Licensure/ Certification: RN License through the State of Ohio * Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management ...
Licensure/ Certification: RN License through the State of Ohio * Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management ...
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
... Nursing (Med-Surg, ER ... Well versed in Utilization Management - Must be able to determine elective vs urgent request with ...
... Nursing (Med-Surg, ER ... Well versed in Utilization Management - Must be able to determine elective vs urgent request with ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
Appeals Pharmacist (Remote)
Columbus, OH · On-site
$54.50 - $65.50/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
New
Appeals Pharmacist (Remote)
Columbus, OH · On-site
$54.50 - $65.50/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
New
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. • 1+ year utilization management, and/or case management. • Required Licensure/Certification: Active, unrestricted State Nursing (RN) ...
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. • 1+ year utilization management, and/or case management. • Required Licensure/Certification: Active, unrestricted State Nursing (RN) ...
Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...
Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...
Clinical Financial Case Mgr - RN
Columbus, OH · On-site +1
... Utilization Management, Peer to Peer processes, complex billing scenarios, audits (governmental ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Clinical Financial Case Mgr - RN
Columbus, OH · On-site +1
... Utilization Management, Peer to Peer processes, complex billing scenarios, audits (governmental ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Minimum 3-4 years of clinical practice in hospital setting. 1+ year utilization management, and/or case management. Required Licensure/Certification: Active, unrestricted State Nursing (RN) license ...
Minimum 3-4 years of clinical practice in hospital setting. 1+ year utilization management, and/or case management. Required Licensure/Certification: Active, unrestricted State Nursing (RN) license ...
License Practical Nurse
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Active, unrestricted State Nursing License Practical Nurse, license in good standing for the State ...
License Practical Nurse
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Active, unrestricted State Nursing License Practical Nurse, license in good standing for the State ...
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
One year of experience in nurse case management, medical case management, utilization review ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...
New
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
One year of experience in nurse case management, medical case management, utilization review ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...
New
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
One year of experience in nurse case management, medical case management, utilization review ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...
New
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
One year of experience in nurse case management, medical case management, utilization review ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...
New
Formulary Management Pharmacist
Columbus, OH · On-site
$54.50 - $65.50/hr
Formulary Management Pharmacist - Influence Therapy Access at Scale | Hybrid/Remote Friendly Shape ... Provide clinical support for utilization management, prior-authorization criteria, and step-therapy ...
Formulary Management Pharmacist
Columbus, OH · On-site
$54.50 - $65.50/hr
Formulary Management Pharmacist - Influence Therapy Access at Scale | Hybrid/Remote Friendly Shape ... Provide clinical support for utilization management, prior-authorization criteria, and step-therapy ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Quick apply
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Current RN, required ... Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
Current RN, required ... Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Quick apply
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Remote Utilization Management Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do remote utilization management nurse jobs pay per hour?
As of Aug 23, 2026, the average hourly pay for remote utilization management nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.
More about Remote Utilization Management Nurse jobs
What are popular job titles related to Remote Utilization Management Nurse jobs?
For Remote Utilization Management Nurse jobs, the most frequently searched job titles are:
- Remote Utilization Review Nurse
- Remote Per Diem Utilization Review Nurse
- Night Shift Remote Utilization Review Nurse
- Evening Utilization Review Nurse
- Freelance Utilization Review Nurse
- Non Exempt No Experience Utilization Management Nurse
- Night Utilization Review Nurse
- Remote Utilization Review Rn
- Seasonal Remote Hedis Review Nurse
- Remote Freelance Utilization Review Nurse
What job categories do people searching Remote Utilization Management Nurse jobs look for?
The top searched job categories for Remote Utilization Management Nurse jobs are:
- Remote Cigna Utilization Review Nurse
- Remote Optum Utilization Review
- Remote Navihealth Utilization Review
- Cigna Utilization Review Nurse
- Remote Hca Utilization Review
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- International Utilization Review Rn
- Full Time Anthem Utilization Review Nurse
- Lpn Utilization Review
- Utilization Review Nurse Lvn
What cities are hiring for Remote Utilization Management Nurse jobs?
Cities with the most Remote Utilization Management Nurse job openings:
What states have the most Remote Utilization Management Nurse jobs?
States with the most job openings for Remote Utilization Management Nurse jobs include:
What are the most commonly searched types of Utilization Management Nurse jobs?
The most popular types of Utilization Management Nurse jobs are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 4 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
570th of 893 rated healthcare providers
Job description
Employment Type:
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
Minimum Qualifications:
Position Highlights and Benefits:
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
- Develops and implements departmental strategic goals, plans, and standards consistent with the clinical, administrative, legal, and ethical requirements/objectives of the organization. Oversees compliance with regulations, laws and ethics via audits and direct observation. Provides leadership in developing and implementing standardized tools, roles and systems to support Utilization Review
- Directs and evaluates departmental operations. Leads operational improvements to facilitate standardization of utilization review practices. Establishes metrics to achieve service targets. Oversees and evaluates programs and services focused on continuous quality improvement. Participates in review of contracts and agreement of services
- Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary and continuing education initiatives. Develops network of high performing teams
- Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates within the allocated funding
- Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals
Minimum Qualifications:
- Education: Bachelor of Science Degree in Nursing, Business or other Healthcare related field. Master's Degree preferred
- Licensure/ Certification: RN License through the State of Ohio
- Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management experience at a Managed Care organization.
- Working knowledge of utilization review practices related to regulatory and accreditation requirements.
- Proven team leader with the ability to interact with all levels of staff members and physicians and other healthcare providers.
- Ability to prioritize issues and solve complex problems.
- Proficient computer, written and verbal communication skills including presentation skills.
- Innovative and self-directed.
- Demonstrates a high tolerance for ambiguity and change and provides leadership to department colleagues and others to adapt effectively to meet changing environment.
Position Highlights and Benefits:
- Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Employee recognition programs.
- Tuition/professional development reimbursement starting on day one.
- RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.
- Relocation assistance (geographic and position restrictions apply).
- Employee Referral Rewards program.
- Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
- Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
What Trinity Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Trinity Health
Sourced by ZipRecruiter
Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US