Remote Utilization Management Nurse Consultant
Hispanic Alliance for Career Enhancement
CVS Health is seeking a Utilization Management Nurse - Precertification RN to support remote precertification processes. The role requires an active RN license and 3+ years of clinical nursing experience, with strong decision-making using evidence-based criteria. You will review information, authorize services, and collaborate with providers and internal teams in a fast-paced environment, ensuring timely coverage decisions and high-quality care. #J-18808-Ljbffr
Vacancy posted 10 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Consultant in Seattle, WA vacancy
- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant for a fully remote role. You will assess and coordinate care options, apply clinical criteria to determine coverage, and communicate with providers to ensure appropriate services for members....Remote workWork at office
CVS Health
Lansing, MI9 hours ago - ...CVS Health is seeking an experienced Utilization Management Nurse - Precertification RN to work remotely on a full-time, weekday schedule. You will review clinical information, apply criteria, and authorize services while collaborating with providers to support timely...Remote workFull timeWeekday work
Hispanic Alliance for Career Enhancement
Iowa, LA9 hours ago - ...CVS Health is hiring a Utilization Management Nurse for precertification. This full-time, remote role involves reviewing clinical data, applying evidence-based criteria, and authorizing services within guidelines. You will work with providers and internal teams to ensure...Remote workFull time
Hispanic Alliance for Career Enhancement
Saint Paul, MN9 hours ago - ...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...Remote work
Hispanic Alliance for Career Enhancement
Oklahoma City, OK2 days ago $32.01 - $68.55 per hour
..., each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...Remote workHourly payFull timeLocal area10 hours per weekFlexible hoursThe Muse
Albany, NY3 days ago$29.1 - $62.32 per hour
## Utilization Management Nurse ConsultantApplyremote type: Remotelocations: MI - Work from home: MS - Work from home: PA - Work from home... ...weekends, holidays, and evening hours.* **UM Nurse Consultant**Fully Remote- WFH**Schedule : Tuesday-Saturday 9:30am-6:00pm****Position...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftCVS Health
Lansing, MI9 hours ago- ...Alliance for Career Enhancement is seeking an experienced Utilization Management Nurse - Precertification RN whose primary focus is ensuring appropriate... ...-quality care through the precertification process. This remote, full-time role emphasizes evidence-based decision-making...Remote workFull time
Hispanic Alliance for Career Enhancement
Topeka, KS10 hours ago - ...CVS Health is seeking a Utilization Management Nurse Consultant specializing in Medical Review. This fully remote role requires an active RN license, 3+ years clinical experience, and 1+ year in Utilization Review/Medical Management. You will apply criteria to determine...Remote work
4062 Aetna Resources, LLC
Kansas City, MO3 days ago $26.01 - $68.55 per hour
...of something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and...Remote workHourly payFull timeTemporary workLocal areaWeekday workHispanic Alliance for Career Enhancement
El Paso, TX9 hours ago- ...CVS Health is seeking an Utilization Management Nurse Consultant (Clinical Precertification RN) for Medicare, remotely. This full-time role asks for an active RN license and several years of experience to evaluate care and determine coverage using evidence-based guidelines...Remote workFull timeAfternoon shiftWeekday work
Hispanic Alliance for Career Enhancement
Wausau, WI10 hours ago $26.01 - $68.55 per hour
...Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring...Remote workHourly payFull timeTemporary workWeekday workOak St. Health
United States2 days ago$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse (RN) - 24/7 Operations Location: Remote (Preference for CST/MT time zones) Schedule: 8:00 am to 5:00 pm Includes evenings, weekends,...Remote workHourly payFull timeTemporary workLocal areaAfternoon shiftCVS Health
Jackson, MS1 day ago$26.01 - $56.14 per hour
...00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American... ..., is a URAC-accredited medical management organization founded in 1993. We provide... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review,...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift workCVS Health
United States8 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 job
$26.01 - $68.55 per hour
...Position Summary Utilizes clinical experience and skills in a collaborative... ...and benefit utilization. Consults and lends expertise to other... ...of the utilization/benefit management function. Typical office... ...of experience as a Registered Nurse in adult acute care/critical...Hourly payFull timeTemporary workWork at officeLocal areaAfternoon shiftHispanic Alliance for Career Enhancement
Hartford, CT9 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
US Tech Solutions
United States8 days ago - ...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, IL2 days ago - ...ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers... ...care quality. Qualifications include a NLN-accredited nursing program, at least 3 years acute care nursing, and an...Remote workPart timeWork from home
Santa Barbara Cottage Hospital
New York, NY9 hours 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
Santa Barbara Cottage Hospital
New York, NY9 hours ago - ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
Guidehealth
Chicago, IL9 hours ago - ...Akron Children’s Hospital is seeking a Utilization Management Nurse to lead medical necessity reviews, assuring appropriate use of hospital resources... ...with physicians and care teams. The role offers a remote work option, standard daytime schedule, and 40 hours per week...Remote work
Akron Children's Hospital
Akron, OH9 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
IntePros
New York, NY9 hours 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 States7 days 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, NY9 hours 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 States5 days ago - ...Santa Barbara Cottage Hospital is seeking a Per Diem RN for Utilization Management Review. This role offers the flexibility of remote work and requires a valid MA Registered Nurse State License. The successful candidate will participate in ensuring quality patient care...Remote workDaily paid
Santa Barbara Cottage Hospital
New York, NY10 hours ago $20 - $26.9 per hour
...Excellus BCBS is hiring for a position supporting Utilization Management workflows in Rochester, NY. This role requires effective handling of... ...role offers a compensation range of $20.00 to $26.90 per hour, with potential remote work options available. #J-18808-Ljbffr...Remote workHourly payExcellus BlueCross BlueShield
Rochester, NY9 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, AZ1 day ago- ...to oversee the design, implementation, and sustainability of Utilization Management clinical programs. You will ensure clinical integrity,... ...standardizing national UM strategy and workflows. This role is remote with potential travel to Humana locations; requires 40 hours...Remote work
Humana
New York, NY10 hours ago - ...Clover Health is hiring a Registered Nurse (RN) for Home Health Utilization Management. This remote role supports CMS-guided reviews, medical necessity determinations, and collaboration with providers to ensure appropriate, efficient care within Home Health services....Remote work
Clover Health
New York, NY9 hours ago
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