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Remote Utilization Management Nurse Jobs in Dillon, SC

ABB

Utility Sales Support

Bennettsville, SC · Remote

$17.75 - $23.25/hr

... management with local business units and other ABB groups. Additionally, the role will expand to ... While this is a remote position, candidates must be located in the United States. You will be ...

All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Dillon, SC

Remote Utilization Management Nurse information

See Dillon, SC salary details

$19

$38

$63

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

As of Aug 27, 2026, the average hourly pay for remote utilization management nurse in Dillon, SC is $38.74, according to ZipRecruiter salary data. Most workers in this role earn between $30.62 and $44.47 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.

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What job categories do people searching Remote Utilization Management Nurse jobs in Dillon, SC look for?

The top searched job categories for Remote Utilization Management Nurse jobs in Dillon, SC are:

What cities near Dillon, SC are hiring for Remote Utilization Management Nurse jobs?

Cities near Dillon, SC with the most Remote Utilization Management Nurse job openings:

Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Dillon, SC as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 2% Contract, and 1% Nights. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $80,570 per year, or $38.7 per hour.

Care Transitions Care Manager (Southern)

Lumberton, NC • Remote

TRILLIUM HEALTH RESOURCES
501 - 1,000 employees
Learn more about TRILLIUM HEALTH RESOURCESexternal

$56K - $68K/yr

Full-time

Medical, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Pay Plan Title: Care Transitions Care Manager

Working Title: Care Transitions Care Manager

FLSA Status: Non-Exempt

Posting Salary Range: $56,270 - $68,428

Office Location: Remote in North Carolina and within 75 miles of Trillium’s Southern region. (See requirements section for included counties)


POSTING DETAILS:


Make an Impact


Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.


Why Work for Us? 


Trillium believes that empowering others begins with supporting our team. We offer our employees:


  • A collaborative, mission-driven work environment
  • Competitive benefits and work-from-home options for most positions
  • Opportunities for professional growth in a diverse inclusive culture


Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.


If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!


What We’re Looking For


Trillium Health Resources has a career opening for a Care Transitions Care Manager to join our team! The Care Transitions Care Manager provides comprehensive care coordination to support individuals transitioning between care settings and maintaining stability over time. The role assesses needs, develops care plans, and coordinates services across providers and community resources to promote continuity of care and long-term outcomes. 


On a typical day, you might:


  • Manage ongoing care for assigned individuals to support continuity and stability across services and settings.
  • Develop and maintain comprehensive care plans that address medical, behavioral, and social needs over time.
  • Coordinate services across providers and community resources to support long-term care management.
  • Monitor overall progress toward care goals and adjust care plans based on changes in needs.
  • Engage individuals and families to support sustained participation in services and care plans. 


Employee Benefits:


Trillium knows that work/life balance is essential. That’s why we offer:


  • Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
  • Work-from-home options available for most positions
  • Health Insurance with no premium for employee coverage
  • Flexible Spending Accounts
  • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
  • NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies


Qualifications


Required:

  • Must meet QP status: 
    • Fully licensed by the NC governing board regulating Human Services professions; OR 
    • Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served. OR 
    • A graduate of a college or university with a Master’s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; OR 
    • A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling; OR 
    • A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling. 
    • Additionally, If serving members with LTSS needs, the care manager, must meet the minimum QP requirements defined above (A-D) and shall additionally have at a minimum two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience. This experience may be concurrent with the years of experience required to become a Qualified Professional.
  • License and/or certification may be accepted as noted above.
  • Must have a valid driver’s license.
  • Must reside in North Carolina and within 75 miles of Trillium’s Southern Region. Counties included: Bladen, Brunswick, Columbus, Hoke, Lee, Moore, New Hanover, Robeson, and Scotland. 
  • Must be able to travel within catchment as required.


Preferred:

  • Degree in Human Services.


Deadline for Application: Thursday August 27, 2026, at 11:59PM


How to Apply


To be considered, submit your application and resume through our ADP Career Center. Your resume must include:


  • Employer name, dates of service (month/year), average hours worked per week, and essential job duties
  • Education details (degree type, date awarded, institution, field of study)
  • Licensure/certification information, if applicable


After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.


Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.


Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.


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