UM Review Nurse
$34 - $47/hr
UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $47.00 / hour ...
UM Review Nurse
$34 - $47/hr
UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $47.00 / hour ...
UM Review Nurse
Monterey Park, CA · On-site +1
$34 - $47/hr
UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $47.00 / hour ...
UM Review Nurse
Monterey Park, CA · On-site +1
$34 - $47/hr
UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $47.00 / hour ...
UM Review Nurse
$34 - $47/hr
UM Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or ...
UM Review Nurse
$34 - $47/hr
UM Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
In-patient Utilization Review RN In-patient Utilization Review RN experience highly preferred ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
In-patient Utilization Review RN In-patient Utilization Review RN experience highly preferred ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
UM Review Nurse
Monterey Park, CA · Remote
$34 - $47/hr
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... At least 1 years of outpatient UM experience * Experience with Microsoft applications such as Word ...
UM Review Nurse
Monterey Park, CA · Remote
$34 - $47/hr
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... At least 1 years of outpatient UM experience * Experience with Microsoft applications such as Word ...
UM Review Nurse
Monterey Park, CA · Remote
$34 - $47/hr
Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our ... At least 1 years of outpatient UM experience * Experience with Microsoft applications such as Word ...
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UM Review Nurse
Monterey Park, CA · Remote
$34 - $47/hr
Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our ... At least 1 years of outpatient UM experience * Experience with Microsoft applications such as Word ...
The UM RN protects the financial interests of the organization by ensuring that the UM review cycle is successfully completed from the point of admission through and including appeal of any denials ...
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The UM RN protects the financial interests of the organization by ensuring that the UM review cycle is successfully completed from the point of admission through and including appeal of any denials ...
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Bachelor's Degree in related field * 2+ years of experience in UM, UR, pre-authorization ...
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Bachelor's Degree in related field * 2+ years of experience in UM, UR, pre-authorization ...
Strong UM Review nurses, LVN or RN * Candidate MUST have UM Review experience, * Aware of Turn-Around-Time for all Lines-of business, * Familiar with Commercial and CMS hierarchy, * Familiar with all ...
Strong UM Review nurses, LVN or RN * Candidate MUST have UM Review experience, * Aware of Turn-Around-Time for all Lines-of business, * Familiar with Commercial and CMS hierarchy, * Familiar with all ...
Strong UM Review nurses, LVN or RN Candidate MUST have UM Review experience, Aware of Turn-Around-Time for all Lines-of business, Familiar with Commercial and CMS hierarchy, Familiar with all health ...
Strong UM Review nurses, LVN or RN Candidate MUST have UM Review experience, Aware of Turn-Around-Time for all Lines-of business, Familiar with Commercial and CMS hierarchy, Familiar with all health ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
About the Job In-patient Utilization Review RN experience highly preferred. Candidate must live in ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
About the Job In-patient Utilization Review RN experience highly preferred. Candidate must live in ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
RN Team Lead, Utilization Review in Clinton, MD
Clinton, MD · On-site
$89K - $162K/yr
In-patient Utilization Review RN experience highly preferred. Candidate must live in the DC ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
RN Team Lead, Utilization Review in Clinton, MD
Clinton, MD · On-site
$89K - $162K/yr
In-patient Utilization Review RN experience highly preferred. Candidate must live in the DC ... Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the ...
The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Coach reviewers on consistent application of medical-necessity criteria, medical policy, and ...
The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Coach reviewers on consistent application of medical-necessity criteria, medical policy, and ...
UM Nurse
San Antonio, TX · On-site
UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory Responsibilities: This ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory Responsibilities: This ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Coach reviewers on consistent application of medical-necessity criteria, medical policy, and ...
The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Coach reviewers on consistent application of medical-necessity criteria, medical policy, and ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
UM Nurse
San Antonio, TX · On-site
General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory ... Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical ...
A facility located near Lexington, Nebraska is seeking a Utilization Review Registered Nurse to join their team. Utilization Review Registered Nurse O.
A facility located near Lexington, Nebraska is seeking a Utilization Review Registered Nurse to join their team. Utilization Review Registered Nurse O.
The Clinical Documentation Review RN is responsible for auditing care plans, health risk ... Educate clinical staff on best practices for documentation, including SCO-specific standards ...
The Clinical Documentation Review RN is responsible for auditing care plans, health risk ... Educate clinical staff on best practices for documentation, including SCO-specific standards ...
Sco Um Review Rn information
See salary details
$20.19 - $25.04
1% of jobs
$25.04 - $29.90
9% of jobs
$33.60 is the 25th percentile. Wages below this are outliers.
$29.90 - $34.75
19% of jobs
$34.75 - $39.60
19% of jobs
The median wage is $40.08 / hr.
$39.60 - $44.45
16% of jobs
$48.97 is the 75th percentile. Wages above this are outliers.
$44.45 - $49.30
12% of jobs
$49.30 - $54.15
7% of jobs
$54.15 - $59
6% of jobs
$59 - $63.85
4% of jobs
$63.85 - $68.71
3% of jobs
$68.71 - $73.56
3% of jobs
$20
$44
$73
How much do sco um review rn jobs pay per hour?
As of Jul 13, 2026, the average hourly pay for sco um review rn in the United States is $44.48, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $51.92 per hour, depending on experience, location, and employer.
What are some common challenges faced by a SCO UM Review RN and how can they be managed effectively?
A SCO UM Review RN often faces challenges such as balancing a high volume of case reviews with the need for thorough, accurate assessments and staying updated with frequently changing regulatory requirements. Time management and strong organizational skills are crucial for managing daily responsibilities, which typically include reviewing medical records, collaborating with interdisciplinary teams, and communicating with providers and members. Building strong relationships with both clinical and non-clinical staff can help streamline workflows, while ongoing professional development ensures you remain current with best practices and compliance standards.
What does an UM review nurse do?
An UM review nurse evaluates medical necessity and appropriateness of healthcare services for insurance or healthcare organizations. They review patient records, collaborate with healthcare providers, and ensure compliance with policies, often using clinical guidelines and documentation to make informed decisions.
What are the key skills and qualifications needed to thrive as a SCO UM Review RN, and why are they important?
To thrive as a SCO UM Review RN (Senior Care Options Utilization Management Review Registered Nurse), you need a valid RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria for managed care populations. Familiarity with utilization management software, InterQual or Milliman guidelines, and electronic health records is typically required. Exceptional attention to detail, critical thinking, and effective communication are vital soft skills for collaborating with care teams and advocating for patient needs. These skills ensure accurate review processes, regulatory compliance, and optimized patient outcomes in managed care environments.
What are SCO UM Review RNs?
SCO UM Review RNs are registered nurses who specialize in Utilization Management (UM) review for Senior Care Options (SCO) programs. They evaluate medical records, treatment plans, and healthcare services to ensure that care provided to elderly patients is medically necessary and meets health plan guidelines. These nurses play a key role in coordinating care, preventing unnecessary services, and advocating for appropriate patient care within managed care organizations.
What is the difference between Sco Um Review Rn vs Licensed Practical Nurse?
| Aspect | Sco Um Review Rn | Licensed Practical Nurse |
|---|---|---|
| Credentials | Registered Nurse (RN) license, possibly specialized certifications | Licensed Practical Nurse (LPN) license |
| Work Environment | Hospitals, clinics, outpatient facilities, often in more complex care settings | Long-term care, nursing homes, clinics, with more routine patient care |
| Job Responsibilities | Assessments, care planning, complex patient care, medication administration | Basic patient care, vital signs, assisting RNs and physicians |
Both Sco Um Review Rn and Licensed Practical Nurse roles involve patient care, but Sco Um Review Rn typically requires a higher level of education and certification, allowing for more complex responsibilities. LPNs focus on routine patient care and support roles. The choice depends on your career goals and desired scope of practice.
How much does Cigna pay remote nurses?
Cigna offers remote nursing positions, and pay rates typically range from $30 to $50 per hour depending on experience, location, and specific role. Compensation may also include benefits such as health insurance and retirement plans, and remote nurses often need relevant licensure and clinical experience.
How to make an extra $2000 a month as a nurse?
A nurse can increase income by taking on overtime shifts, working in high-demand specialties, or providing private care services. Developing specialized skills or certifications, such as in anesthesia or critical care, can also qualify for higher-paying roles or side gigs outside regular hours.
How to make $300,000 as a nurse?
To earn $300,000 as a nurse, professionals often work in high-paying specialties such as nurse anesthetist or nurse practitioner, which require advanced certifications and education. Increasing hours, taking on overtime, or working in high-demand areas can also boost income, along with gaining experience and specialized skills. Some nurses pursue travel nursing or administrative roles to increase earning potential.
More about Sco Um Review Rn jobs
What states have the most Sco Um Review Rn jobs? States with the most job openings for Sco Um Review Rn jobs include:
What job categories do people searching Sco Um Review Rn jobs look for? The top searched job categories for Sco Um Review Rn jobs are:
$34 - $47/hr
Other
Posted 20 days ago
Job description
UM Review Nurse
Department: HS - UM
Employment Type: Full Time
Location: 1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To: Phillip Vasquez
Compensation: $34.00 - $47.00 / hour
Description
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans.
This position requires open availability between Monday through Sunday, 8 A - 8 P. You would be scheduled for 5 shifts per week. This is a remote position for CA-licensed nurses. Candidates must live in California.
We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.
Our Values:
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Department: HS - UM
Employment Type: Full Time
Location: 1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To: Phillip Vasquez
Compensation: $34.00 - $47.00 / hour
Description
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans.
This position requires open availability between Monday through Sunday, 8 A - 8 P. You would be scheduled for 5 shifts per week. This is a remote position for CA-licensed nurses. Candidates must live in California.
We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
- Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment
- Refer cases to Medical Directors as needed/appropriate
- Maintain knowledge of state and federal regulations and accreditation standards
- Comply with internal policies and procedures
- Perform any other job duties as requested
- Active and unrestricted LVN license in CA.
- At least 1 years of outpatient UM experience
- Experience with Microsoft applications such as Word, Excel, and Outlook
- At least two (2) years of health plan, IPA or MSO experience
- Strong interpersonal skills
- Ability to collaborate with co-workers, senior leadership, and other management
- Experience educating and training staff
- This is a remote position. Our office is located at 1600 Corporate Center Drive in Monterey Park, CA. Candidates who live within a 30 mile radius of the office may be expected to work hybrid.
- Typical business hours are Monday - Friday from 8:30 AM to 5 PM, however, this position requires open availability between 8 AM - 8 PM PST, M-Su. Your schedule will be compromised of 5 shifts per week. Nurses rotate weekend and holiday coverage. Overtime is required in this position.
- The national target pay range for this role is $34.00 - $47.00 per hour. Actual compensation will be based on job level, geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.