Reno, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Reno, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Reno, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Reno, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Sparks, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Sparks, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Sparks, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Sparks, NV · Remote
$30.50 - $59.47/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... At least 2 years clinical nursing experience, including at least 1 year of utilization review ...
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
New
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
New
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
New
Carson City, NV · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
New
Reno, NV · Remote
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Quick apply
Reno, NV · Remote
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Reno, NV · Remote
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Reno, NV · Remote
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Reno, NV · On-site +1
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Reno, NV · On-site +1
Promote patient health through education on preventive care and self-management strategies ... Strong experience in remote roles, showcasing proficiency with technology and digital communication ...
Reno, NV · Remote
$25 - $26/hr
In this role, you'll be a key contributor to the management and delivery of our care program ... or any Nursing license * 2+ years of experience in patient-facing or customer-facing roles
Reno, NV · Remote
$25 - $26/hr
In this role, you'll be a key contributor to the management and delivery of our care program ... or any Nursing license * 2+ years of experience in patient-facing or customer-facing roles
Be Seen First
... nurses to deliver RPM and/or CCM programs. This is a fully remote, phone- and computer-based position focused on patient outreach and care coordination. Key Responsibilities * Manage a panel of up to ...
Quick apply
Be Seen First
... nurses to deliver RPM and/or CCM programs. This is a fully remote, phone- and computer-based position focused on patient outreach and care coordination. Key Responsibilities * Manage a panel of up to ...
Be Seen First
... LVN) to join our growing virtual care team at 1bios. In this fully remote role, you will work directly with patients to help manage chronic conditions and improve health outcomes -- all from home ...
Quick apply
Be Seen First
... LVN) to join our growing virtual care team at 1bios. In this fully remote role, you will work directly with patients to help manage chronic conditions and improve health outcomes -- all from home ...
Sparks, NV · Remote
... nurses--to provide supplemental life insurance benefits that help protect their families. As we ... Be sure to highlight any leadership or management experience.
Sparks, NV · Remote
... nurses--to provide supplemental life insurance benefits that help protect their families. As we ... Be sure to highlight any leadership or management experience.
... nurses--to provide supplemental life insurance benefits that help protect their families. As we ... Be sure to highlight any leadership or management experience.
... nurses--to provide supplemental life insurance benefits that help protect their families. As we ... Be sure to highlight any leadership or management experience.
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Reno, NV · On-site +1
$34.67 - $52.01/hr
... patient care, resource utilization, and seamless patient flow. This role is challenged with ... transfers, managing virtual care, and ensuring smooth patient flow across Renown Health. • ...
Truckee, CA · On-site +1
$110 - $130/hr
As a Registered Nurse with Premier Home Health Providers, you will play a key part in ensuring the ... utilization and flag potential financial risks or underutilization to clinical management.
Truckee, CA · On-site +1
$110 - $130/hr
As a Registered Nurse with Premier Home Health Providers, you will play a key part in ensuring the ... utilization and flag potential financial risks or underutilization to clinical management.
$21.33 - $25.65
2% of jobs
$25.65 - $29.96
9% of jobs
$32.91 is the 25th percentile. Wages below this are outliers.
$29.96 - $34.27
21% of jobs
The median wage is $37.77 / hr.
$34.27 - $38.59
23% of jobs
$38.59 - $42.90
13% of jobs
$46.26 is the 75th percentile. Wages above this are outliers.
$42.90 - $47.22
10% of jobs
$47.22 - $51.53
8% of jobs
$51.53 - $55.85
5% of jobs
$55.85 - $60.16
5% of jobs
$60.16 - $64.47
2% of jobs
$64.47 - $68.79
2% of jobs
$21
$42
$68
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.
| Aspect | Remote Utilization Management Nurse | Remote Case Manager |
|---|---|---|
| Credentials | RN license, certifications like CCM or ANCC | RN license, certifications like CCM or similar |
| Work Environment | Healthcare organizations, insurance companies, telehealth | Insurance companies, healthcare providers, telehealth |
| Job Focus | Reviewing medical necessity, authorizations, and utilization | Coordinating 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.
$30.50 - $59.47/hr
Full-time
Posted 19 days ago
8.0
Based on 191 frontline employees who took The Breakroom Quiz
147th of 258 rated insurance
Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.
Pay Range: $30.5 - $59.47 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980
