UM Operations Clinical Guide
Devoted Health · United States · US
Utilization Review
Remote
Nurse
Dentist
Demand78
Career growth72
Healthcare fit78
Remote potential65
Salary band
USD 82k – 96k
5-year outlook
Likely stable to growing demand as payers strengthen UM compliance and audit functions; compensation should remain competitive for experienced RNs, though exact salary is not stated.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-23
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Dentist
- Rate period
- Annual
Why this was classified this way
- Contract
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 considering for RNs with utilization management, quality, or audit exposure who want a non-bedside payer role. Less suitable for clinicians without UM, compliance, or clinical review background.
Who should apply
RNs with utilization review, case management, quality improvement, compliance, or clinical audit experience; nurses interested in payer UM operations, clinical education, and regulatory readiness.
CV angle
Frame bedside RN experience around clinical judgment, criteria application, documentation review, and cross-functional collaboration. Emphasize any real UM, insurance, CMS/regulatory, audit, quality improvement, staff education, or compliance work, using metrics only where accurate.
Skills to highlight
- Utilization Management
- Clinical audit and monitoring
- CMS and regulatory compliance
- Clinical criteria application
- Quality improvement
- Clinical documentation review
- Staff education and training
- Cross-functional collaboration
Role summary
An RN-led Utilization Management operations role focused on auditing clinical reviews, monitoring compliance with CMS and regulatory requirements, identifying trends, supporting staff education, and helping UM teams maintain accurate and consistent clinical decision-making.
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