Browse Jobs
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
26 jobs match your filters
1mo
I
Utilization Management Nurse
IntusCare
About IntusCare IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual
Remote - USA
remoteFull-timeEasy Apply
110mo
I
Utilization Management Nurse
Integrated Resources INC
Job Title : Utilization Management Nurse Consultant Duration : 6 months (Possible ext) Location : Downers Grove, IL Responsibilities : · Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellnes
Downers Grove, IL, United States
hybridContractMid-Senior LevelEasy Apply
2w
B
Utilization Management Nurse
Brighton Health Plan Solutions, LLC
About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remo
Remote
remoteEasy Apply
3d
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
Work At Home, Ohio, United States
onsiteFull-time
3d
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
Work At Home, Michigan, United States
onsiteFull-time
3d
Utilization Management Nurse BWH
Salem Hospital
Site: The Brigham and Women's Hospital, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, researc
Boston, MA
hybridFull-time
1w
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
Work At Home, New Jersey, United States
onsiteFull-time
1w
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
Work At Home, Michigan, United States
onsiteFull-time
1w
L
Utilization Management Nurse - Emergency Department
luminishealth
Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Essential Job Duties: 1. Chart Review : Reviews the med
Annapolis, MD
hybridEasy Apply
2w
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
Work At Home, Ohio, United States
onsiteFull-time
2w
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
OH - Work from hom
remoteFull-time
2w
Utilization Management Nurse Consultant
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
NJ Work From Home
remoteFull-time
2w
Utilization Management Nurse Consultant - Weekends (4-10 hour shifts)
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
TX - Work from home
remoteFull-time
2w
Utilization Management Nurse Consultant - Weekends (4-10 hour shifts)
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize saf
TX - Work from home
remoteFull-time
3w
L
Utilization Management Nurse (RN) - Part Time
luminishealth
Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Essential Job Duties: 1. Chart Review : Reviews the med
Annapolis, MD
onsiteEasy Apply
1mo
Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)
Alignment Health
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team
Anywhere in the U.S.
remoteFull-time
1mo
Utilization Management Nurse Registered
St. Joseph's Health
The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services in accordance with established criteria, regulatory requirements, and organizational role. The UM RN ensures optimal pat
Paterson, NJ, United States
hybridFull-time
1mo
N
Utilization Management Nurse - RN
NeueHealth
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and aff
California, United States
remoteEasy Apply
1mo
N
Utilization Management Nurse, LVN/LPN
NeueHealth
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and aff
California, United States
remoteEasy Apply
111mo
I
Utilization Management Nurse Consultant
Integrated Resources INC
Job Title : Utilization Management Nurse Consultant Duration : 6 months (Possible extension) Location : Downers Grove, IL Responsibilities : · Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting w
Downers Grove, IL, United States
hybridContractMid-Senior LevelEasy Apply
1d
Utilization Management Nurse (Sun–Thurs or Tues–Saturday)
Curana Health
Utilization Management Nurse open to either a Sun–Thursday or Tuesday–Saturday shift The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The ro
Remote, US
remoteFull-time
1w
Utilization Management Nurse Practitioner
NaphCare, Inc.
NaphCare is a medical technology company delivering excellent patient care to our correctional facilities across the United States. Come join our team of over 3000 employees as we continue to grow into the leading vendor of correctional healthcare services. Position Summary:
Birmingham, AL, US
remoteFull-time
4w
Utilization Management Nurse I, RN
Clever Care Health Plan
Remote in California only Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? ✨ Clever Care was created to mee
Huntington Beach Office - Huntington Beach, CA 92647
onsiteFull-time
1w
RN Utilization Management Nurse (InPatient) – California HMO
Elevance Health
Anticipated End Date: 2026-07-10 Position Title: RN Utilization Management Nurse (InPatient) – California HMO Job Description: RN Utilization Management Nurse (InPatient) – California HMO Virtual: This role enables associates to work virtually full-time, with the exception of
CA-WOODLAND HILLS, 21215 BURBANK BLVD
onsite
3w
Manager, Utilization Management Nurse Management
Blue Shield of California
The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi-Cal and Medicare populations. The Utilization Management Manager will report to the Dire
El Dorado Hills, CA, United States
onsite