Utilization Management RN: Remote CM Pathway

WPS, a health solutions company, seeks an Utilization Management RN to evaluate medical necessity and appropriateness of services for our Health Plan. This role uses clinical judgment to authorize services and refers questionable cases to medical directors to avoid unnecessary procedures and prolonged hospital stays.

There's potential to cross-train in Case Management and grow into a combined UM/CM position.

Start Date:

01/10/2027.

This posting is for the Utilization Management RN:
Remote with CM Pathway role at WPS—A health solutions company, based in NJ, United States.

Please review the full job details above before applying.

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

All applications are reviewed carefully by our team.

The position is based in NJ, United States.

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