Remote UM Nurse Consultant - Utilization Management
$29.1 - $62.32 per hourCVS Health
- Remote job
CVS Health is seeking a fully remote UM Nurse Consultant. This role utilizes clinical experience to assess, plan, and coordinate healthcare services. The candidate must have 3+ years of Med Surg experience and an active RN licensure. The position offers a competitive salary, with typical pay ranging from $29.10 to $62.32 per hour, and includes a comprehensive benefits package, supporting the well-being of colleagues and their families. Join CVS Health and be part of a mission to simplify health care with a collaborative approach. #J-18808-Ljbffr CVS Health
- ...Primary Duties and Responsibilities The Utilization Nurse utilizes clinical expertise, discretion... ...independent judgment to utilization management and care coordination methodologies and... ...based Inpatient Care Guidelines. The UM Nurse will also be responsible for...Remote workLocal area
$26.01 - $62.32 per hour
4062 Aetna Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to work remotely. The role involves reviewing clinical information and coordinating treatment plans to ensure quality care. Candidates must have an active RN license...Remote workHourly payFull timeAfternoon shift$26.01 - $62.32 per hour
...Medicare Precertification Utilization Management Nurse Consultant (RN) – Remote, Full‑Time. Responsibilities Review and assess clinical information to support coverage determinations. Apply clinical guidelines, policies, and sound judgment across the care continuum. Collaborate...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayShift workWeekend workAfternoon shift$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 hours- 4004 Aetna Medicaid Administrators is seeking a Utilization Management Nurse Consultant for a crucial role in a 24/7 operation based in Florida. This position works from home and requires applicants to reside in Florida. The ideal candidate will have clinical experience...Remote workWork from home
- ...POSITION The Clinical Product Consultant for Utilization Management is a member of the... ...experienced Utilization Review Nurse who will serve as an... ...creating efficient workflow for UM nurses. Deliver on go-... ...external clients Ability to work remotely, effectively, and...Remote workLive outLocal areaFlexible hours
- ...A leading healthcare facility in the United States seeks a Clinical Product Consultant for Utilization Management. The role involves providing clinical insights, ensuring product accuracy, and managing implementation milestones. Candidates should have a BSN, extensive...Remote workFlexible hours
$26.01 - $74.78 per hour
...do it all with heart, each and every day. Position Summary CVS Health Aetna has an opportunity for a full‑time Utilization Management (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate...Hourly payFull timeTemporary workWork at officeLocal areaFlexible hours- ...GEHA is seeking a Nurse Consultant II to provide professional nursing care within Clinical Operations... ...through effective communication and management of health-care needs. Responsibilities... ...experience in case management or utilization management. The compensation range is...Remote work
$34 - $42 per hour
...Astrana Health is seeking a CA-licensed Utilization Review Nurse to assist in approving outpatient... ...least one year of outpatient Utilization Management experience. Open availability is needed, and this position offers a remote work option for nurses living in California...Remote workHourly pay- ...We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’ll... ...Advantage regulations (LCD/NCD policies) . This is a fully remote opportunity requiring discipline, accuracy, and...Remote work
- ...A leading managed care organization is seeking an experienced LPN... ...pre-service and post-service utilization reviews for durable medical equipment... ...a license, 3 years of nursing experience, and strong communication... ...include performing UM reviews, communicating outcomes...Remote work
- ...POSITION The Clinical Product Consultant for Utilization Management is a member of the... ...experienced Utilization Review Nurse who will serve as an... ...creating efficient workflow for UM nurses. Deliver on go-... ...clients. Ability to work remotely, effectively, and efficiently...Remote workLive outLocal areaFlexible hours
- ...Primary Responsibilities The Utilization Management Nurse will determine the medical appropriateness... ...Location Requirements This position is remote but requires the employee to live... .../payer experience required). ~ UM for Medicare Advantage, Managed Medicaid...Remote workWork at officeWeekend work
- ...GeBBS Consulting is a healthcare technology professional... ...Provider Practice 2) Managed Care / Payer Practice... ...currently hiring a Utilization Management Nurse Specialists Summary:... ...clients is looking for a UM Nurse Specialist to... ...Location: 100% Remote If you are interested...Remote workCurrently hiring
$34.98 - $42.85 per hour
...Remote in California only Are you ready to make a lasting... ...Job Summary The UM Nurse I - RN performs clinical review... ...policies. This role conducts utilization review activities under established... ...one (1) year in utilization management or case management preferred...Remote workHourly payWork at office$34 - $42 per hour
...UM Review Nurse Department: HS - UM Employment Type: Full Time... ...is looking for a CA-licensed Utilization Review Nurse to assist our Health... ...shifts per week. This is a remote position for CA-licensed... ...year of outpatient Utilization Management experience in a fast-paced...Remote workHourly payFull timeLive inWork at officeMonday to FridayShift work- ...Are you an experienced Registered Nurse (RN) – Utilization Management / Case Management (Medicare) with a desire... ..., including Utilization Management (UM) and Case Management (CM/DM),... ...required (1–6 weeks depending on role) Remote/hybrid flexibility available post-training...Remote workContract workLocal area
$60k
...experienced in the managed care payor... ...and post-service utilization reviews and appeals... ...an NCQA-compliant UM program. Salary:... ...ABILITIES The UM Nurse’s responsibilities... ...cases to independent consultants or IROs, when necessary... ...development opportunities Remote Opportunities We...Remote workTemporary workLocal area$44.64 - $71.24 per hour
...Summary Performs utilization review in accordance with... ...affecting utilization management. Reviews patients... ...Process Maps specific to UM functions. Follows... ...Associate's Degree in Nursing. Three (3) years experience... ...a hybrid setting with remote work as well as in an...Remote workHourly payFull timeContract workWork at officeFlexible hoursShift work- ...A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating medical services. Responsibilities... ...service eligibility and facilitating care. This remote role requires an RN license and clinical experience. Benefits...Remote workWork from home
- Vaya Health is seeking an IDD UM Clinician for a remote position based in North Carolina. The role involves conducting utilization review tasks, collaborating with care coordinators, and ensuring quality service provision for individuals with intellectual and developmental...Remote work
- ...a leader in the home health management industry and is preparing for... ...are currently looking for a UM Clinical Support Specialist to... ...Suite 700, Phoenix, AZ 85020 Remote Essential Functions Works independently... ...comprehensive reports on utilization and productivity and...Remote workWork at officeLocal areaWork from home
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...and Description of Project: Managing a case load for healthcare members with... ...contact and will include 80% travel. Remote role. Will require a driver’s license....Remote workHourly payFull timeContract workImmediate startShift work3 days per week$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...and Description of Project: Managing a case load for healthcare members with... ...contact and will include 80% travel. Remote role. Will require a driver’s license....Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...Job Title:Registered Nurse - Utilization Management (RN-UM) Location: Colorado Military Health System (CMHS), Fort Carson, CO, 80913 Tentative Start Date: December 1, 2025 Work Schedule: Monday-Friday, 8-hour shifts between 0600-1700, excluding federal holidays...For contractorsMonday to FridayShift work
$29.1 - $62.32 per hour
...Position Summary Utilization Management Nurse Consultant – A 24/7 operation based in Florida. This role works from home and requires the applicant to reside in Florida. Responsibilities Coordinate, document and communicate all aspects of the utilization/benefit management...Hourly payLocal areaWork from home$67.6k - $127k
...client needs are met in a dynamic environment. The ideal candidate should have a Registered Nursing License and at least five years of clinical experience. The position offers remote work flexibility within the continental US, excluding specific states. A competitive...Remote 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
$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 work
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