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Remote Optum Rn Jobs in Oregon (NOW HIRING)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Ascension

Director of Nursing Practice

$129K - $183K/yr

Remote with 25% Travel Department: Research and EBP Schedule: Full-Time, Days Salary range: $129 ... Registered Nurse obtained prior to hire date or job transfer date required. * BLS Provider obtained ...

Ascension

Director of Nursing Practice

Remote Department: Research and EBP Schedule: Day l Full-time Salary range: $129,942.00 - $183,447 ... Registered Nurse obtained prior to hire date or job transfer date required. * BLS Provider obtained ...

Corvel

Hospital Bill Audit Supervisor

$76K - $117K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver ...

CERiS

Hospital Bill Audit Supervisor

$76K - $117K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver ...

ZoomCare

Psychiatric Nurse Practitioner

Portland, OR · On-site +1

$140K - $163K/yr

Remote Schedule (Must be located in Oregon) ESSENTIAL FUNCTIONS Reasonable accommodations may be ... Current Registered Nursing licensure in Oregon and Washington. * Master of Science in Nursing (MSN ...

Umpqua Health

Care Coordinator

Roseburg, OR · On-site +1

$80K - $92K/yr

CARE COORDINATOR REMOTE, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 ... Active, unrestricted Oregon licensure as a Registered Nurse (RN, BSN, or MSN) or Licensed Clinical ...

Jobs for Humanity

Quality Compliance Specialists

Salem, OR · Remote

$21.82 - $42.55/hr

Specialist, Quality Interventions/QI Compliance (Remote) Application Deadline: Open Until Filled ... (RN may be preferred for specific roles) Certified HEDIS Compliance Auditor (CHCA) To all current ...

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All JobsRemote Optum Rn JobsRemote Optum Rn Jobs in Oregon

Remote Optum Rn information

What is the difference between Remote Optum Rn vs Remote UnitedHealth Group Rn?

AspectRemote Optum RnRemote UnitedHealth Group Rn
CredentialsRegistered Nurse (RN) license, applicable certificationsRegistered Nurse (RN) license, applicable certifications
Work EnvironmentRemote healthcare services, telehealth platformsRemote healthcare services, telehealth platforms
Employer & IndustryOptum, healthcare and health services industryUnitedHealth Group, healthcare and insurance industry

Both Remote Optum Rn and Remote UnitedHealth Group Rn roles involve providing remote nursing care within the healthcare industry. They require similar credentials and work environments, often utilizing telehealth platforms. The main difference lies in the employer and specific focus areas within the healthcare sector, with Optum focusing on health services and UnitedHealth Group encompassing broader health insurance and services.

What are the most commonly searched types of Optum Rn jobs in Oregon? The most popular types of Optum Rn jobs in Oregon are:
What are popular job titles related to Remote Optum Rn jobs in Oregon? For Remote Optum Rn jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Remote Optum Rn jobs in Oregon look for? The top searched job categories for Remote Optum Rn jobs in Oregon are:
What cities in Oregon are hiring for Remote Optum Rn jobs? Cities in Oregon with the most Remote Optum Rn job openings:
Remote Optum Rn jobs near you
Utilization Review Nurse

Utilization Review Nurse

Umpqua Health

Roseburg, OR • On-site, Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Job description

UTILIZATION REVIEW NURSE
REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as needed for business operations.
EMPLOYMENT TYPE: Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization-we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare, and applicable regulations. The UM Nurse collaborates with interdisciplinary teams and community providers to promote integrated, high-quality care.
ESSENTIAL JOB RESPONSIBILITIES
  • Perform clinical assessments and prior authorizations to determine medical necessity
  • Escalate complex cases to Medical Directors and request additional documentation as needed
  • Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions
  • Liaise with internal departments to resolve eligibility, benefits, or service issues
  • Participate in discharge planning for members transitioning from acute, long-term, or residential care
  • Conduct audits and support quality improvement initiatives
  • Provide training and mentorship on UM protocols and workflows
  • Maintain relationships with community providers and service organizations
  • Ensure compliance with organizational policies, clinical standards, and federal/state regulations
  • Perform other nursing-related duties as assigned

CHALLENGES
  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS
  • Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state
  • Graduation from an accredited nursing program
  • Minimum 5 years of direct patient care experience
  • Proficiency with Microsoft Office, EHR systems, and UM software
  • Strong clinical knowledge, communication, and organizational skills
  • No suspension, exclusion, or debarment from federal healthcare programs

PREFERRED QUALIFICATIONS
  • 2+ years of utilization review or case management experience in managed care
  • Oregon residency and license
  • Bilingual or translation skills a plus
  • Experience with quality improvement audits and diverse team collaboration
  • Ability to work independently in fast-paced environments
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $85,000- $105,340
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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