... Utilization Managers (RNUM ... These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
... Utilization Managers (RNUM ... These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... The schedule for this role is Tuesday - Saturday (fully remote) Key Responsibilities: * Review and ...
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... The schedule for this role is Tuesday - Saturday (fully remote) Key Responsibilities: * Review and ...
Registered Nurse, Utilization Management
Phoenix, AZ · On-site +1
$89K - $166K/yr
The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. The UM RN ...
Registered Nurse, Utilization Management
Phoenix, AZ · On-site +1
$89K - $166K/yr
The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. The UM RN ...
Utilization Management (UM) Registered Nurse (RN)
Tucson, AZ · On-site +1
$87K - $158K/yr
Summary Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
New
Utilization Management (UM) Registered Nurse (RN)
Tucson, AZ · On-site +1
$87K - $158K/yr
Summary Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization ...
New
We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE ... • Utilization Management, health care cost containment, and Managed Care practices • URAC ...
We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE ... • Utilization Management, health care cost containment, and Managed Care practices • URAC ...
Remote Prior Authorization Pharmacist
Yuma, AZ · Remote
$50 - $60.25/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Yuma, AZ · Remote
$50 - $60.25/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Phoenix, AZ · Remote
$58 - $69.75/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Phoenix, AZ · Remote
$58 - $69.75/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical ...
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical ...
Appeals Pharmacist (Remote)
Phoenix, AZ · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Appeals Pharmacist (Remote)
Phoenix, AZ · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Appeals Pharmacist (Remote)
Yuma, AZ · On-site +1
$49.25 - $60/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Appeals Pharmacist (Remote)
Yuma, AZ · On-site +1
$49.25 - $60/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
... utilization management, case management, appeals and grievances or quality review field (Applies to All Levels) Preferred Education * Bachelor's Degree in Nursing or related field of study (Applies ...
... utilization management, case management, appeals and grievances or quality review field (Applies to All Levels) Preferred Education * Bachelor's Degree in Nursing or related field of study (Applies ...
Health Plan Pharmacist - Remote
Phoenix, AZ · On-site +1
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... drug utilization management. * Directly interfaces with Medicare and/or Medicaid members, and ...
Health Plan Pharmacist - Remote
Phoenix, AZ · On-site +1
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... drug utilization management. * Directly interfaces with Medicare and/or Medicaid members, and ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Scottsdale, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Scottsdale, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Tucson, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Tucson, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Mesa, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Mesa, AZ · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Your work location will be entirely remote . This position does require Arizona residency for ... Must have a working knowledge of care management, case management, hospital and community resources.
Your work location will be entirely remote . This position does require Arizona residency for ... Must have a working knowledge of care management, case management, hospital and community resources.
Utilization Review Nurse
Tempe, AZ · Remote
$35 - $45.94/hr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
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Utilization Review Nurse
Tempe, AZ · Remote
$35 - $45.94/hr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Utilization Review Nurse - Remote
Tempe, AZ · On-site +1
$40 - $45/hr
Experience * 1+ year of utilization review experience in a managed care setting. * 1+ years of clinical experience including at least 1 year of clinical practice in an acute care setting such as ER ...
Utilization Review Nurse - Remote
Tempe, AZ · On-site +1
$40 - $45/hr
Experience * 1+ year of utilization review experience in a managed care setting. * 1+ years of clinical experience including at least 1 year of clinical practice in an acute care setting such as ER ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management activities related to dental care services for members, including appropriateness and medical necessity of ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management activities related to dental care services for members, including appropriateness and medical necessity of ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities related to dental care services for members, including appropriateness and medical necessity of ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities related to dental care services for members, including appropriateness and medical necessity of ...
Remote Utilization Management information
See Arizona salary details
$19.94 - $23.97
2% of jobs
$23.97 - $28
9% of jobs
$30.76 is the 25th percentile. Wages below this are outliers.
$28 - $32.03
21% of jobs
The median wage is $35.30 / hr.
$32.03 - $36.07
23% of jobs
$36.07 - $40.10
13% of jobs
$43.23 is the 75th percentile. Wages above this are outliers.
$40.10 - $44.13
10% of jobs
$44.13 - $48.16
8% of jobs
$48.16 - $52.19
5% of jobs
$52.19 - $56.23
5% of jobs
$56.23 - $60.26
2% of jobs
$60.26 - $64.29
2% of jobs
$19
$39
$64
How much do remote utilization management jobs pay per hour?
How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?
What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?
What is remote utilization management?
What is the difference between Remote Utilization Management vs Remote Case Management?
| Aspect | Remote Utilization Management | Remote Case Management |
|---|---|---|
| Credentials | RN, LPN, or licensed healthcare professionals | RN, LPN, or social workers |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Healthcare providers, insurance, community agencies |
| Industry Usage | Insurance, healthcare, telehealth | Healthcare, social services, insurance |
| Primary Focus | Reviewing medical necessity, authorizations | Coordinating patient care, support services |
Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.
- No Experience Utilization Management Nurse
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- Utilization Review Nurse
- Seasonal Remote Hedis Review Nurse
- Utilization Management
- Remote Prior Authorization Nurse
- Weekend Appeals Nurse Remote
- Medical Review Nurse
- Remote Cvs Utilization Management Nurse
- Contract Utilization Review
- Remote Cigna Utilization Review Nurse
- Remote Navihealth Utilization Review
- Remote Anthem Utilization Review Nurse
- Utilization Review Manager
- Director Optum Utilization Review
- Aetna Utilization Review Nurse
- Remote Supervisor Utilization Management
- Chart Utilization Review
- Flex Schedule Remote Utilization Review

Job description
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation's Active Duty and eligible retirees.
The Nurse will be working remotely Monday through Friday, 8 hours per day.
Requirements
- Bachelors Nursing Degree
- At least one active state nurse license, preferably compact state licensure
- At least 2 years' experience working as an RNUM, preferably in a remote or hybrid environment.
- Possess current certification in either
- Completion of an accredited Certified Professional Utilization Review (CPUR) program
- Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.
--OR--
- Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.
- Highly organized, self-directed worker able to function in a high-volume environment without distractions.
- Strong verbal and written communication skills.
- Proficient level of experience with Microsoft Office applications and strong technical aptitude.
- Must have access to secure, high speed internet.
Company Overview:
Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.
At Spectrum, we utilize over thirty-five years of experience providing optimal solutions for federal agencies that are both innovative and cost-effective. We hold ourselves to the highest standard to ensure successful outcomes for the facilities and healthcare professionals we serve. As a Joint Commission Certified Healthcare Resource, dependability and service are the driving forces of our mission.
EOE / Disability / Veterans
Location : LocationUS-AZ-PhoenixRecruiter : Full Name: First LastJoseph DayDirect phone number314-744-4138Recruiter : Emailjoseph_day@spectrumhealth.comEmployment Type: OTHERAbout Spectrum Healthcare Resources
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Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Saint Louis, MO, US
Year founded
1988