Remote Utilization Management Nurse Consultant
Hispanic Alliance for Career Enhancement
CVS Health is seeking a Utilization Management Nurse Consultant for a remote role prioritizing Massachusetts residents. You will coordinate the utilization/benefit management program and ensure timely, appropriate care and location-specific turn-around times. Key duties include reviewing medical necessity, coordinating with facilities and providers, and applying clinical criteria to determine coverage. An RN with licensure and BSN preferred fits well. #J-18808-Ljbffr
Vacancy posted 6 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Consultant in Oklahoma City, OK vacancy
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Kansas City, MO17 hours ago - ...CVS Health is seeking an RN Utilization Management Nurse Consultant specialized in Medical Review. This fully remote role (U.S. only) requires a valid RN license and clinical experience to ensure medically necessary care through thoughtful review and collaboration with...Remote work
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Jefferson City, MO3 days ago $32.01 - $68.55 per hour
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Albany, NY17 hours ago$26.01 - $68.55 per hour
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Michigan3 days ago$26.01 - $68.55 per hour
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United States4 days ago$26.01 - $56.14 per hour
...family and one community at a time. Utilization Management is a 24/7 operation and work schedules... ...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...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shiftCVS Health
United States4 days ago$26.01 - $56.14 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual shaping a more connected, convenient and compassionate... ...review and collaboration with providers. This fully remote position offers the opportunity to apply your clinical...Remote jobHourly payFull timeLocal areaFlexible hoursShift work- ...Research, Rehabilitation Therapy and Nursing. Job Description Location :... ...programs are comprised of network management, clinical coverage, and policies. · Utilizes clinical skills to coordinate,... ...Services and benefit utilization · Consults and lends expertise to other...Work at officeWeekend work
Integrated Resources
Downers Grove, IL4 days ago $29.1 - $62.32 per hour
...of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and...Hourly payFull timeTemporary workLocal areaAfternoon shiftCVS Health
Phoenix, AZ17 hours ago- ...Remote, RI Contract Job Description: Responsible for the review and evaluation of clinical information and documentation... ...with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST...Remote workContract work
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United States5 days ago - ...Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote work
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New York, NY4 days ago - ...Registered Nurse - Utilization Review About Company Bestica We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
Bestica Healthcare
United States4 days ago - ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...Observation (OBS). Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (...Remote work
3B Healthcare, Inc.
United States2 days ago - ...skilled and experienced Registered Nurse with specialties in Medical/... ...skilled nursing care, case management, and hospice care to... ...Certifications: Experience in Utilization Review or case management... ...to work independently in remote settings. Must be able to...Remote workFlexible hours
vTech Solution
Santa Rosa, CA17 hours 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, AZ3 days ago$26.35 - $39.53 per hour
...NeueHealth is seeking a Concurrent Utilization Review Nurse responsible for real-time clinical reviews to ensure the medical necessity of healthcare services. The role includes conducting assessments, coordinating with providers, and collaborating with the Medical Director...Remote workHourly payNeueHealth
California, MO4 days ago- ...Utilization Management Nurse Des Moines, Iowa, United States Utilization Management Nurse Location: Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys...Remote workFull timeWork at office
Cottingham & Butler
Des Moines, IA3 days ago - ...We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’... ...Advantage regulations (LCD/NCD policies) . This is a fully remote opportunity requiring discipline, accuracy, and...Remote work
Appworkshub
New York, NY3 days ago - ...Guidehealth leverages remotely‑embedded Healthguides™ and a centralized Managed Service Organization to... ...precise and timely Utilization Review. In this role,... ...timeframes. Clinical Consultation & Collaboration Partner... ...aligned with Illinois nursing regulations and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home
Guidehealth
Chicago, IL17 hours ago $65 per hour
...Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role As a Utilization Review Registered... ...policies. Job details $65.00 / hour Remote, California Profession: Registered Nurse Facility...Remote workTotalMed Staffing
United States3 days ago$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ..., 0730-1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~ U.S. Citizenship...Remote workContract workImmediate startMonday to FridayVarite
Aurora, CO2 days ago$81.12k - $115.94k
...Location: Partially Remote, with onsite coverage required... ...Agnes Hospital Department: Utilization Management Schedule: Day-Shift |... ...expert case management and consultation, providing a roadmap for high... ...: ~ Registered Nurse credentialed from the Maryland...Remote workFull timeLocal areaMonday to FridayWeekend workDay shiftAscension
Baltimore, MD4 days ago- ...Description: This is a remote position but will need onsite... ...Collaborate with physicians, nursing staff, and interdisciplinary... ...ensure appropriate resource utilization and care planning Review admissions... ...utilization review, case management, or payer review experience preferred...Remote workFull timePart timeReliefWork at officeLocal areaShift workRotating shiftDay shift
Trinity Health
Mishawaka, IN3 days ago $80k - $95k
...Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly... ...this role is $80K-$95K. Work location: This is a fully remote role based in the United States. Sponsorship: This position...Remote workIntus Care
United States4 days ago$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination... ...or Interqual. Experience working in a fully remote, metrics-focused role Experience as an MDS Coordinator...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome officeHumana
Tallahassee, FL4 days ago$84.06k - $118.67k
...Your future role at a glance Location: Remote Facility: Ascension Network Service Department: Utilization Management Schedule: Days l Full Time Salary... .../ Registration: ~ Licensed Registered Nurse credentialed from the Texas Board of Nursing...Remote workFull timeLocal areaAscension
Austin, TX17 hours ago$84.06k - $118.67k
...glance Location: Remote Facility: Ascension... ...Hospital Department: Utilization Review Schedule:... ...spiritual care and stress management resources Family... .... Manage and consult on high-acuity or complex... ...~ Licensed Registered Nurse credentialed from the...Remote workFull timeLocal areaAscension
Pensacola, FL6 days ago$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible... ...Work Environment: Corporate office preferred / remote may be considered Collaborative environment requiring frequent...Remote workHourly payWork at officeNeueHealth
Encino, CA17 hours ago$46.79 - $72.52 per hour
***REMOTE*** Sr Risk Management Consultant (RN/Registered Nurse) - Sinai Hospital ~ Baltimore, MD ~ SINAI HOSPITAL ~ QUALITY LBH ~ Full-time w/Weekend Commitment... ...state and federal regulatory requirements. Utilize the domains of Enterprise Risk Management...Remote workFull timeTemporary workShift workWeekend workDay shift$72.8k - $130k
...and projects. We have collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaUnitedHealth Group
Boston, MA1 day ago
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