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Remote Um Nurse Jobs (NOW HIRING)

Enterprise Engineering

UM Nurse

OR · Remote

UM Nurse (California License) - Must be licensed in California- Remote Opportunity Work Hrs : (8am - 5pm PDT) would like to include evening, weekend and holiday coverage. 3 month contract plus Remote ...

RIT Solutions

UM Nurse (California License)

UM Nurse (California License) - Must Be Licensed In California- Remote Opportunity The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating ...

Astrana Health, Inc.

UM Review Nurse

$34 - $47/hr

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · On-site +1

$34 - $47/hr

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... The UM Nurse collaborates with interdisciplinary teams and community providers to promote ...

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... The UM Nurse collaborates with interdisciplinary teams and community providers to promote ...

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR ... The UM Nurse collaborates with interdisciplinary teams and community providers to promote ...

Vytwo

Epic Tapestry UM Analyst

Prosper, TX · Remote

$50/hr

^Remote Work **Must be authorized to work in USA. We are seeking an experienced Epic Tapestry ... Clinical background (e.g., RN) or strong experience partnering with clinical reviewers and Medical ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... The UM Nurse collaborates with interdisciplinary teams and community providers to promote ...

Dignity Health Medical Foundation

$53.46 - $79.52/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... Ensures UM Physicians are provided the relevant information needed to accurately review a referral.

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Remote Um Nurse information

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$39K

$89.5K

$163K

How much do remote um nurse jobs pay per year?

As of Aug 11, 2026, the average yearly pay for remote um nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote UM Nurse?

To excel as a Remote UM Nurse, you need an active RN license, strong clinical assessment skills, and experience in utilization management or case review. Familiarity with utilization management software, electronic health records (EHRs), and medical coding systems such as ICD-10 and CPT is typically required, along with certifications like CCM or CPUR being advantageous. Exceptional organizational abilities, clear written/verbal communication, and self-motivation are critical soft skills for success in this autonomous, remote position. These competencies allow Remote UM Nurses to accurately evaluate medical necessity, efficiently manage case loads, and collaborate effectively with healthcare teams on care decisions.

What are some common challenges faced by Remote UM Nurses and how are they addressed?

Remote UM Nurses often encounter challenges such as managing high case volumes, interpreting complex medical documentation, and coordinating care across various providers without direct patient contact. These challenges are typically addressed through strong organizational skills, continuous professional development, and efficient use of digital tools for communication and case management. Many employers provide thorough onboarding, standardized protocols, and ongoing support from team leads and peers to help UM Nurses excel. Staying current with changing guidelines and participating in regular team meetings are also essential strategies for success in this role.

What is a Remote UM Nurse?

A Remote Utilization Management (UM) Nurse reviews medical records and authorization requests to ensure that healthcare services are medically necessary and cost-effective. They work from home, using clinical guidelines and insurance policies to determine approvals or denials. Their role helps balance quality patient care with cost efficiency by coordinating with healthcare providers and insurance companies.

More about Remote Um Nurse jobs
What cities are hiring for Remote Um Nurse jobs? Cities with the most Remote Um Nurse job openings:
What states have the most Remote Um Nurse jobs? States with the most job openings for Remote Um Nurse jobs include:
What job categories do people searching Remote Um Nurse jobs look for? The top searched job categories for Remote Um Nurse jobs are:
Remote Um Nurse jobs near you
Infographic showing various Remote Um Nurse job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 58% Full Time, 16% Part Time, and 23% Contract. Highlights an 98% Physical, and 2% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

UM Nurse

Enterprise Engineering

OR • Remote

Contractor

Re-posted yesterday

Job description

Job Title: UM Nurse (California License) – Must be licensed in California- Remote Opportunity

Work Hrs: (8am – 5pm PDT) would like to include evening, weekend and holiday coverage.

3 month contract plus

Remote Opportunity


Ready to Hire ASAP.

JD: The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure members receive the services and resources required to meet desired health and social outcomes. The UM Nurse is responsible for providing patient-centered care across the care continuum.

This position is not patient facing, they will be reviewing patient records and providing recommendations.

Role and Responsibilities

  • Perform prospective, retrospective, or concurrent medical necessity reviews for an assigned panel of members
  • Review cases for medical necessity and apply the appropriate clinical criteria; to include, but not limited to Medicare criteria, Medicaid/Medi-cal criteria, Interqual, Milliman, or Health Plan specific guidelines
  • Collaborate with the Medical Director to ensure the integrity of adverse determination notices based on the quality standards for adverse determinations
  • Ensure discharge planning is timely and appropriately communicated to the transition of care teams, when applicable.
  • Meet or exceed productivity targets set forth
  • Serve as a resource to non-clinical team members when applicable

Qualifications and Education Requirements

  • Associate's degree in Nursing, preferred
  • Minimum 2 years of experience in medical management clinical functions.
  • UM Reviewer in patient experience required
  • Working knowledge of MCG, InterQual, and NCQA standards
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About Enterprise Engineering

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Our team is composed of architects and application experts skilled in Open Banking and Digital Transformation. Financial Data is in our DNA, and for years we have been helping our clients design, develop and deploy modern, innovative solutions bringing the greatest value to our clients and their business. If you have a constant thirst for emerging technology and a passion for pushing the needle towards excellence, you might be just like us. Life at EEI At EEI, our cultural pillars have been and continue to be a collaborative work environment that cultivates teamwork, mentoring, knowledge sharing, individual and team development. We are a humble bunch that cares for the personal and professional wellbeing of our clients and coworkers and support a healthy work life balance. Do you share our values?

Industry

It services

Company size

51 - 200 Employees

Headquarters location

NY, US

Year founded

1995

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