Remote Utilization Management Nurse Consultant
CVS Health
CVS Health is seeking a Registered Nurse for Utilization Management on a work-from-home schedule with weekend coverage. You will assess, plan, implement, coordinate, monitor, and evaluate options to facilitate healthcare services and member benefits. Responsibilities include gathering clinical information, communicating with providers, and coordinating care. Requires active RN licensure, 3+ years RN experience, and 1+ years in UM/CM, with strong communication and multitasking abilities. #J-18808-Ljbffr
Vacancy posted 2 days ago
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- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant for a fully remote, 100% work-from-home role in the CST zone. The position supports utilization and benefit management with a 40-hour work week, Monday–Friday, and occasional after-hours coverage...Remote workWork from homeMonday to Friday
CVS Health
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...lunch Position Summary Utilizes clinical experience and... ...Services and benefit utilization Consults and lends expertise to other... ...administration of the utilization/benefit management function. Required... ...Associates Degree in Nursing required BSN preferred...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayCVS Health
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United States3 days ago- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate care...Remote jobFull timeWork from home
- ...Health Corporation is seeking an experienced Registered Nurse for Utilization Management. The role examines and coordinates care options, applying... ...a 24/7 environment with weekends, holidays and evenings. Remote work is supported for colleagues who live in-state, with...Remote jobLive inHome officeWeekend workAfternoon shift
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...of something bigger - helping to simplify health care one person, one family and one community at a time. NICU Utilization Management Nurse Consultant (Remote) Are you passionate about improving outcomes for the most vulnerable patients? We are seeking an experienced...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from home$26.01 - $56.14 per hour
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...determined in collaboration with management to ensure adequate weekend coverage. Position Summary Utilize your clinical experience and... ...and benefit utilization. Consult and lend expertise to other internal... ...Qualifications Registered Nurse Education: Diploma RN acceptable...Hourly payFull timeTemporary workWork at officeLocal areaWork from homeShift workWeekend work$80 - $120 per hour
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Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends... ...Services and benefit utilization. Consults and lends expertise to other internal... ...+ years of experience as a Registered Nurse in adult acute care/critical care setting...Hourly payFull timeTemporary workWork at officeLocal areaAfternoon shift- ...Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments...Remote workWork from home
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Frankfort, KY3 days ago - ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
SHR (Spectrum Healthcare Resources)
Honolulu, HI4 hours ago - ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing... ...This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
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New York, NY1 day ago - A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote work
The Judge Group, LLC
New York, NY1 day ago - ...Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting, and communicating medical... ...independent decisions aligned with organizational strategy. Remote-friendly, standard hours, with occasional travel. #J-18808...Remote work
Humana
Brooklyn, NY3 days ago - ...Optum is seeking an experienced Utilization Review Nurse (RN) to support inpatient care management in a remote-capable role. You will review admissions and preauthorizations using evidence-based criteria and collaborate with Medical Directors. The position requires an...Remote work
Palo Verde Community College District
Sacramento, CA13 hours ago - CVS Health seeks a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations through clinical review, care coordination, and evidence-based decision-making. This remote role requires an active RN license, NICU nursing experience, and familiarity...Remote jobWork from home
- ...Devoted Health is seeking a Clinical Guide for our Outpatient Utilization Management team. You will perform timely clinical reviews of outpatient... ...medical necessity and appropriate setting. This full-time, remote role supports CMS and Medicare Advantage requirements while...Remote workFull time
Talanto
Brooklyn, NY1 day ago $59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend workkozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ1 day ago- ...UnitedHealth Group is seeking a Utilization Management Nurse to help ensure high-quality, cost-efficient care across the continuum. You will assess... ...levels of care in collaboration with care teams. This remote role requires Pacific or Mountain Time Zone residence. You...Remote work
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Sacramento, CA4 days ago - ...Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective... ...with CMS, URAC, and other regulators. This fully remote role requires a US-based location, strong nursing background...Remote work
Vālenz Health
Brooklyn, NY2 days ago
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