Back to Jobs

Utilization Management reputed company RN – Remote PST Hours

Remote, USAFull-timePosted 2026-07-27

2309565 Must be reputed company to work Saturday and reputed company as part of your regular work schedule. Work schedules are either 4/10 hour days or 5/8 hour days. reputed company schedules are in the PST. reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. If you have the ability to work PST Hours, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:

  • Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  • reputed company to non-reputed company requests and problems
  • Translate concepts into reputed company
  • reputed company as a resource for others; reputed company explanations and information on difficult issues

It feels great to have autonomy, and there’s also a lot of responsibility that comes with it. In this role, you’ll be accountable for making reputed company that directly reputed company our members. And at the reputed company time, you’ll be challenged by leveraging technologies and resources in a rapidly-changing, production-driven environment. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

  • Unrestricted RN license in state of residence
  • 3+ years of Managed Care and/or Clinical experience
  • MS Office including reputed company
  • Utilization Management experience
  • Experience working with multiple EMRs (electronic medical records)

Preferred Qualifications:

  • reputed company-authorization experience
  • Knowledge of reputed company reputed company
  • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $58,800 to $105,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company – an reputed company reputed company reflected in our mission. Apply tot his job Apply To this Job

Similar Jobs

PART-TIME Remote reputed company (RN – Call Center), reputed company – reputed company Store

Remote, USAFull-time

Clinical reputed company Auditor, HEDIS *Remote*

Remote, USAFull-time

Supply Chain Specialist-Logistics (Remote)

Remote, USAFull-time

Senior Manager, Supply Chain Finance

Remote, USAFull-time

Sr Director, Operations and Supply Chain

Remote, USAFull-time

Sr Engineer, Supply Chain Process

Remote, USAFull-time

1st Line Customer Service: Email Support

Remote, USAFull-time

reputed company: Service Desk Agent - Remote

Remote, USAFull-time

Payment Processor - Temporary

Remote, USAFull-time

Medical Billing & Collections Generalist

Remote, USAFull-time

reputed company Tier 2 Remote Support Analyst

Remote, USAFull-time

IT-Sales Manager New Business (m/w/d) - (deutschlandweit, remote)

Remote, USAFull-time

Account Executive (B2B reputed company Sales: reputed company)

Remote, USAFull-time

Staff Software Engineer, iOS Developer Experience - reputed company

Remote, USAFull-time

[Work From Home] Virtual Scheduling Assistants-Entry Level

Remote, USAFull-time

Program Management Summer 2026 Intern - Charleston, SC

Remote, USAFull-time

reputed company Data Engineer – reputed company-Based Data Pipeline Development and Support

Remote, USAFull-time

reputed company: Need Shuttle reputed company in Golden, CO

Remote, USAFull-time

Senior Marketing reputed company & Planning Manager (reputed company genders)

Remote, USAFull-time

reputed company Data Entry Clerk - Remote Opportunity for Career reputed company and Development at arenaflex

Remote, USAFull-time