jobs include:
What job categories do people searching Independent Contractor Remote Utilization Management Nurse jobs look for?
The top searched job categories for Independent Contractor Remote Utilization Management Nurse jobs are:
- Remote Lpn Utilization Review
- Utilization Review Nurse Compact License
- Seasonal Remote Utilization Review
- Internship Rn Utilization Review Nurse
- Remote Dental Utilization Management
- Utilization Management Review Nurse
- Full Time Weekend Utilization Review
- Commission Optum Utilization Review
- Full Time Remote Lpn Utilization Review
- Freelance International Utilization Review Nurse
Utilization Management Nurse
Remote
Intus Care •
Health Care and Social Assistance • 1 - 10 employees1 - 10 employees
$80K - $95K/yr
Other
Medical, Dental, Vision
Posted 11 days ago
Job description
Utilization Management Nurse
IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors – some of the most socially vulnerable and clinically complex individuals in the US healthcare system.
The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual partners closely with PACE Interdisciplinary Teams, Medical Directors, and provider networks to review service utilization, guide care decisions and support timely, appropriate transitions across care settings. Blending clinical expertise with analytical thinking, the Utilization Management Nurse ensures services are medically necessary, aligned with care plans and consistent with PACE regulations and best practices. This role is essential to maintaining program integrity, improving participant outcomes and supporting the delivery of coordinated, value-based care.
Responsibilities include rigorous adherence to PACE program service authorization policies, ensuring that participant care and related claims are reasonable and necessary for diagnosis or treatment and consistent with PCP coordination decisions. Active involvement in various aspects of the utilization management process, including concurrent review of all hospital admissions, retrospective review of inpatient admissions under 48 hours, and coordination and review of all other services delivered by contracted providers. Employ effective use of knowledge, critical thinking, and skills to advocate quality care and enhanced quality of life, maintain accurate records of all patient related interactions, and appeal management in cases of claim rejection.
Qualifications include 3 to 5 years of utilization management experience, current RN license, proven experience working in risk based integrated models of care, ability to use data to drive decisions and collaboration with internal and external stakeholders, strong strategic thinking, problem solving, and decision making skills, and excellent communication and leadership abilities.
What We Offer includes a chance to be a part of a trailblazing team in healthcare technology, competitive salary and equity package, comprehensive benefits including health, dental, and vision insurance, a collaborative, inclusive, and dynamic work environment, and opportunities for professional growth and development.
Compensation: The salary range for this role is $80K-$95K. Work location: This is a fully remote role based in the United States. Sponsorship: This position is not eligible for sponsorship.
About Intus Care
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1 - 10 Employees
Headquarters location
Providence, RI, US
Year founded
2019