Medicare Predetermination Nurse Consultant
CVS
CVS Health is hiring a Medicare Predetermination Utilization Management Nurse Consultant. The role requires an RN with 3+ years of clinical experience and active licensure, plus Med/Surg exposure and MS Office proficiency. The job supports a 40-hour week with a 24/7 operation, including weekend shifts after training. Ideal candidates have Medicare or managed care exposure and the ability to coordinate care with providers and teams to optimize benefits and services. #J-18808-Ljbffr CVS Health
- CVS Health is seeking a Medicare Predetermination Utilization Management Nurse Consultant to join a 24/7 operation. The role involves assessing care needs, applying clinical criteria, and coordinating with providers to ensure appropriate benefits for members. Responsibilities...SuggestedShift work
- ...Relocation to Northern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner with facilities as the primary clinical resource in the pursuit of clinical excellence and,...SuggestedRelocation
$54.1k - $116.76k
...simplify health care one person, one family and one community at a time. Position Summary CVS Aetna is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you will play a critical role in ensuring fair and accurate resolution of clinical...SuggestedFull timeLocal areaRemote workMonday to FridayShift work- ...Position: Remote Nurse Consultant Company Overview: Absolute Elder Care is a leading provider of in-home care services for seniors. Our mission is to provide compassionate, personalized care to help seniors maintain their independence and quality of life. We are dedicated...SuggestedFull timeRemote workMonday to FridayFlexible hours
- ...Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant I (NS) Position Number 60090392 Grade MH16 About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex...SuggestedLocal areaRemote workNight shift
- Agency Dept of Health and Human Services Division Child and Family Well Being Job Classification Title Nurse Consultant II (NS) Position Number 60041079 Grade MH17 About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex...Local areaNight shift
- Medcan is seeking a Nurse Consultant, RN to join the LiveWell Client Care nursing team in a full-time, 18-month contract. This role supports patients with education, care navigation, and coordinated follow-up across health programs. Ideal candidates have 3+ years of nursing...Remote jobFull timeContract work
- ...and Human Services (DHHS) in Health Service Regulation seeks a Nurse Consultant I (NS) to license and certify health care providers and... ...on-site surveys or in-office reviews, for State Licensure and Medicare/Medicaid programs. You will provide regulatory oversight by surveying...Work at office
$76k
...contributions truly matter? If so, Medcan is the place for you! This job is for a current vacancy. Medcan is recruiting for a Nurse Consultant, RN to join our collaborative LiveWell Client Care nursing team in a full-time, 18-month contract position . This is an...Full timeContract workRemote workWeekend workAfternoon shift- CVS Health is seeking a licensed Registered Nurse for a remote, full-time Utilization Management role focused on weekend coverage. The position supports Saturday and Sunday shifts, with schedules including four 10-hour shifts or other approved configurations. You will assess...Remote jobFull timeShift workWeekend work
$40 - $50 per hour
...com. The Opportunity Carrot is expanding its telemedicine clinic with a network of part-time to full-time, fully remote Registered Nurses who deliver evidence-based virtual care to members across all U.S. states. As an RN in this network, you are often the first clinical...Full timeTemporary workPart timeFor contractorsRemote workWorldwideMonday to FridayFlexible hoursShift work- Vatica Health, Inc. is seeking a Clinical Nurse Consultant I for a remote role focused on CDI and risk adjustment. You will review chart data, evaluate active conditions, and communicate findings to providers to support accurate documentation and care gap closure. The...Remote job
$26.01 - $68.55 per hour
...us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Make an impact on patient care while working in a dynamic, collaborative environment. We're seeking an...Hourly payFull timeTemporary workWork at officeLocal areaWork from homeFlexible hoursAfternoon shift$62.04k - $102.37k
Agency: Dept of Health and Human Services Division: Health Service Regulation Job Classification Title: Nurse Consultant I (NS) Position Number: 60053997 Grade: MH16 About Us: The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most...Local areaNight shift$91k - $113k
...salary Flexible schedule About the Role: APremium Healthcare Solution, LLC is looking for a passionate and dedicated Virtual Nurse Consultant to join our growing team full time in Conyers, GA. This is an exciting opportunity to make a meaningful impact on patient outcomes...Full timeRemote workFlexible hours$62.04k - $102.37k
Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant I (NS) Position Number 60054032 Grade MH16 About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most...Local areaNight shiftWeekend work3 days per week$62.04k - $102.37k
...Division Health Service Regulation Job Classification Title Nurse Consultant I (NS) Position Number 60054181 Grade MH16 About Us: The North... ...have both adult care and nursing home beds. Those receiving Medicare/Medicaid undergo routine federal inspections every nine to fifteen...Local areaRemote workNight shiftAfternoon shift- Absolute Elder Care is seeking a Remote Nurse Consultant to provide expert guidance and support for in-home senior care. This full-time, remote role involves collaborating with families to manage health care needs, conducting comprehensive assessments, and developing individualized...Remote jobFull time
- The North Carolina Department of Health and Human Services (DHHS) is seeking a Nurse Consultant I (NS) to conduct regulatory inspections of nursing homes to ensure compliance with federal and state requirements. The role is home-based, servicing multiple counties in the...3 days per week
$65 - $70 per hour
...NOW HIRING: RN LACTATION CONSULTANT (IBCLC) –MATERNITY Location: Forest Hills, Queens, NY 11375 Pay: $65–$70/hour Schedule: Monday–Friday... ...Consultants! We are seeking a compassionate and experienced Registered Nurse (RN) –International Board Certified Lactation Consultant (IBCLC...Immediate startMonday to FridayFlexible hoursShift workDay shiftWeekday work- APremium Healthcare Solution, LLC seeks a Virtual Nurse Consultant to join our Conyers, GA team in a full-time, remote capacity. You will provide virtual nursing consultations, assess patient needs, and coordinate care with physicians and interdisciplinary teams. This...Remote jobFull time
$35 - $50 per hour
...A healthcare technology company seeks an experienced Registered Nurse for a remote role providing clinical technology services. This position is for independent contractors, focusing on chart reviews and clinical data analysis. Candidates should have an active RN license...Hourly payContract workFor contractorsRemote work$7.8k
A healthcare consulting firm is seeking a Provider Relations Representative to work with Health Plan clients to assist Medicare providers. This contract position requires five years of experience in provider relations roles, particularly within managed care settings. The...Contract work- Teleperformance is seeking a Healthcare Customer Support Specialist to manage inbound and outbound communications, ensuring a seamless customer experience in a high-velocity environment. The role emphasizes service quality, problem solving, and professional communication...Remote job
- Healix Infusion Therapy, LLC is seeking a Regional Coverage RN to join our Dallas/Fort Worth nursing team. The role involves staffing Office Infusion Centers across the region, providing infusion therapy and patient education in fast-paced settings. Travel is required to...Work at office
- ...in your success. You’ll be challenged, supported, and inspired, often all in the same day. You’ll develop technical expertise and consulting skills in a culture built on continuous learning, mentorship, and coaching. High-performing interns have a clear pathway into IBM...Full timeContract workPart timeFixed term contractWork experience placementInternshipWork from homeShift work
- ...Per Diem Clinical Nurse The (Per Diem) Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care... ...Certification ~ IBCLC Certification ~2 years of Lactation Consultant RN experience required Collective bargaining unit: NYSNA-MSH...Hourly payDaily paidLocal areaShift work
$65k - $80k
Overview BerryDunn is seeking a Staff Consultant, Medicaid to join our Medicaid Practice Group within our Consulting Team. This position... ...agencies to request funding approval from the Centers for Medicare & Medicaid Services (CMS). In support of OBP engagements, you...Remote work$166.5k - $208k
...Chartis has offices in Boston, Chicago, New York, Washington D.C., and Nashville. Remote work is allowed. Role Overview Consultants are integral members of our consulting teams, generally working on a single engagement to meet client needs while under the direction...Full timeWork at officeRemote work- Trusted Leader in Healthcare Services is seeking a remote Customer Service Specialist to handle inquiries related to Member Services, Medicare, and Billing. You will document interactions, maintain HIPAA privacy, and explain plan benefits with providers and members. A...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare Predetermination Nurse Consultant. Be the first to apply!
- disaster recovery consultant New York, NY
- part time communications consultant New York, NY
- remote consultant New York, NY
- network relations consultant New York, NY
- patient consultant New York, NY
- lighting consultant New York, NY
- entry level consultant New York, NY
- azure consultant New York, NY
- loss control consultant New York, NY
- family consultant New York, NY


