FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Utilization Management Nurse – Physical Health
Trillium Health Resources. Conduct prospective, concurrent, and retrospective clinical reviews using established criteria .
Posted 9/23/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $68,890 - $92,138 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting clinical reviews and assessments to determine medical necessity and level of care, while collaborating effectively with healthcare providers to support treatment planning and discharge coordination.
Highest-signal resume keywords
Utilization ManagementClinical ReviewRegistered Nurse (RN) LicensureClinical Experience in Managed CareUtilization Management Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentCare CoordinationDischarge PlanningEvidence-Based Clinical Decision SupportAcute Inpatient CareBehavioral Health ReviewMedical Necessity DeterminationOngoing Care Monitoring
Soft Skills
CollaborationCommunication
Certifications & Qualifications
Utilization Management Certification
Industry Keywords
Managed Care OrganizationHealth PlanNorth Carolina LicensureComplianceClinical Reviews
About the role
Key responsibilities & impact- Conduct prospective, concurrent, and retrospective clinical reviews using established criteria
- Assess clinical information to determine medical necessity and level of care
- Collaborate with providers and facilities to support treatment planning and discharge coordination
- Perform admission and concurrent reviews to monitor ongoing care needs
- Identify cases requiring physician review and present clinical recommendations
- Coordinate care to ensure appropriate use of services and effective care transitions
- Support discharge planning to improve outcomes and continuity of care
Requirements
What you’ll need- Associate's degree in Nursing
- Two (2) years of Utilization Management/Review, to include clinical acute inpatient care (ER, ICU, Med-Surg), behavioral health, compliance, or evidence-based clinical decision support tools
- Active North Carolina Licensure as a Registered Nurse (RN)
- Must have a valid driver's license
- Must reside within North Carolina
- Must be able to travel within catchment as required
- Clinical experience in a managed care organization, health plan or hospital setting (preferred)
- Utilization Management certification (preferred)
- All candidates must pass a drug test as a condition of employment
Benefits
Comp & perks- A collaborative, mission-driven work environment
- Competitive benefits and work-from-home options for most positions
- Opportunities for professional growth in a diverse inclusive culture
- Flexible work schedules with some roles with management approval
- Work-from-home options available for most positions
- Health Insurance with no premium for employee coverage
- Flexible Spending Accounts
- 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
- NC Local Government Retirement Pension (defined-benefit plan)
- 401k with 5% employer match and immediate vesting
- Public Service Loan Forgiveness (PSLF) qualifying employer
- Quarterly stipend for remote work supplies