Top 5127 Rn utilization manager Jobs in United States

UR Analyst Manager
Strive Recovery —Fort Wayne, IN
- Full-time
- Nursing
- Management
- Addiction Medicine
- Health insurance
- Dental insurance
Quick Apply
Care Manager (RN) - Discharge Planning
MaineHealth —Portland, ME
- Email
- Nursing
- RN License
- Hospital
- Paid parental leave
- Parental leave
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 - Surgery Services
UCLA Health —Los Angeles, CA
- $65.53 - $84.75 an hour
- Nursing
- Surgery
- RN License
RN Case Manager
AMN Healthcare —Salem, MA
- $1,800 - $2,700 a week
- Part-time
- RN License
- BLS Certification
- Acute care experience
- Paid jury duty
- Paid holidays
2d
Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)
Adventist Health —Roseville, CA
- $59.23 - $81.24 an hour
- Part-time
- Remote
- Nursing
- RN License
- Mid-level
12d
Care Manager RN - Utilization Management (UM) Remote
Highmark Inc. —Pennsylvania
- $68,400 - $105,900 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
10d
RN Case Manager
Zócalo Health —Remote
- $85,000 a year
- Full-time
- Remote
- RN License
- Writing skills
- Mid-level
- Health insurance
- Dental insurance
9d
RN Case Manager
Arkansas Blue Cross and Blue Shield —Remote
- Full-time
- Nursing
- Microsoft Outlook
- RN License
11d
Nurse Case Manager, Utilization Management
1199SEIU Family of Funds —New York, NY
- $89,400 - $106,100 a year
- Full-time
- Nursing
- RN License
- Mid-level
RN Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
Care Manager (RN) **Hospital Care Management Experience Highly Preferred** (Sunday-Thursday, 8:00AM-4:00PM)
NYU Langone Health —Mineola, NY
- $147,153.96 - $180,190.08 a year
- Full-time
- Nursing
- RN License
- Computer literacy
- Wellness program
3d
RN Inpatient Case Manager
MedStar Health —Baltimore, MD
- $89,065 - $162,801 a year
- Full-time
- Acute care
- Nursing
- Microsoft Excel
5d
RN Utilization Management
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
- Vision insurance
Remote Nurse Case Manager - Utilization Review SNF
LTC Ally —Remote
- From $30 an hour
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Utilization Management Registered Nurse
Humana —Georgia
- $71,100 - $97,800 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
Lead Utilization Review-RN
Personify Health —Remote
- $38 - $43 an hour
- Email
- Remote
- Microsoft Outlook
- RN License
- Supervising experience
- Health insurance
- Dental insurance
5d
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
13d
Senior Case Manager (RN)
Arlo —New York, NY
- $90,000 - $110,000 a year
- Full-time
- Remote
- RN License
- 5 years
- Senior level
Quick Apply

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rn utilization manager jobs near united states

UR Analyst Manager

Strive Recovery
Fort Wayne, IN

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance

Qualifications

Management
Bachelor's degree
Pre-authorization review for utilization management
Utilization management

Full Job Description

At Strive Recovery, we are committed to transforming lives through compassionate, evidence-based behavioral health and addiction services. As we grow, we are seeking dedicated professionals who are ready to elevate care and make a difference every day.

Position Summary

The UR Analyst is responsible for reviewing clinical documentation to ensure medical necessity, appropriateness of care, and compliance with payer requirements. This role supports the facility’s mission by maximizing reimbursement and maintaining high standards of care for individuals undergoing addiction services and behavioral health treatment. Experience building or significantly improving a UR department.

Job Descriptions

Conduct initial and concurrent reviews for all levels of care: Detox, Residential, PHP, IOP, and Outpatient.

Verify Medicaid/MCO eligibility and benefits before admission

Submit initial authorizations for 3.5, 3.1 or 2.5 level of care

Peer to Peer and appeal experience

Collaborate with clinical and medical teams to support documentation for payor compliance

Monitor and track authorization status, denials, appeals and stay reviews timely

Closely work with Accounts Receivables department to ensure accurate records and manage requests in payer portals

Assist with audits and ensure compliance with state, federal, and accreditation standards.

Prepare and support NPs for peer-to-peer reviews (complete template for NP)

Maintain census tracker, auth dates and review due dates

Generate weekly utilization and denial reports

Knowledge of ASAM critera

Follow up on denials with understanding and to make sure those are appealed timely

Communicate with insurance case managers and advocate for client care needs

Coordinate discharge/step-down coverage and aftercare

Other duties necessitated by the respective facility

Benefits

Competitive Salary
Medical, Dental and Vision plan
Vacation plan
Paid Time Off
Tuition Reimbursement
Positive work environment
Regular staff Appreciation and Recognition

Qualifications

Bachelor’s degree in Nursing, Social Work, Psychology, or related field (RN or LCSW preferred).

Minimum 5 years of experience in utilization review, preferably in addiction treatment or behavioral health.

Knowledge of insurance authorization processes.

Strong communication, organizational, and documentation skills.

Prior leadership experience

We are an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for all employees; free from discrimination on the basis of race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preferences, status as a qualified individual with a disability, or status as a protected veteran.

#IND

Quick Apply

Refine Your Search

rn utilization manager jobs in united states

UR Analyst Manager

Care Manager (RN) - Discharge Planning

Senior Manager, Utilization Management

RN Case Manager - Surgery Services

RN Case Manager

Claims - Care Manager, RN, Claims

RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)

Care Manager RN - Utilization Management (UM) Remote

RN Case Manager

RN Case Manager

Nurse Case Manager, Utilization Management

RN Case Manager

Care Manager (RN) Hospital Care Management Experience Highly Preferred (Sunday-Thursday, 8:00AM-4:00PM)

RN Inpatient Case Manager

RN Utilization Management

Remote Nurse Case Manager - Utilization Review SNF

Utilization Management Registered Nurse

Lead Utilization Review-RN

Denials & Appeals Administrator (RN)

Senior Case Manager (RN)

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