Registered Nurse, Utilization Management

Job not on LinkedIn

🔥 20 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $76.4k - $122.2k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

UVA Pipelines & Pathways

WebsiteLinkedInAll Job Openings

10,000+ employees

📚 Education

🎯 Recruiter

Education • Recruitment

UVA Pipelines & Pathways is a University of Virginia careers program focused on helping job seekers access entry-level employment at UVA that does not require advanced education or prior work experience. The program aims to open doors into the university workforce and provide opportunities for upward mobility through targeted hiring pathways (including temporary and wage positions) and resources for applicants looking to join academic, administrative, and health-related roles within UVA.

📋 Description

• Review patient admissions to determine medical necessity and appropriate level of care • Evaluate whether patients are placed in the correct admission status and timeframe • Ensure adherence to CMS, Medicare, and payer-specific guidelines • Communicate with physicians, nurses, and care teams to clarify or adjust patient status as needed • Engage with insurance payers to support authorization and reimbursement processes • Identify and act on opportunities to maintain compliance and optimize outcomes • Independently assess medical necessity and collaborate across care teams • Support regulatory compliance, reimbursement integrity, and patient-centered outcomes

🎯 Requirements

• Bachelor of Science in Nursing from accredited nursing program • 2 years acute care hospital experience • Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia required • Proficient communicative, auditory and visual skills • Attention to detail • Ability to write legibly • Ability to sit for prolonged periods • Understanding of medical necessity and appropriate level of care • Knowledge of CMS, Medicare, and payer-specific guidelines • Ability to support authorization and reimbursement processes

🏖️ Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance • Paid Time Off • Long-term and Short-term Disability • Retirement Savings • Health Saving Plans • Flexible Spending Accounts • Certification and education support • Generous Paid Time Off • Relocation assistance may be available for qualified candidates