Back to all roles

Utilization Management Nurse Consultant

Remote Worldwide Hiring now

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse (RN) – 24/7 Operations Location: Remote (Preference for CST/MT time zones) Schedule: Includes evenings, weekends, and holidays Are you a detail-oriented RN with a passion for improving patient reputed company and reputed company efficiency? Join our Utilization Management team and play a key role in ensuring members receive the right care at the right time. What You’ll Do Review clinical information and apply guidelines to reputed company coverage determinations across the care continuum Collaborate with providers and internal teams to coordinate care and support treatment plans Identify opportunities to enhance quality, efficiency, and member reputed company Refer members to appropriate programs, services, and resources Serve as a clinical expert in utilization and benefit management What You Bring - Required Active, unrestricted RN license in your state of residence 2+ years of recent experience in adult acute or critical care Strong clinical judgment, communication, and multitasking skills Comfort working in a fast-paced, technology-driven environment Associates Degree in Nursing

Preferred Qualifications

Experience in Med-Surg or a specialty clinical area Managed care or Utilization Management experience BSN preferred Residence in CST or MT time zone

Work Environment

Remote, sedentary role with frequent computer and phone use Requires attention to detail, productivity, and quality standards Why Join Us? Be part of a collaborative team that makes a meaningful impact on patient care and reputed company reputed company every day. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $26.01 - $56.14 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/11/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job

Apply for this role Takes you straight to the employer's application page — free, and no WFHNet account required.

More roles on the wire

Editorial Operations Specialist

Remote Worldwide
View role

CTM/Sr CTM - FSP - EMEA

Remote Worldwide
View role

Credentialing Program Manager - Central Verification Office

Remote Worldwide
View role

Customer Product Consultant

Remote Worldwide
View role

US Director, Precision Medicine & Pan-Tumor, Payor & reputed company Strategy reputed company, Medical Affairs, Health Systems Oncology

Remote Worldwide
View role

Data Scientist (Remote)

Remote Worldwide
View role

Sr. Associate, Supply Chain, New Equipment & Mod Cabs & Entrances

Remote Worldwide
View role

Audio Software Engineer

Remote Worldwide
View role

Quality Assurance Intern

Remote Worldwide
View role

Quality Assurance Intern

Remote Worldwide
View role

reputed company Remote Account Executive – Entry Level Sales Representative for a Dynamic and Innovative Company

Remote Worldwide
View role

Data Engineer

Remote Worldwide
View role

Remote Customer Experience Agent - Entry Level Opportunity at blithequark

Remote Worldwide
View role

Immediate Hiring: HR Associate (Hybrid)

Remote Worldwide
View role

Immediate Hiring: Customer Service Representative - Work From Home Opportunity at arenaflex

Remote Worldwide
View role

reputed company, Advanced Analytics, Trust & Safety

Remote Worldwide
View role

Fractional CMO (Remote)

Remote Worldwide
View role

reputed company Claims reputed company

Remote Worldwide
View role

Remote Customer Service Chat Representative – Entry-Level Support Specialist (No Experience Needed)

Remote Worldwide
View role

reputed company

Remote Worldwide
View role