Nurse Liaison I - Utilization Management & Quality Review - Remote
Health Care Service Corporation · United States · US
Utilization Review
Remote
Nurse
Demand82
Career growth68
Healthcare fit86
Remote potential88
Salary band
USD 70k – 126k
5-year outlook
Payer UM/QR roles tend to offer stable compensation with progression to senior reviewer, team lead, or manager; exact pay depends on region, licensure, and Medicare Advantage experience.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-22
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse
- 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
Worth applying for RNs with utilization review or Medicare Advantage prior authorization experience who want remote payer work; less suitable for nurses without UM/QR exposure.
Who should apply
RNs with utilization review, quality assurance, prior authorization, or managed care experience, especially those with Medicare Advantage background and comfort with documentation and compliance.
CV angle
Frame bedside RN experience as clinical decision-making, documentation, and interdisciplinary collaboration; quantify UM, prior authorization, quality review, Medicare Advantage exposure, compliance, and denial/authorization write-ups without inventing payer experience.
Skills to highlight
- Utilization management
- Medical necessity review
- Prior authorization
- Medicare Advantage
- Managed care principles
- Clinical documentation
- Quality review
- Regulatory compliance
Role summary
A remote payer-side RN role supporting utilization management and quality review, including medical necessity reviews, benefit determinations, prior authorization, compliance, and clinically sound documentation for coverage decisions.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.