Top 6247 Rn utilization manager Jobs

Prior Authorization RN
RCM Health Care Services —New York, NY
- $90,000 - $108,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Excel
- RN License
Quick Apply
Utilization Management- RN
South Country Health Alliance —Medford, MN
- $34.39 - $47.94 an hour
- Weekends as needed
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Disability insurance
- Health insurance
11d
Hybrid Inpatient Case Manager
Everly Talent LLC —Garden City, NY
- $95,000 - $105,000 a year
- Hybrid work
- Nursing
- RN License
- Inpatient
Quick Apply
3d
Senior Manager, Utilization Management
1199SEIU Family of Funds —New York, NY
- $125,400 - $156,700 a year
- Full-time
- Nursing
- 6 years
- RN License
RN Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
Clinical Review & Correspondence RN
Cohere Health —Remote
- $31 - $35 an hour
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
Denials & Appeals Administrator (RN)
Boston Medical Center —Remote
- $43.03 - $62.50 an hour
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health insurance
- Dental insurance
Concurrent Utilization Review Nurse, RN
NeueHealth —Los Angeles, CA
- $74,286.15 - $111,429.23 a year
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Utilization Review Nurse
Cobalt Benefits Group LLC —Orlando, FL
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply
Utilization Review RN
Beth Israel Lahey Health —Boston, MA
- $38.11 - $98.61 an hour
- Full-time
- Nursing
- RN License
- Hospital
Telehealth Triage Registered Nurse (RN)
Lumina Care —Remote
- $38 - $45 an hour
- Weekends as needed
- Remote
- Nursing
- Psychiatry
- RN License
- Paid holidays
- Health insurance
Quick Apply
TPA Utilization RN
USI Holdings Corporation —Buffalo, NY
- $75,000 - $100,000 a year
- Remote
- Nursing
- RN License
- Research
- Wellness program
- Health savings account
5d
Case Manager Nurse-RN
Personify Health —Remote
- $36 - $38 an hour
- Email
- Nursing
- RN License
- Computer literacy
- Health insurance
- Dental insurance
13d
Case Manager, Registered Nurse (Oncology experience required)
CVS Health —Pennsylvania
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
RN Case Manager
Arkansas Blue Cross and Blue Shield —Remote
- Full-time
- Nursing
- Microsoft Outlook
- RN License
Nurse Specialist II
Qlarant —Remote
- $56,055 - $83,665 a year
- Remote
- RN License
- Mid-level
- Bachelor's degree
Quick Apply
CHS Utilization and Appeals Manager
Catholic Health —Melville, NY
- $110,000 - $150,000 a year
- Nursing
- RN License
- Word processing
- Health insurance
- Tuition reimbursement
RN Manager of Utilization Management
North Memorial Healthcare —Robbinsdale, MN
- $52.46 - $81.30 an hour
- 8 hour shift
- Hybrid work
- Nursing
- RN License
- Bachelor's degree
- Health insurance
- Tuition reimbursement
InterQual Senior Clinical Education Consultant (RN) - Remote
Optum —Chicago, IL
- $91,700 - $163,700 a year
- Full-time
- Hybrid work
- Spanish
- Nursing
- RN License
- Health insurance

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Prior Authorization RN

RCM Health Care Services -
New York, NY

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Job Details

Full-time
$90,000 - $108,000 a year

Qualifications

Medicare
RN License
Medicaid health insurance
CMS regulatory compliance
Centers for Medicare and Medicaid Services (CMS)
Medicaid regulations
Medicaid
Associate's degree
Associate Degree in Nursing

Full Job Description

Pre-Authorization RN
Compensation
Salary Range: $90,000 – $108,000 per year
Bonus / Commission (if applicable):
This role is eligible for a $15,000 sign-on bonus.
Location: Lower Manhattan, NY (Training) / Remote
Hybrid training transitioning to Remote
Position Summary
As a Pre-Authorization RN, you will support care coordination by reviewing and processing authorization requests in alignment with regulatory and organizational guidelines. This role involves collaboration with interdisciplinary teams to ensure timely and appropriate care delivery. Following a structured hybrid training period, this position transitions to a fully remote setting while maintaining high standards of clinical accuracy and compliance.
Responsibilities
? Schedule / Shift

Shift details: Monday – Friday (Business Hours)
Hours per week: 40

? Key Duties:

Review and process authorization requests in accordance with Medicare, Medicaid, and internal guidelines
Collaborate with care managers, nurses, and providers to ensure timely and appropriate service delivery
Coordinate completion of UAS-NY assessments to reflect members’ current clinical status
Ensure care plans are accurate, updated, and aligned with member needs
Maintain accurate documentation and support compliance with utilization management standards

Requirements
? Education

Required: Associate’s Degree in Nursing
Preferred (if applicable): Bachelor’s Degree in Nursing (BSN)

? Licenses & Certifications

Required: Active New York State Registered Nurse (RN) license
Additional certifications (if applicable): CCM certification preferred

? Skills:

Strong knowledge of Medicare and Medicaid regulations
Experience in prior authorization or utilization review processes
Excellent clinical judgment, assessment, and decision-making skills
Proficiency in Microsoft Office (Word, Excel) and familiarity with InterQual preferred

About Us
RCM Healthcare Services works with professionals across schools, healthcare, and community-based settings nationwide. We support both contract and direct hire opportunities, connecting people early in their careers and experienced professionals to roles that align with their experience and preferences. With more than 50 years of staffing experience, our team understands the environments you’re stepping into and what it takes to be successful in them. We stay closely involved from first conversation through placement, with consistent communication, a reliable point of contact, and follow-through at every step. We’re committed to caring for the professionals we work with and the communities they support, and offer competitive pay and benefits designed to support your well-being. RCM Healthcare Services is Joint Commission certified, reflecting a commitment to quality, compliance, and a consistent experience.

Equal Employment Opportunity & Reasonable Accommodation
RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us and we will engage in an interactive process to support your needs.

#AC1
#ACP

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Refine Your Search

rn utilization manager jobs

Prior Authorization RN

Utilization Management- RN

Hybrid Inpatient Case Manager

Senior Manager, Utilization Management

RN Case Manager

Claims - Care Manager, RN, Claims

Clinical Review & Correspondence RN

Denials & Appeals Administrator (RN)

Concurrent Utilization Review Nurse, RN

Utilization Review Nurse

Utilization Review RN

Telehealth Triage Registered Nurse (RN)

TPA Utilization RN

Case Manager Nurse-RN

Case Manager, Registered Nurse (Oncology experience required)

RN Case Manager

Nurse Specialist II

CHS Utilization and Appeals Manager

RN Manager of Utilization Management

InterQual Senior Clinical Education Consultant (RN) - Remote

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