Utilization Management Nurse - RN
NeueHealthCalifornia, United States
Posted April 18, 2026
74 - 111 USD
Full Time
About the Company
NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care.
Job Description
NeueHealth is seeking a Utilization Management Nurse - RN to promote quality and cost-effective outcomes for a designated population. The role involves reviewing prior authorizations, collaborating with healthcare providers and patients, and analyzing utilization data to ensure alignment with contract requirements and coverage policies.
Requirements
- Active California license as a Registered Nurse (RN)
- Bachelor of Science in Nursing (BSN) preferred but not required
- Certification Managed Care Nursing (CMCN) preferred
- Minimum 2 years of clinical nursing experience
- Familiarity with insurance authorization processes, medical billing, and coding (e.g., ICD-10, CPT codes)
- Working knowledge of MCG, InterQual, and NCQA standards
Benefits
- Health benefits
- Life and disability benefits
- 401(k) savings plan with match
- Paid Time Off
- Paid holidays