Remote RN Case Manager – Utilization & Managed Care

Cynet Health; Somerville (MA); Remote; USD 85,000 - 110,000; Full time

Job summary

Cynet Health is seeking a remote RN Case Manager in the U.S. to support utilization review activities across multiple lines of business. This full-time role requires Massachusetts RN licensure and experience in utilization management, with remote work options available.

Candidates should have 2–4 years in utilization management, managed care exposure, and familiarity with Medicaid, Medicare, and commercial products. InterQual not required but knowledge is advantageous.

Qualifications

• Utilization Management experience
• Managed care experience
• Line of Business experience (Medicaid, Medicare, Commercial products)
• EPIC experience preferred

Skills

Utilization Management

Managed Care

Line of Business experience

Tools

EPIC

Job description

Cynet Health is seeking a remote RN Case Manager in the U.S. to support utilization review activities across multiple lines of business. This full-time role requires Massachusetts RN licensure and experience in utilization management, with remote work options available.

Candidates should have 2–4 years in utilization management, managed care exposure, and familiarity with Medicaid, Medicare, and commercial products. InterQual not required but knowledge is advantageous.