Remote Utilization Review Jobs in Minnesota (NOW HIRING)

RN Manager of Utilization Management
Robbinsdale, MN
Posting Date: Jun 25 2026
Requisition Number: 513885
Why North Memorial Health?
At North Memorial Health, you're part of an inclusive health team that is rooted in our values: Advocate Courageously, Rally Together, Respect Uniqueness and Create Impact. Empathy and care are at the heart of North's culture which is designed to actively support each team member's wellbeing and growth. Our strength lies in our diversity, and we embrace the unique contributions and experiences of each person. Together, we empower patients to achieve their best health.
Our health system encompasses two hospital locations in Robbinsdale and Maple Grove as well as a network of 23 clinics which includes 13 primary clinics, 6 specialty clinics, 4 urgent care/urgency centers and emergency care offerings covering five counties. Our Robbinsdale Hospital, established in 1954, is a 385-bed facility recognized as the top Level 1 Trauma center for 25 years, as well as serving as a Level II pediatric trauma center. Our Maple Grove Hospital was established in 2009, is a 134-bed facility recognized as a top hospital in the state for Women and Children Care, with a Level III NICU, and is the largest Family Birth Center in the state (~5,000 deliveries per year and over 60,000 babies delivered). Both have been named to the 2022 Fortune/Merative 100 Top Hospitals® list, 2023 Women's Choice Award Best Hospitals list.
Benefits the North Way!
As North Memorial Health is a non-profit organization you are eligible for the Public Student Loan Forgiveness program. Most part-time and all full-time positions are eligible for benefits.

• Health & Welfare Benefit Packages
• 401k Retirement Match or Pension Plan, based on workgroup eligibility
• Generous Paid Time Off (PTO) Plans
• Adoption Reimbursement up to $3000 per child
• Child Care Discount Program with New Horizon 10% off weekly childcare tuition
• Education/Tuition Reimbursement
• 24/7 Fitness Center Access for all benefit eligible team members

Commitment to Diversity, Equity & Inclusion
At North Memorial Health we recognize that the strength of our team lies in our diversity and make every effort to embrace the unique contributions and experiences of each person on our team. We strive to ensure that everyone feels like they are a valuable part of our community, with initiatives that reinforce our belief in diversity, equity, and inclusivity, to promote a workforce that enables authenticity, as we want to be our best when providing effective services to our patients. We acknowledge and celebrate the unique traditions, backgrounds, languages, beliefs, and customs of our community, and want everyone to feel welcome. Through our DE&I initiatives we hope to dispel myths, assumptions, and acts of implicit bias.
About this position
The Utilization Management Manager helps develop and advance the strategic and tactical utilization review goals of NMH. The Manager manages the NMH System Utilization Management program and staff, including services provided at North Memorial Health Hospital and Maple Grove Hospital. The Utilization Management program includes processes for determining insurance authorization, medical necessity, patient status management and payor denials/appeals for medical necessity.
Requirements
Education
• Four-year nursing degree required.
Experience
• Registered Nurse with a minimum of 4 years clinical experience in an acute hospital setting required.
• Minimum of 5 years of utilization management experience required.
• Familiar with State and Federal standards/requirements.
• Knowledgeable about third party payer source criteria for medical necessity.
• Organized and able to meet deadlines consistently.
• Experienced in team and collaborative approaches to management. Ability to work with various individuals across the organization to facilitate change and build interdepartmental cooperation.
• Excellent written and verbal communication skills.
Licensure/Certification
The North Memorial Health System is dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role, but your past experience doesn't perfectly align with every qualification listed, we encourage you to apply anyway. You may still be the right candidate for this or other roles.
Work Group: Non Contract
Hours per two week pay period: 80
Shift: Days 8 hours
Weekend Requirement: None
Call Requirement: None
Remote or On-site: Hybrid Remote- Must live in MN or WI
FLSA Status: Exempt
Benefit Eligibility: Health insurance benefits are available for this position. North Memorial Health offers multiple health plans based on work group eligibility.
Salary Range: L12 ($52.46 - $81.30), based on experience
Shift Differential: Compensation may include shift differential pay depending on the position and shift worked.
STI Bonus Eligible: True 15%
Employment Sponsorship: Applicants must be currently authorized to work in the United States on a full-time basis. Work visa sponsorship is not available for this position
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EEO/AA STATEMENT
North Memorial Health is an equal employment and affirmative action employer. North Memorial Health does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status. North Memorial Health provides reasonable accommodation to disabled applicants and employees and takes affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to protected class status. If you believe that you have been treated in a way that does not conform to these statements, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com. If you need a reasonable accommodation, due to a disability, or to assist with the application process, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com.
INSPECTION OF AAP
North Memorial Health is a Federal government contractor or subcontractor.
As a part of our obligations under law, we must develop a written Affirmative Action Program for Individuals with Disabilities and Protected Veterans, as specified by law (AAP).
This AAP is available for inspection by applicants and employees in the Human Resources Office during normal business hours.
Link to Policy
North Memorial Health
Be challenged. Be empowered. Be accountable. Join an empowering, supportive, and responsive environment that delivers unmatched customer service - not only for the community we serve but our own team members, too.