Utilization Review Nurse
Plano, TX · Remote
Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ... Counties). POSITION: 6-month assignment
Plano, TX · Remote
Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ... Counties). POSITION: 6-month assignment
Plano, TX · Remote
Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ... Counties). POSITION: 6-month assignment
Seattle, WA · Remote
$74K - $115K/yr
This position is available fully remote in Washington state. Who we are Community Health Plan of ... About the Role The Level I Utilization Management Clinician performs utilization review for medical ...
Seattle, WA · Remote
$74K - $115K/yr
This position is available fully remote in Washington state. Who we are Community Health Plan of ... About the Role The Level I Utilization Management Clinician performs utilization review for medical ...
This position is available fully remote in Washington state. Who we are Community Health Plan of ... About the Role The Level I Utilization Management Clinician performs utilization review for medical ...
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This position is available fully remote in Washington state. Who we are Community Health Plan of ... About the Role The Level I Utilization Management Clinician performs utilization review for medical ...
The Utilization Management Coordinator reports to the Director of Claims. This position is ... This is a fully remote position. * If work is performed offsite, location must be HIPAA compliant.
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The Utilization Management Coordinator reports to the Director of Claims. This position is ... This is a fully remote position. * If work is performed offsite, location must be HIPAA compliant.
Monterey Park, CA · Remote
$275K - $325K/yr
Provide physician oversight and final determination for outpatient utilization management ... This is a remote position. The position will operate in Pacific Standard Time. * The national ...
Monterey Park, CA · Remote
$275K - $325K/yr
Provide physician oversight and final determination for outpatient utilization management ... This is a remote position. The position will operate in Pacific Standard Time. * The national ...
Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality ...
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Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality ...
Monterey Park, CA · Remote
$275K - $315K/yr
Provide physician oversight and final determination for outpatient utilization management ... This is a remote position. The position will operate in Pacific Standard Time. * The national ...
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Monterey Park, CA · Remote
$275K - $315K/yr
Provide physician oversight and final determination for outpatient utilization management ... This is a remote position. The position will operate in Pacific Standard Time. * The national ...
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
Summary Utilization Management Nurse open to either a Sun-Thursday or Tuesday-Saturday shift The ... This is primarily a remote telephonic position with normal business day hours, with one weekend day ...
Summary Utilization Management Nurse open to either a Sun-Thursday or Tuesday-Saturday shift The ... This is primarily a remote telephonic position with normal business day hours, with one weekend day ...
Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location: This is a remote position ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
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Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location: This is a remote position ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Tacoma, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Tacoma, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Coeur D Alene, ID · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Coeur D Alene, ID · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Morrisville, NC · On-site +1
$68K - $86K/yr
The Utilization Management (UM) Clinical Specialist RN for physical health (PH) independently ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Morrisville, NC · On-site +1
$68K - $86K/yr
The Utilization Management (UM) Clinical Specialist RN for physical health (PH) independently ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Morrisville, NC · Remote
$68K - $86K/yr
The Utilization Management (UM) Clinical Specialist RN for physical health (PH) independently ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Morrisville, NC · Remote
$68K - $86K/yr
The Utilization Management (UM) Clinical Specialist RN for physical health (PH) independently ... Perform other related duties as required by the immediate supervisor or other designated Alliance ...
Salt Lake City, UT · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Salt Lake City, UT · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Burlington, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Burlington, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas ... Health plan utilization management * Medicare and Medicaid rules and regulations and health plan ...
Renton, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Renton, WA · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Beaverton, OR · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
Beaverton, OR · Remote
$25.90 - $37.30/hr
Utilization Management Inpatient Clinical SpecialistWork from home within Washington, Oregon, Idaho ... for all work. #LI-Remote Pay ranges vary based on the candidate's work location. The expected ...
$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.

Performs initial and concurrent review activities and discharge care coordination to determine the efficiency, effectiveness, and quality of medical and surgical services.
Acts as a liaison between providers and medical and network management divisions.
Collects clinical and non-clinical data and verifies eligibility in accordance with contract guidelines.
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***
JOB DESCRIPTION:
RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
JOB RESPONSIBILITIES:
JOB QUALIFICATIONS (Required):
JOB QUALIFICATIONS (Preferred):
LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin Counties).
POSITION: 6-month assignment
Sourced by ZipRecruiter
Professional, scientific, and technical services
1 - 10 Employees
Plano, TX, US
2002