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RN Utilization Management: Remote Care & Cost Optimization

Remote / Online - Candidates ideally in
Little Rock, Pulaski County, Arkansas, 72208, USA
Listing for: Arkansas Blue Cross and Blue Shield
Remote/Work from Home position
Listed on 2026-09-02
Job specializations:
  • Nursing
    RN Nurse, Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 65000 - 90000 USD Yearly USD 65000.00 90000.00 YEAR
Job Description & How to Apply Below

Arkansas Blue Cross and Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, benefit inquiries for providers and contracted lines of business. The role evaluates medical necessity using evidence-based criteria, clinical guidelines and policies to support cost effective and quality care.

The ideal candidate holds a Bachelor's degree in Nursing, an active RN license, and at least four years of clinical practice in

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