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Remote Utilization Management RN
Remote / Online - Candidates ideally in
Omaha, Douglas County, Nebraska, 68197, USA
Listed on 2026-07-13
Omaha, Douglas County, Nebraska, 68197, USA
Listing for:
WPS Health Solutions
Remote/Work from Home
position Listed on 2026-07-13
Job specializations:
-
Healthcare
Healthcare Management
Job Description & How to Apply Below
WPS Health Solutions is seeking an experienced Utilization Management RN to evaluate medical necessity, authorize services, and coordinate patient care for our Health Plan. You will review cases against evidence-based criteria and refer questionable cases to medical directors.
This remote-friendly role requires strong clinical judgment, prior authorization experience in managed care, and the ability to work cross-functionally with medical directors, Sales, Claims, and Enrollment teams.
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