Utilization Management Rn

Remote Utilization Management RN

Leading healthcare facility that aims to improve the health and wellness of those in need is now looking for a REMOTE Health Plan Nurse Coordinator to join their team! Here you will have the opportunity to gain experience in multiple departments and help others receive access to high-quality health services.

If this sounds like an opportunity that you are interested in, please email me directly at olpeterson@actalentservices. com

WHAT'S IN IT FOR YOU:

• Benefits included
• Very collaborative, supportive and helpful team
• Fully remote!!

REQUIREMENTS:

• California Registered Nurse (RN) and/or Nurse Practitioner (NP) License
• Must be able to start working as soon as possible!

Description:

• REMOTE
• RN with experience in providing Case Management services to the Pediatric population.
• Includes, knowledge of "whole-person" "person-centered" case management, California Children's Services (CCS), experience in managed care or working with managed care organizations, knowledge of community-based resources local/ general i.e. Transportation, food banks, mental health, regional center, resource centers, parent support centers - Jack heling hand, alpha resource center, parents helping parents, etc. knowledge of Utilization Management process/ turnaround times.
• Familiar with mandated reporting, working with multi-discipline team, time management skills, efficient with navigating various platforms to research, review data and track/ monitor workload.
• Experience with completing Assessments and building Individual Care Plans with members.
• Coordinating with providers, members, community partners, internal staff efficiently to support member care plan goals.
• Perform utilization management activities, which may include telephonic or onsite clinical review; case or disease management, care coordination or transition, or population health activities; or a combination of all.
• Assigned to sub-specialized programs within an operational unit, such as Mental/Behavioral Health services.

Skills: Care plans, Case Manager, Pediatrics, Utilization Management, Clinical Reviews

Experience level:

2 Years Utilization Management Experience

Pay and Benefits

The pay range for this position is $47.00 - $47.00/hr.

Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Oct 14, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $47