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Remote Supervisor Utilization Management Jobs (NOW HIRING)

Dignity Health Management Services

$57.37 - $85.33/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... Previous inpatient Utilization Management (UM) experience strongly preferred * Experience with MCG ...

Intus Care

Contract Utilization Management Nurse

$42/hr

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 ...

INTUS INC

Contract Utilization Management Nurse

$42/hr

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 ...

Intus, Inc

Contract Utilization Management Nurse

$42/hr

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 ...

CommonSpirit Health

Utilization Management RN

$57.37 - $85.33/hr

Utilization Management RN Inspired by faith. Driven by innovation. Powered by humankindness ... As a remote employee, we will provide you with the equipment needed to work from home, including a ...

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team where your clinical ... Remote/office-based environment with extensive computer and telephone use * Sedentary role ...

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Remote Supervisor Utilization Management information

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$39K

$91K

$167.5K

How much do remote supervisor utilization management jobs pay per year?

As of Aug 10, 2026, the average yearly pay for remote supervisor utilization management in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What is the difference between Remote Supervisor Utilization Management vs Remote Utilization Review Nurse?

AspectRemote Supervisor Utilization ManagementRemote Utilization Review Nurse
CredentialsRN, often with management or supervisor certificationsRN, with clinical review certifications
Work EnvironmentSupervises teams, manages utilization processes remotelyPerforms clinical reviews, assesses patient necessity remotely
Employer & Industry UsageHealth insurance companies, managed care organizationsInsurance companies, third-party administrators
Primary FocusOverseeing utilization management operationsConducting 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.

More about Remote Supervisor Utilization Management jobs
What cities are hiring for Remote Supervisor Utilization Management jobs? Cities with the most Remote Supervisor Utilization Management job openings:
What are the most commonly searched types of Supervisor Utilization Management jobs? The most popular types of Supervisor Utilization Management jobs are:
What states have the most Remote Supervisor Utilization Management jobs? States with the most job openings for Remote Supervisor Utilization Management jobs include:
What job categories do people searching Remote Supervisor Utilization Management jobs look for? The top searched job categories for Remote Supervisor Utilization Management jobs are:
Remote Supervisor Utilization Management jobs near you
Infographic showing various Remote Supervisor Utilization Management job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 19 days ago

Job description

Utilization Management Specialist (UM / Utilization Review Nurse) — Remote

Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: Mon–Fri, 8:00am–5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00am–9:00am ET Pay (W2): USD 51.00/H

Job overview

In this role, you’ll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. You’ll 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 you’ll do

  • Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health).
  • Make medical necessity / appropriateness determinations and support prior authorizations.
  • Use clinical criteria and policy resources daily (including MCG / Milliman Care Guidelines).
  • Review clinical documentation, benefits, and mandates to ensure services align with coverage and guidelines.
  • Research diagnoses/treatments and high-cost services; summarize findings and escalate complex cases to Medical Directors as needed.
  • Collaborate with internal partners and providers to support benefit application and appropriate levels/settings of care.
  • Maintain accurate documentation and protect PHI while managing a busy caseload.

Required qualifications

  • Active RN or LPN license (RN preferred) — Maryland compact/eligibility required
  • 5+ years clinical nursing experience
  • 2+ years care management / utilization management experience
  • MCG experience (required)
  • Experience supporting Commercial/FEP/Medicare lines of business and applying medical policy/regulatory standards
  • Strong critical thinking, written communication, and ability to work independently in a remote setting
  • Comfortable with web-based tools + Microsoft Office (Word/Excel/PowerPoint)
  • Guiding Care and FACETS (required)

Nice to have

  • Critical Care or ER clinical background
  • Experience with LCD/NCD, Medicare guidelines, ASAM, or other authorization criteria sets

System One, and its subsidiaries including Joulé 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