Authorization Management Clinical Reviewer - Appeals and Denials
WellSky · United States · US
Utilization Review
Remote
physician
Nurse
Dentist
Demand75
Career growth65
Healthcare fit72
Remote potential60
5-year outlook
Demand for utilization review and denials management roles is likely to remain steady as payers increase scrutiny. Compensation for experienced RNs in this niche is competitive, with growth potential into leadership or consulting.
Clinical license
Required
Applicant reach
narrow
Seniority
mid
Employment type
full-time
Date found
2026-11-08
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Nurse, Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Strong fit for RNs with acute-care and utilization management experience who want to transition to a non-clinical, technology-enabled role. Others may need to gain relevant UM/denials experience first.
Who should apply
Registered Nurses with acute-care background and 1-2+ years of hospital-based utilization management or denial management experience.
CV angle
Emphasize active RN license, acute-care nursing experience, utilization review, denial management, InterQual use, appeals writing, payer communication, and collaboration with physicians. Highlight any process improvement or revenue cycle knowledge.
Skills to highlight
- Denials management
- Medical necessity appeals
- Utilization review
- InterQual guidelines
- Clinical documentation review
- Payer policy interpretation
- Peer-to-peer review
- Revenue cycle awareness
- Communication
Role summary
Manage medical necessity denials and appeals for a healthcare technology company, applying clinical expertise and payer criteria to resolve denials and improve reimbursement outcomes.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.