Utilization Management RN
- Location
- Madison, WI
- Listed
- Today
About the role
Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to review medical services with evidence-based criteria, authorize requested services as appropriate.
Our Utilization Management RN will be responsible for referring questionable cases to medical directors to prevent unnecessary procedures, treatments, or prolonged hospital stays. We’re looking for someone who’s open to cross-training in Case Management (CM), with the potential for the role to grow into a combined UM/CM position or transition into CM in the future.
From Wps—A Health Solutions Company's careers page, first listed on Rolev.ai on November 12, 2026. Rolev.ai is not the employer.
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Common questions
Where is the Utilization Management RN job at Wps—A Health Solutions Company located?
This Utilization Management RN position at Wps—A Health Solutions Company is located in Madison, WI. Always check Wps—A Health Solutions Company's application page for specific state eligibility or relocation policies.
How do I apply for the Utilization Management RN position at Wps—A Health Solutions Company?
This listing links directly to Wps—A Health Solutions Company's application page. You can apply directly on Wps—A Health Solutions Company's site, or use Rolev.ai to check your resume fit, generate a zero-hallucination tailored resume and cover letter for this posting, and autofill the application form in 1 click with the Rolev.ai Chrome extension. You always review the form and press Submit yourself.