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Remote Utilization Management Nurse Jobs in Springfield, IL

Humana

Manager, Care Management

Springfield, IL · Remote

Become a part of our caring community The Manager, Care Management leads teams of nurses, social ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

Humana

Manager, Care Management

Springfield, IL · Remote

Become a part of our caring community The Manager, Care Management leads teams of nurses, social ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

Humana

Manager, Care Management

Springfield, IL · Remote

Become a part of our caring community The Manager, Care Management leads teams of nurses, social ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

micro1 AI

Pharmacovigilance Expert

Springfield, IL · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Working fluency with ICH E2F, ICH E2C(R2), and GVP guidelines, including signal management and ...

micro1 AI

Clinical Pharmacy Technicians

Springfield, IL · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Working fluency with ICH E2F, ICH E2C(R2), and GVP guidelines, including signal management and ...

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All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Springfield, IL

Remote Utilization Management Nurse information

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$41

$68

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

As of Aug 9, 2026, the average hourly pay for remote utilization management nurse in Springfield, IL is $41.91, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

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.

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.
More about Remote Utilization Management Nurse jobs
What are popular job titles related to Remote Utilization Management Nurse jobs in Springfield, IL? For Remote Utilization Management Nurse jobs in Springfield, IL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management Nurse jobs in Springfield, IL look for? The top searched job categories for Remote Utilization Management Nurse jobs in Springfield, IL are:
What cities near Springfield, IL are hiring for Remote Utilization Management Nurse jobs? Cities near Springfield, IL 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 Springfield, IL as of August 2026, with employment types broken down into 67% Full Time, and 33% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,174 per year, or $41.9 per hour.

Senior z/OS Administrator / Systems Programmer (Remote)

DivIHN

Springfield, IL • On-site, Remote

$85K - $115K/yr

Full-time

Posted 23 days ago

Job description

For further inquiries regarding the following opportunity, please contact our Talent Specialist, Abdul at (224) 507-1295 or Saravanakumar at (224) 507-1183 or Ragu at (224) 704 1713 or Justeen at (224) 394-4903
Title: Senior z/OS Administrator / Systems Programmer (Remote)
Location: Remote
Duration: 6 Months
Working Hours: 37.5 hours per week, with 7.5 hours per day.
Initial 2 days onsite visit (Springfield, IL) is required for onboarding purposes; the rest of the engagement will be remote.
Only W2 candidates are eligible for this position. Third-party or C2C candidates will not be considered.
Job Description
Job Summary:
• The Senior z/OS Administrator / Systems Programmer is responsible for the overall administration, maintenance, security, and optimization of the organization's z/OS mainframe environment.
• This role requires deep expertise in z/OS system internals, storage and hardware management, networking, and virtualization.
• The Senior Administrator ensures high availability, reliability, and performance of mission critical mainframe systems while supporting modernization initiatives and maintaining robust operational documentation.
Key Responsibilities:
1. z/OS System Administration:
Install, configure, maintain, and administer z/OS operating systems. Perform performance tuning, system health checks, problem determination, and root cause analysis to ensure stable and efficient system operation.
2. Storage Management:
Manage DASD and tape storage environments, oversee allocation and placement of datasets, perform capacity planning, and implement backup and recovery strategies using DFSMS and related technologies.
3. Hardware Infrastructure Management:
Maintain and support IBM mainframes, storage subsystems, and peripheral hardware. Coordinate and execute hardware upgrades, lifecycle maintenance, and incident remediation.
4. System Security:
Implement and maintain mainframe security controls to safeguard data and system resources. Utilize security tools, monitor access, and ensure compliance with established cybersecurity and audit requirements.
5. Performance Monitoring and Optimization:
Monitor system performance using RMF, WLM, and other tools. Identify performance bottlenecks and implement tuning strategies to enhance resource utilization, throughput, and reliability.
6. z/OS TCP/IP and Networking Administration:
Administer and support all networking components within the z/OS environment, including TCP/IP configuration, network security, connectivity troubleshooting, and performance tuning.
7. z/VM and Virtualization Support:
Install, configure, and maintain z/VM environments. Build, administer, and support virtualized Linux servers running under z/VM, ensuring stable interoperation with z/OS and supporting workloads.
8. Documentation and Knowledge Transfer:
Develop and maintain detailed documentation for system configurations, procedures, standards, and operational policies. Provide guidance, training, and mentorship to junior staff and operational support teams as needed.
Qualifications:
• Bachelor's degree in Computer Science, Information Technology, or equivalent experience.
• More than 10 years of hands on experience as a z/OS administrator or systems programmer in an enterprise environment.
• Expert level knowledge of z/OS internals, subsystems, utilities, and operational best practices.
• Strong proficiency in DASD management, DFSMS, tape management, catalog management, and related storage technologies.
• Solid understanding of IBM mainframe architecture, hardware components, and system integration.
• Experience with performance tools such as RMF, WLM, Omegamon, and similar monitoring solutions.
• Effective communication skills and ability to work both independently and collaboratively.
• Strong analytical and troubleshooting skills with a focus on reliability and operational excellence.
Additional Technical Requirements:
• Deep knowledge of JES2, WLM, SMF, ICSF, DFSMS, ISPF, TSO, 3270 interfaces, TCP/IP, SMP/E, ISH, OMVS, Omegamon, and z/OS Connect.
• Familiarity with third party tools including Syspertec Virtel (browser based 3270 emulator), Rocket TMON (monitoring tool), and Chicago Soft QuickRef (reference tool).
• Experience supporting IBM software such as Tivoli Workload Scheduler, Fault Analyzer, File Manager, zSecure, DB2 Tools, and zLinux.

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