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Remote Utilization Management Nurse Jobs in Nebraska

CHI Health

Utilization Review RN

Omaha, NE · On-site +1

$33.51 - $48.58/hr

Job Summary and Responsibilities As our Utilization Review RN, you will play a pivotal role in ... Your expertise in managed care environments and CMS standards will be essential in navigating payer ...

New

DaVita

Provide comfort case management for patients where palliative care is not available or whenpatients ... Current RN License isrequired,BSN preferred. * Current Cardiopulmonary Resuscitation (CPR) or Basic ...

CSAA

$109K - $110K/yr

... Management - Remote Requisition Number R7944 Sr. Manager, Program Management - Remote (Open ... Optimize the allocation and utilization of resources across multiple programs, ensuring efficiency ...

New

Harris

$10/hr

Improve revenue by creating billable Care Management episodes, increasing visits for management of ... Graduates from accredited Schools of Nursing (LPN, LVN, RN, BSN, etc.) * Current COMPACT license to ...

Aviary

$20 - $30/hr

... managing their recovery post-cardiac event. The Remote Exercise Physiologist will work closely with a multidisciplinary team including nurses, exercise physiologists, and dietitians to provide ...

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How much do remote utilization management nurse jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for remote utilization management nurse in Nebraska is $40.31, according to ZipRecruiter salary data. Most workers in this role earn between $31.88 and $46.30 per hour, depending on experience, location, and employer.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.

What is the difference between Remote Utilization Management Nurse vs Remote Case Manager?

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

More about Remote Utilization Management Nurse jobs

What are the most commonly searched types of Utilization Management Nurse jobs in Nebraska?

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What are popular job titles related to Remote Utilization Management Nurse jobs in Nebraska?

For Remote Utilization Management Nurse jobs in Nebraska, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management Nurse jobs in Nebraska look for?

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What cities in Nebraska are hiring for Remote Utilization Management Nurse jobs?

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Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Nebraska as of August 2026, with employment types broken down into 3% As Needed, 81% Full Time, 13% Part Time, and 3% Contract. Highlights an 100% Remote job distribution, with an average salary of $83,852 per year, or $40.3 per hour.

Utilization Review RN

Omaha, NE • On-site, Remote

CHI Health
Health Care and Social Assistance • 10K+ employees

6.5

Company rating: 6.5 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

609th of 895 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about CHI Healthexternal

$33.51 - $48.58/hr

Other

Posted 3 days ago

New

Job description

Where You'll Work
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.
Job Summary and Responsibilities
As our Utilization Review RN, you will play a pivotal role in optimizing healthcare delivery by ensuring medical necessity and appropriate patient status throughout the hospitalization journey. You will serve as a clinical expert, collaborating with attending physicians, consultants, and care coordination teams to apply evidence-based guidelines-such as MCG or InterQual-to facilitate seamless patient care transitions. Your expertise in managed care environments and CMS standards will be essential in navigating payer requirements, preventing claim denials, and upholding the high-quality standards of our health system.
Every day you will perform comprehensive admission and concurrent stay reviews to validate the clinical necessity of care, ensuring every patient interaction is documented with precision. You will engage in proactive denial prevention strategies, coordinate peer-to-peer reviews between providers and insurance payers, and communicate critical status updates to stakeholders. By balancing clinical data analysis with professional communication, you will ensure our facility remains compliant with regulatory agencies and Joint Commission standards while supporting the overall progression of care for our diverse patient population.
To be successful in this role, you will hold an active Registered Nurse (RN) license in NE or IA and possess at least two years of acute hospital clinical experience. We are seeking a detail-oriented professional with a strong grasp of utilization management programs, excellent time management skills, and the ability to thrive in a fast-paced, self-directed environment. Proficiency in clinical criteria application, a collaborative mindset, and a commitment to our organizational mission and core values are required to succeed as a key member of our utilization management team.
Job Requirements
Required
  • Graduate of an accredited school of nursing and 1-3 years Minimum two (2) years of acute hospital clinical experience , upon hire or
  • Masters Other In Case Management or Nursing field in lieu of 1 year experience., upon hire and
  • Registered Nurse: NE, upon hire or
  • Registered Nurse: IA, upon hire and

Preferred
  • Bachelors Of Science BSN in Nursing or related healthcare field and 4-6 years Five years of nursing experience, upon hire
  • Certified Case Manager, upon hire and
  • Accredited Case Manager, upon hire

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