Remote Utilization Management Nurse: Care Oversight
Valenz
- Remote job
Valenz, a remote-first health services platform in the United States, seeks a Utilization Management Nurse to oversee the UM process for plan participants, ensuring appropriate, necessary, and cost-effective care. You will review prospective, concurrent, and retrospective UM activities, collaborate with internal teams and healthcare professionals, and maintain HIPAA confidentiality while driving high-quality outcomes. #J-18808-Ljbffr Valenz
- ...Role BHPS provides Utilization Management services to its... ...Utilization Management Nurse performs medical necessity... ...while working remotely. Primary Responsibilities... ...of services and care. • Provides referrals... ...for medical director oversight and necessity...Remote workContract workWork at office
- ...Job Description Job Description Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like... ...stays, outpatient surgeries, outpatient tests, care, etc. Review requests and match up to an...Remote workFull timeWork at office
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports... ..., coordinating with providers, and ensuring timely care while meeting state and federal requirements. Strong documentation...Remote jobWork from home
- ...of Dignity Health Management Services Organization... ...population health care management pathways... ...As our UM RN (Utilization Management Registered Nurse), you will be responsible... ...maintain rigorous oversight of care appropriateness... ...resources. As a remote employee, we will...Remote workLocal areaWork from homeShift workWeekend work
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents... ...activities, ensuring timely, safe, and appropriate care for members. In this role you will review medical necessity...Remote jobFull timeWork from home
$29.1 - $62.32 per hour
...surrounded by passionate colleagues who care deeply, innovate with purpose,... ...and one community at a time. Utilization Management is a 24/7 operation and work schedule... ..., and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule : Monday-Friday 1...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management... ...while supporting transitions of care and ensuring patients receive... ...(LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy...Remote work
- ...Seeking a California Licensed UM Nurse for a full-time remote position, who will review... ..., apply CMS and Milliman Care Guidelines, and collaborate... ...expertise is needed Utilize CMS guidelines and Milliman... ...service UM experience in a managed care environment Active, valid...Remote workFull time
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will leverage...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$32.01 - $68.55 per hour
...Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support our 24/7 Utilization Management operations. In this role, you...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$29.1 - $62.32 per hour
...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...family and one community at a time.Utilization Management is a 24/7 operation and work... ...weekends, holidays, and evening hours. UM Nurse ConsultantFully Remote- WFHSchedule : Tuesday-Saturday 9:3...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift- ...Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit... ...ability to work independently in a fast-paced managed care environment. #J-18808-Ljbffr Santa Barbara Cottage...Remote job
- ...California is seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior authorizations... ...contracts and participate in UM care programs. Required are an active CA... ...for experience. Hybrid work and remote- interview options are offered. #J...Remote jobTemporary work
- Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the... ...of high-quality, cost-effective care for plan participants. You will review... ...URAC, and other regulators. This fully remote role requires a US-based location, strong...Remote job
- CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document,... ...utilization and benefit management, ensuring appropriate care levels within state and federal requirements and...Remote jobFull time
- CVS Health seeks a Utilization Management Nurse Consultant to support a 24/7 operation. In this role you will assess, plan, implement, coordinate,... ...coverage determinations. You will communicate with providers and care teams to facilitate treatment decisions. Required RN...Remote job
$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... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate will...Remote jobWeekend work$42 per hour
IntusCare is seeking a Contract Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. The role collaborates with interdisciplinary... ...care settings. The position is fully remote within the United States and offers a 1-...Remote jobHourly payContract work- ...Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate... ...Office, and 2+ years in UM within managed care. Prior experience in various reviews and...Remote jobWork at office
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring... ...us in helping ensure members receive the appropriate care and benefits while making a meaningful impact on...Remote workHourly payFull timeTemporary workWeekend workAfternoon shift- ...Utilization Management Nurse Vālenz ® Health is the platform to simplify healthcare – the destination... ...across the entire patient journey – from care navigation and management to payment... ...Where You'll Work: This is a fully remote position, and we'll provide all the necessary...Remote workFull timeImmediate startMonday to FridayFlexible hours
- CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving candidates in the EST or CST zones. You... ...benefit management activities to ensure appropriate care while complying with state and federal...Remote jobFull time
- 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 jobFull timeAfternoon shiftWeekday work
- CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to EST residents across the U.S. You will... ...members receive safe, appropriate and cost-effective care. Schedule: Monday-Friday, 8:00 AM-5:00 PM EST,...Remote jobFull timeMonday to FridayWeekend work
$26.01 - $56.14 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual — shaping... ...by passionate colleagues who care deeply, innovate with purpose, hold ourselves... ...8:00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American Health...Remote workHourly payFull timeMonday to FridayFlexible hoursShift work$32.01 - $68.55 per hour
...Utilization Management Position We're building a world of health around every individual — shaping... ...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...2+ years of experience as a Registered Nurse in adult acute care/critical care setting...Remote workHourly payFull timeTemporary workWork at officeAfternoon shift- ...Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The... ...on assessment, coordination of care, and collaboration with providers to optimize... ...evenings/holidays after training; remote work is allowed with required home setup...Remote jobShift workAfternoon shift
$42 per hour
...help Programs of All-Inclusive Care for the Elderly (PACE)... ...adjustment, population health, and utilization management. IntusCare empowers teams to... ...Utilization Management Nurse plays a critical role in ensuring... ...location : This is a fully remote role based in the United...Remote workContract work$29.1 - $62.32 per hour
...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...family and one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home | Full... ...Consultant to join our team. This is a fully remote role available to candidates in any U...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayShift workWeekend work$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the... ...team. This team manages post-acute care services, including Skilled Nursing... ...Interqual. Experience working in a fully remote, metrics‑focused role. Experience...Remote workBi-weekly payTemporary work
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