Remote Utilization Review Case Manager & Appeals; RN

Partner Company is seeking a Case Manager – Utilization Review Specialist for a fully remote position based in the United States. You will oversee admission and concurrent utilization reviews, assess medical necessity, and coordinate appeals to support patient care and financial performance.

You will apply clinical nursing expertise to evaluate records, identify denials, and work with physicians, directors, and payer representatives to resolve complex cases and improve review processes.

We are looking to fill the Remote Utilization Review Case Manager & Appeals (RN) position at Jobgether in CA, United States.

If your experience matches this role, we encourage you to apply.

All applications are reviewed carefully by our team.

This is a Full Time role.

The position is based in CA, United States.

This opportunity is part of our work in Bio & Pharmacology & Health.