Medicare Utilization Nurse Consultant (Predetermination)
CVS Health
CVS Health in the United States seeks a Medicare Clinical Predetermination Nurse to support utilization management for members, with a Monday–Friday schedule from 9:00am to 5:30pm EST or CST and occasional holiday rotation. The role requires assessing, planning, coordinating and evaluating options to provide appropriate healthcare services and benefits, collaborating with providers, and identifying referral opportunities to improve care and program effectiveness. #J-18808-Ljbffr CVS Health
- CVS Health is hiring an Utilization Management Nurse Consultant to enhance patient outcomes through clinical assessment in a remote environment. The role emphasizes collaboration with care teams, applying guidelines, and coordinating treatment plans to ensure appropriate...SuggestedRemote job
$26.01 - $56.14 per hour
...care one person, one family and one community at a time. Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient... ...Preferred Qualifications BSN preferred Experience in Medicaid, Medicare, or Commercial Health Plan Utilization Management...SuggestedHourly payFull timeTemporary workWork experience placementWork at officeLocal areaRemote workWork from home- ...Services we bring together our capabilities across strategy, consulting, technology, operations, Song and Industry X with our deep industry... ...stakeholders. Visit us at accenture.com.Within Accenture's Utilities Practice, We use our deep industry expertise in digital...SuggestedFull timeWork experience placementLive inWork at officeLocal area
$70.35k - $205.8k
We Are: Accenture's Utility Industry, Power Generation Practice is providing power for a safe, connected, and sustainable planet. Every... ...solving challenges and not just studying them, then Accenture Consulting is the right place for you. Join us to develop your ideas into...SuggestedFull timeWork experience placementLive inWork at officeLocal area$77k - $202k
...ApplicableSpecialismFunctional & Industry TechnologiesManagement LevelSenior AssociateJob Description & SummaryThe OpportunityAs a Utilities EAM Maximo Consultant, Sr. Associate, you will specialize in Maximo applications, assisting clients in optimizing operational efficiency...SuggestedFull timeH1b$26.01 - $56.14 per hour
...person, one family and one community at a time. Concurrent Review Nurse (RN) 100% Remote | Monday-Friday, 8:00 AM-5:00 PM CST... ...evidence-based criteria Collaborate with hospitals, physicians, utilization review departments, and care teams to support appropriate levels...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to Friday$26.01 - $56.14 per hour
...care one person, one family and one community at a time. Utilization Management Nurse Consultant (RN) - Remote | Prior Authorization | Utilization... ...Qualifications BSN preferred Experience supporting Medicaid, Medicare, or Commercial Health Plan populations Prior...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from home$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... ...in an acute care setting Experience as an RN for a Medicare Certified Home Health agency Health Plan or Medicare...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome office- We Are:Our Utility Industry, Transmission & Distribution Practice is powering the progress to a safe, connected, and sustainable planet... .... Visit our site to learn more about Accenture Strategy & Consulting Utilities Practice.You Are:A utility industry professional with...Full timeLive inWork at officeLocal areaFlexible hours
$99k - $232k
...ApplicableSpecialismFunctional & Industry TechnologiesManagement LevelManagerJob Description & SummaryThe OpportunityAs a Utilities EAM Maximo Consultant, Manager, you will specialize in Maximo applications, assisting clients in optimizing operational efficiency through...Full timeH1b$70.35k - $205.8k
We Are: Accenture's Utility Industry, Power Generation Practice is providing power for a safe, connected, and sustainable planet. Every... ...solving challenges and not just studying them, then Accenture Consulting is the right place for you. Join us to develop your ideas into...Work experience placementWork at officeLocal area- ...Ongoing clinical education to improve your skills. As a Registered Nurse at St. David's North Austin Medical Center, you'll have all the... ...What qualifications you will need: The Lactation Consultant is a Registered Nurse who champions and serves as an expert consultant...Temporary workFlexible hours
$29.1 - $62.32 per hour
...family and one community at a time. Medicare Clinical Predetermination Nurse Must be willing and able to work... ...occasional holiday rotation. Utilization Management is a 24/7 operation and... ...Services and benefit utilization. Consults and lends expertise to other internal...Hourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shift$99k - $232k
...Description & SummaryAt PwC, our people in business application consulting specialise in consulting services for a variety of business... ...requirements.The OpportunityAs part of the Energy Resources and Utilities Enabling Technologies team you are expected to lead efforts in...Full timeH1b$77k - $202k
At PwC, our people in business application consulting specialise in consulting services for a variety of business applications, helping... ...deliver quality work Uphold rigorous standards in deliverables Utilize firm methodologies and technology resources effectively What...H1b$99k - $232k
...ApplicableSpecialismFunctional & Industry TechnologiesManagement LevelManagerJob Description & SummaryThe OpportunityAs a Utility Network / ArcFM Consultant, Manager, you will play a pivotal role in helping clients optimize their operational efficiency through the...Full timeH1b- ...Ongoing clinical education toimproveyour skills.As a Registered Nurse at St. Davids North Austin Medical Center, you’... ...Qualifications What qualifications you will need: The Lactation Consultant is a Registered Nurse who champions and serves as an expert consultant...Temporary workFlexible hours
$1,766.5 per month
...Travel Offering Nursing Profession Registered... ...Nurse Specialty Utilization Review Job ID 385... ...Deliver case management and consultation for complex cases - Assist... ...- Knowledge of managed Medicare and Medicaid insurers - Experience...Weekly payWork experience placementRemote workShift work$99k - $232k
The Opportunity As a Utility Network GIS Consultant, Manager, you will play a pivotal role in helping clients optimize operational efficiency through business application consulting. You will focus on utilizing Esri's software suite, such as ArcGIS, to analyze, manage...H1b$1,492 - $1,724 per week
Details of the RN - Utilization Review opening in Austin, TX: Anticipated Start Date: 11/10/2026 Anticipated Pay Range: $1492.43 - $1723... ...origin, gender, sexual orientation, age, marital status, veteran status, or disability status. #J-18808-Ljbffr Travel Nurse Source- CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations and care coordination. This remote, full-time role features a weekend schedule after training and requires strong clinical judgment and proficiency...Remote jobFull timeWork at officeWeekend work
- ...Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning... ...policy criteria. Provides case management and/or consultation for complex cases. Assists departmental staff with issues...Remote work
- Job Description Spectrum Healthcare Resources has a potential opportunity for a Registered Nurse Utilization Management at Lackland AFB in San Antonio, TX. This contract position offers: Monday-Friday 730am-430pm Outpatient Clinic No Nights, Weekend or Holidays No...Contract workMonday to FridayWeekend work
- ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote role supporting EST/CST time zones. The position requires 2+ years of RN experience, current unrestricted RN licensure, and ability to work weekends/evenings as part of a 24/7 operation. The...Work at officeRemote workWeekend workAfternoon shift
$26.01 - $62.32 per hour
About This Role The Utilization Management Nurse Consultant at CVS Health is a detail-oriented RN role focused on improving healthcare outcomes by ensuring members receive appropriate care. This position is ideal for those passionate about clinical assessment and collaboration...Full timeRemote workShift workWeekend work- CVS Health is seeking a Utilization Management Nurse Consultant for a remote Texas position. The role uses clinical nursing experience to assess, plan, implement and evaluate services for members, with a strong focus on utilization management and care coordination. Ideal...Remote jobAfternoon shift
$29 - $62 per hour
About This Role The Utilization Management Nurse Consultant role at CVS Health involves utilizing clinical experience to assess, plan, implement, and evaluate healthcare services for members. This position is ideal for nurses with a strong background in acute care and a...Work at officeRemote workWork from homeAfternoon shift- CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote Utilization Management team. This full-time role focuses on ensuring appropriate care coverage and optimizing member outcomes within a 4‑day weekend schedule...Remote jobFull timeWeekend work
$26.01 - $62.32 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Medicare Precertification Utilization Management Nurse Consultant (RN) Remote | Full-Time | Weekends Are you a detail-oriented RN passionate about improving...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayShift workWeekend workAfternoon shift$103.6k - $141.1k
...implementations. We are hiring for a Senior Sage Intacct Implementation Consultant, who will be responsible for assisting our clients by... ...new processes and proceduresDevelop reports and dashboards utilizing the Intacct toolsSetup and configure 3rd integration toolsWork...Full timeContract workWork at officeLocal areaFlexible hours
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