---
title: 'Utilization Management Nurse, LVN/LPN (Part Time) at NeueHealth'
canonical: 'https://feeny.ai/job/utilization-management-nurse-lvn-lpn-part-time-neuehealth-remote-2k15a32ppf9g'
type: 'job'
last_seen: '2026-09-07'
---

# Utilization Management Nurse, LVN/LPN (Part Time) at NeueHealth

- **Company:** NeueHealth
- **Location:** Remote
- **Work type:** remote
- **Posted:** 2026-07-21
- **Last confirmed live:** 2026-09-07
- **Apply:** https://job-boards.greenhouse.io/neuehealth/jobs/6121357004

## Job description

## WHO WE ARE

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

## SCOPE OF ROLE

The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member’s receive services and resources required to meet desired health and social outcomes. The UM Nurse is responsible for providing patient centered care across the care continuum.

This is a part time position that requires availability to work weekends (Saturday and Sunday).

## ROLE RESPONSIBILITIES

- Capacity to perform prospective, retrospective, or concurrent medical necessity reviews for an assigned panel of members
- Capacity to review cases for medical necessity and apply the appropriate clinical criteria; to include, but not limited to Medicare criteria, Medicaid/Medi-cal criteria, Interqual, Milliman, or Health Plan specific guidelines
- Capacity to collaborate with the Medical Director to ensure the integrity of adverse
- determination notices based on the quality standards for adverse determinations
- Capacity to ensure discharge planning is timely and appropriately communicated to transition of care teams, when applicable.
- Capacity to meet or exceed productivity targets set forth
- Capacity to serve as a resource to non-clinical team members when applicable
- Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

- Associate’s degree in Nursing, preferred
- Minimum 2 years of experience in medical management clinical functions.
- Working knowledge of MCG, InterQual, and NCQA standards

## LICENSURES AND CERTIFICATIONS

- Active California and Unrestricted License as a Licensed Vocational Nurse (LVN)
- Certification Managed Care Nursing (CMCN) preferred

## WORK ENVIRONMENT

- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
- Some travel may be required.

For individuals assigned to a location(s) in California, NeueHealth is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant’s education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $26.35-$39.53 Hourly.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

## About NeueHealth

## Company Overview
- **One-liner**: NeueHealth is a value-driven healthcare company that aligns the interests of health consumers, providers, and payors to deliver high-quality, coordinated care across the ACA Marketplace, Medicare, and Medicaid.
- **Entity Type**: Public (NYSE: NEUE) – acquired by New Enterprise Associates in December 2024
- **Headquarters**: Doral, Florida, United States
- **Founded**: 2021 (IPO date; predecessor Bright Health Group founded earlier)
- **Founders**: Not publicly listed as a single founder entity; leadership includes G. Mike Mikan (CEO) and Robert J. Sheehy (Executive Chairman)

## Core Business
- **Primary industry**: Healthcare – value-based care delivery and provider enablement
- **Target customers**: Health consumers (patients), independent providers/medical groups, and payors (health plans, government programs)
- **Mission or purpose**: "Driving value in healthcare for all" – making high-quality, coordinated healthcare accessible and affordable to all populations

## Products & Services
- **NeueCare**: A value-driven care delivery business that manages risk in partnership with external payors. Operates 66 owned primary care clinics (in-person and virtual) in Florida and Texas, with embedded pharmacy, laboratory, radiology, and population health focused specialty services. Serves ACA Marketplace, Medicare, and Medicaid populations.
- **NeueSolutions**: A provider enablement business offering technology, services, and clinical care solutions to independent providers and medical groups. Helps them succeed in performance-based arrangements through financial alignment, population health tools, and partnerships with leading health plans and government programs (including CMMI’s ACO REACH program). Serves approximately 42,000 value-based care consumers.

## Market Standing
- **Valuation/Market Cap**: Acquired by New Enterprise Associates in December 2024 for $1.3 billion (private now). Prior public market cap varied.
- **Key Metric**: Annual Revenue of approximately $890 million (latest available); manages $2.5 billion in medical expense; serves 600,000+ health consumers; works with 3,000+ affiliated providers and 21 payor partners.
- **Notable Investors/Partners**: Parent company is New Enterprise Associates, Inc. (NEA). Key payor partners include leading health plans and government programs (Medicare, Medicaid, ACA Marketplace).
- **Growth Signals**: Acquired Centrum Health in July 2021; headcount of ~106 employees with +4.5% yearly growth; 26,171 LinkedIn followers (+3.6% yearly); 8 active job postings (though down 85.2% year-over-year, indicating post-acquisition consolidation).

## Competitive Advantages
- **Value-driven alignment**: Uniquely aligns interests of consumers, providers, and payors to drive value, rather than volume.
- **Integrated care model**: Owns clinics (NeueCare) and enables external providers (NeueSolutions), creating a hybrid delivery system with embedded pharmacy, lab, and specialty services.
- **Risk management expertise**: Deep experience in performance-based arrangements, including participation in CMMI’s ACO REACH program.
- **Scale and reach**: Serves hundreds of thousands of consumers across multiple insurance programs (ACA, Medicare, Medicaid) with a national provider network.

## Strategic Focus
- **Current priorities**: Advancing value-driven, consumer-centric care; expanding NeueCare clinics in Florida and Texas; deepening NeueSolutions provider enablement tools and partnerships; integrating post-acquisition operations under NEA ownership.
- **Direction for growth**: Scaling performance-based arrangements with payors, increasing the number of affiliated providers, and improving health outcomes for all populations served.

## Why Work Here
- **Culture highlights**: "Transforming healthcare to make it work the way it should for everyone" – mission-driven environment focused on positive impact. Collaborative work environment with supportive clinical staff (e.g., dedicated Medical Assistant for providers).
- **Remote/hybrid/office policy**: Several roles listed as "Work from home" (e.g., UM Coordinator, Associate, Affiliate Growth). Clinics require in-person presence. Hybrid likely for corporate roles.
- **Notable perks**: Comprehensive benefits including flexible medical/dental/vision plans, virtual visits, Health Savings Account company contributions, 401(k) with competitive match, flexible paid time off, company holidays, Employee Assistance Program (counseling, legal/financial advice). For providers: Monday–Friday schedule with limited/compensated on-call time, guaranteed base salary with annual bonus, sign-on bonus eligibility, annual CME reimbursement.
- **Engineering/technical culture**: Small but growing AI engineering team (Director of AI Engineering listed); technical roles in product, project management, and consulting. Talent drawn from UnitedHealth Group, Bright Health, Optum, Centrum Health, and PwC.

## Sources
1. [NeueHealth.com](https://neuehealth.com/)
2. [NeueHealth Careers Page](https://neuehealth.com/careers)
3. [LinkedIn – NeueHealth](https://www.linkedin.com/company/neuehealth)
4. [Reuters – NeueHealth Inc](https://www.reuters.com/markets/companies/NEUE.N)
5. [NEA Careers – NeueHealth Jobs](https://careers.nea.com/jobs/bright-health)

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