Utilization Management RN: Remote with CM Pathway

WPS, a health solutions company, seeks an Utilization Management RN to evaluate medical necessity and appropriateness of services for our Health Plan. This role uses clinical judgment to authorize services and refers questionable cases to medical directors to avoid unnecessary procedures and prolonged hospital stays.

There's potential to cross-train in Case Management and grow into a combined UM/CM position. Start Date: 01/10/2027.