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Remote Supervisor Utilization Management Jobs (NOW HIRING)

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 ...

Humana

Utilization Management Nurse

Reporting to the Manager, Utilization Management Nursing, the Part C Grievance & Appeals (G&A ... This is a remote position. * This role is responsible for overseeing weekend workflow, monitoring ...

Humana

Utilization Management Nurse

Reporting to the Manager, Utilization Management Nursing, the Part C Grievance & Appeals (G&A ... This is a remote position. * This role is responsible for overseeing weekend workflow, monitoring ...

Humana, Inc.

Utilization Management Nurse

Reporting to the Manager, Utilization Management Nursing, the Part C Grievance & Appeals (G&A ... This is a remote position. * This role is responsible for overseeing weekend workflow, monitoring ...

Corrohealth

Coordinator, Utilization Management

This is a REMOTE position within US only. About this position: Title: Coordinator, Utilization ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CorroHealth

Coordinator, Utilization Management

This is a REMOTE position within US only. About this position: Title: Coordinator, Utilization ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

University of Kentucky

Utilization Management Reviewer Requisition Number: R-000002878 Department Name ... Supervisor, Utilization Review Work Location: UK Chandler Hospital, Pavilion A Grade Level: 11 Type ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... Experience working in a fully remote, metrics-focused role * Experience as an MDS Coordinator or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... Experience working in a fully remote, metrics-focused role * Experience as an MDS Coordinator or ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... Experience working in a fully remote, metrics-focused role * Experience as an MDS Coordinator or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

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Remote Supervisor Utilization Management information

See salary details

$39K

$91K

$167.5K

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

As of Sep 4, 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

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Cities with the most Remote Supervisor Utilization Management job openings:

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What states have the most Remote Supervisor Utilization Management jobs?

States with the most job openings for Remote Supervisor Utilization Management jobs include:

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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 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Contract Utilization Management Nurse

Intus, Inc

Remote

$42/hr

Full-time

Re-posted 8 days ago

Job description

About IntusCare
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.
Role Overview
The Contract 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
  • 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.
    • In accordance with accepted medical standards and consistent with the participant care needs including level of care and advanced care planning principles.
  • Active involvement in various aspects of the utilization management process, including:
    • Concurrent review of all hospital admissions (observation and inpatient) with the Interdisciplinary Team driving efficient and timely transitions of care, retrospective review of inpatient admissions under 48 hours, and claims submitted inconsistent with the service authorization.
    • Concurrent review of all subacute and SNF admissions with the Interdisciplinary Team driving efficient and timely discharge plans and transitions of care.
    • Coordination and review of all other services delivered by contracted providers and identified by the PACE program assuring consistency with Interdisciplinary Team service authorization, care plans, and PCP coordination decisions.
  • Employ effective use of knowledge, critical thinking, and skills to:
    • Advocate quality care and enhanced quality of life
    • Advocate decreased hospital stay when appropriate
    • Maintain accurate records of all patient related interactions
  • Appeal Management - In cases of claim rejection, the IntusCare Utilization Management Nurse will lead the provider appeals process. Responsibilities Include:
    • Comprehensive review of provider network appeals.
    • Collaboration with the PACE Program's Medical Director to review and respond to appeal requests, ensuring issuance of a written determination consistent with the PACE program policies.

Qualifications
  • 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.
  • Excellent communication and leadership abilities, capable of motivating and guiding teams toward timely and efficient care management strategies

What We Offer
  • 1 year contract with the possibility of extension
  • A chance to be a part of a trailblazing team in healthcare technology.
  • A collaborative, inclusive, and dynamic work environment.

Compensation: The range for this role is $42.00/Hour.
Work location: This is a fully remote role based in the United States.
Sponsorship: This position is not eligible for sponsorship.

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