ZipRecruiter

Log In

1

Sco Um Review Rn Jobs (NOW HIRING)

NeighborHealth

RN SCO

Winthrop, MA · On-site

$44/hr

MA RN license and minimum one year working with geriatric population. Community Health or nursing ... reviews of the care plan, maintain continuity of care between home, health center and hospital ...

East Boston Neighborhood Health Center

RN SCO

Boston, MA · On-site

$44/hr

MA RN license and minimum one year working with geriatric population. Community Health or nursing ... reviews of the care plan, maintain continuity of care between home, health center and hospital ...

next page

Showing results 1-20

All JobsSco Um Review Rn Jobs

Sco Um Review Rn information

See salary details

$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?

AspectSco Um Review RnLicensed Practical Nurse
CredentialsRegistered Nurse (RN) license, possibly specialized certificationsLicensed Practical Nurse (LPN) license
Work EnvironmentHospitals, clinics, outpatient facilities, often in more complex care settingsLong-term care, nursing homes, clinics, with more routine patient care
Job ResponsibilitiesAssessments, care planning, complex patient care, medication administrationBasic 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:
Sco Um Review Rn jobs near you
Infographic showing various Sco Um Review Rn job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $92,525 per year, or $44.5 per hour.
Clinical Review Registered Nurse

Clinical Review Registered Nurse

BlueCross BlueShield of Vermont

Montpelier, VT • On-site

$73K - $82K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

Blue Cross and Blue Shield of Vermont is looking for a Clinical Review Registered Nurse to join our Utilization Management team. Our company culture is built on an unwavering focus on the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. We offer a balanced and flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401K, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.
COMPENSATION: The base salary range for this position is $73,000 - $82,000. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).
LOCATION: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. We are only hiring Vermonters for this role. Standard work hours are 8:00-4:30.
The Clinical Review Registered Nurse will be responsible for facilitating members' healthcare needs, authorizing medically necessary services including behavioral health at the right level of care to promote optimal health.
Clinical Review Registered Nurse Responsibilities:

  • Conduct clinical reviews for preservice, concurrent, and retrospective authorizations that promote efficient and medically appropriate use of members benefits to provide cost effective and high-quality care.
  • Self-directed, working independently and collaboratively with the team to facilitate care using clinical skills, principles of managed care, nationally recognized medical necessity criteria, and company medical policies.
  • Emphasis on utilization management, discharge planning, clinical outcomes and the ability to assess, analyze, draw conclusions, and construct effective solutions, identify questionable cases and refer to superior or medical director for review.
  • Proficient with multiple IT systems.
  • Strong written and spoken communication skills
  • Able to follow regulatory requirements with audit feedback incorporated into future work.
Clinical Review Registered Nurse Qualifications:
  • RN with Vermont License required, BSN desired.
  • 3-5 years of relevant experience in a variety of appropriate clinical health care settings (inpatient, outpatient, or differing levels of care),
  • 1- 3 years of insurance related experience desired.
  • Must be willing to participate in on-going CEU training.
  • Must be willing to participate in after hours on call rotation
Clinical Review Registered Nurse Benefits:
  • Health insurance (including vision)
  • Dental coverage (free to employees)
  • Wellness Program
  • 401(k) with employer match + automatic employer contribution
  • Life Insurance
  • Disability Insurance
  • Combined time off (CTO) - 20 days per year + 10 paid holidays
  • Tuition Reimbursement
  • Student Loan Repayment
  • Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at http://www.bluecrossvt.org/about/diversity-equity-and-inclusion.
*Complete job description attached to ADP posting

Apply