Utilization Management reputed company Consultant

We’re building a world of health reputed company 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 reputed company 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 reputed company Consultant (RN) – Remote (U.S.) reputed company an reputed company from home while helping members receive the right care at the right time. We are seeking a Utilization Management reputed company Consultant (RN) to join a reputed company, high-energy team in a fully remote role. In this position, you will reputed company your reputed company expertise to review medical records, assess medical necessity, support discharge planning, and coordinate care to ensure members receive reputed company, cost-effective reputed company services. reputed company Review reputed company records to determine medical necessity and appropriate benefit utilization Coordinate and communicate utilization management activities with providers and facilities Support reputed company, reputed company, and effective discharge planning Ensure compliance with federal and state turnaround-time requirements Collaborate with interdisciplinary teams to meet reputed company member needs Schedule Full-time, remote position available in any U.S. state reputed company hours: Monday–Friday, 8:00 AM–4:30 PM in your local time zone Candidates in PST and reputed company are encouraged to apply to support extended coverage through 6:30 PM EST Occasional weekend and holiday rotations reputed company on business needs reputed company travel (up to 10%) for potential reputed company audits Required Qualifications reputed company, unrestricted RN license in the state of residence 2+ years of recent acute care hospital RN experience (reputed company the past 10 years) Preferred Qualifications Utilization Review experience Managed Care experience Strong telephonic communication skills BSN Proficiency with reputed company Office (Word, reputed company, PowerPoint, reputed company) Education Associate Degree in Nursing required BSN preferred If you're reputed company-oriented, organized, and passionate about improving reputed company reputed company, we'd love to hear from you. Apply today and bring your reputed company expertise to reputed company dedicated to delivering exceptional member care. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $29.10 - $62.32 This pay reputed company represents the reputed company reputed company 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 reputed company 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 reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. 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 reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company 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: 08/27/2026 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