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Remote Um Nurse Jobs (NOW HIRING)

Humana

Utilization Management Nurse

As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well ... This is a remote position supporting members and providers throughout Illinois with periodic in ...

Humana

Utilization Management Nurse

As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well ... This is a remote position supporting members and providers throughout Illinois with periodic in ...

Humana

Utilization Management Nurse

Reports to the UM Nurse, Manager The Utilization Management Nurse 2 uses clinical knowledge ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

Utilization Management Nurse

Reports to the UM Nurse, Manager The Utilization Management Nurse 2 uses clinical knowledge ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Appworks

Utilization Management Registered Nurse

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented ... This is a fully remote opportunity requiring discipline, accuracy, and effective collaboration ...

Humana

Utilization Management Nurse

Reports to the UM Nurse, Manager The Utilization Management Nurse 2 uses clinical knowledge ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

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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 Sep 2, 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 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.

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.

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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?

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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 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

Outpatient UM Clinician

MedPOINT Management

Sherman Oaks, CA • Remote

$36 - $48/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 22 days ago

Job description

Benefits:
  • 401(k)
  • 401(k) matching
  • Company parties
  • Dental insurance
  • Employee discounts
  • Free food & snacks
  • Health insurance
  • Opportunity for advancement
  • Paid time off
  • Parental leave
  • Savings bank
  • Training & development
  • Vision insurance
  • Wellness resources

About the Role:
Join MedPOINT Management as an Outpatient UM Clinician in Sherman Oaks, CA, where you will play a vital role in ensuring quality care for our patients. Be part of a dynamic team dedicated to improving patient outcomes through effective utilization management.
Responsibilities:
  • Conduct utilization reviews for outpatient services to ensure compliance with standards.
  • Collaborate with healthcare providers to assess patient needs and treatment plans.
  • Document and track patient progress and treatment outcomes.
  • Communicate with insurance companies regarding authorizations and appeals.
  • Provide education and support to patients and families regarding care options.
  • Participate in quality improvement initiatives to enhance service delivery.
  • Stay updated on industry regulations and best practices in utilization management.
  • Assist in training and mentoring new staff on UM processes.
Requirements:
  • Licensed clinician with a background in nursing, social work, or a related field.
  • Minimum of 2 years of experience in utilization management or case management.
  • Strong understanding of healthcare regulations and insurance processes.
  • Excellent communication and interpersonal skills.
  • Ability to work collaboratively in a fast-paced environment.
  • Proficient in electronic health records and documentation practices.
  • Detail-oriented with strong analytical and problem-solving skills.
  • Commitment to patient-centered care and quality improvement.
About Us:
MedPOINT Management has been a leader in outpatient management solutions for over a decade. Our commitment to quality care and patient satisfaction has earned us the trust of both our clients and employees, creating a supportive and rewarding work environment.

This is a remote position.