Utilization Management Nurse - LVN (Work from Home)

NeueHealth(1 month ago)

California, United StatesOnsiteFull TimeMedior$54,200 - $81,300Utilization Management

About this role

The Utilization Management (UM) Nurse at NeueHealth supports the company’s value-driven approach to delivering coordinated, high-quality care across payer programs. The role focuses on ensuring members receive appropriate, cost-effective services by working within clinical standards and partnering with providers and internal teams. The position operates within NeueHealth’s clinical operations to help improve access, affordability, and outcomes for enrolled populations.

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Required Skills

Utilization Management
Medical Review
Clinical Criteria
InterQual
MCG
NCQA
Care Coordination
Discharge Planning
Provider Collaboration
Patient Advocacy

+2 more

Qualifications

Associate's Degree in Nursing
Active Unrestricted LVN License (California)
Certification in Managed Care Nursing (CMCN) - Preferred

About NeueHealth

neuehealth.com

NeueHealth is a tech-enabled healthcare company focused on making care more personal, accessible, and affordable. Through its operating businesses — including NeueCare, NeueSolutions, and an ACO — it provides integrated care delivery, value‑based care programs, and operational and technology services for providers and payors. NeueHealth serves health systems, clinicians, payors, and consumers with solutions designed to simplify access, improve outcomes, and lower costs.