Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...
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Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...
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Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...
North Palm Beach, FL ยท On-site +1
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
North Palm Beach, FL ยท On-site +1
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
Review timely filing guidelines regarding the utilization management process. * Track and follow up ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Review timely filing guidelines regarding the utilization management process. * Track and follow up ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Oak Brook, IL ยท On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... supervisor.
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Oak Brook, IL ยท On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... supervisor.
Location Requirements This position is remote but requires the employee to live within our service ... Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office ...
Location Requirements This position is remote but requires the employee to live within our service ... Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office ...
UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
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UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
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UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
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UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
Draper, UT ยท On-site +1
$60K - $70K/yr
Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health / Utilization Management Who We Are At Row Partners , we're more than a healthcare support organization ...
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Draper, UT ยท On-site +1
$60K - $70K/yr
Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health / Utilization Management Who We Are At Row Partners , we're more than a healthcare support organization ...
Morrisville, NC ยท On-site +1
The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Morrisville, NC ยท On-site +1
The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
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UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
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UTILIZATION MANAGEMENT COORDINATOR Location ... Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ...
Morrisville, NC ยท Remote
The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Morrisville, NC ยท Remote
The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
New York, NY ยท Remote
$29.10 - $62.32/hr
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ... UM Nurse Consultant Fully Remote- WFH Schedule : Tuesday-Saturday 9:30am-6:00pm Position Summary:
New York, NY ยท Remote
$29.10 - $62.32/hr
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ... UM Nurse Consultant Fully Remote- WFH Schedule : Tuesday-Saturday 9:30am-6:00pm Position Summary:
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Pearland, TX ยท On-site +1
$16 - $29/hr
Under the supervision of the Health Service Supervisor, the Utilization Management Representative is primarily responsible for collection of non-clinical data, report generation, health plan ...
Pearland, TX ยท On-site +1
$16 - $29/hr
Under the supervision of the Health Service Supervisor, the Utilization Management Representative is primarily responsible for collection of non-clinical data, report generation, health plan ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
Concord, NC ยท Remote
$35 - $40/hr
Additional duties as requested by supervisor * Maintains knowledge of CMS, State and NCQA ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
| Aspect | Remote Supervisor Utilization Management | Remote Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or supervisor certifications | RN, with clinical review certifications |
| Work Environment | Supervises teams, manages utilization processes remotely | Performs clinical reviews, assesses patient necessity remotely |
| Employer & Industry Usage | Health insurance companies, managed care organizations | Insurance companies, third-party administrators |
| Primary Focus | Overseeing utilization management operations | Conducting clinical utilization reviews |
Remote Supervisor Utilization Management roles focus on overseeing utilization management teams and processes, ensuring compliance and efficiency. In contrast, Remote Utilization Review Nurses primarily perform clinical assessments to determine the necessity of services. Both roles require RN credentials but differ in responsibilities and scope within the utilization management field.

Contractor
Medical, Dental, Vision, Life, Retirement
Posted 28 days ago
Utilization Management Specialist (UM / Utilization Review Nurse) โ Remote
Location: 100% Remote (U.S.) โ Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: MonโFri, 8:00amโ5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00amโ9:00am ET Pay (W2): USD 51.00/H
Job overview
In this role, youโll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. Youโll work fully remote and leverage MCG, medical policy, and regulatory guidelines while collaborating with Medical Directors and internal teams to support timely, accurate authorization decisions.
What youโll do
Required qualifications
Nice to have
System One, and its subsidiaries including Joulรฉ and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
#M-1 #LI-AJ1 Ref: #851-Rockville-S1