Remote Utilization Nurse Consultant - Care Optimization

CVS Health

Remote job

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 care and utilization management. The RN with 3+ years of experience, including Med/Surg, and an Associate’s degree (BSN preferred) will support coverage decisions and connect members to additional services as needed. #J-18808-Ljbffr CVS Health

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Remote Utilization Nurse Consultant - Care Optimization in Austin, TX vacancy

UM Nurse Consultant
$26.01 - $56.14 per hour
...surrounded by passionate colleagues who care deeply, innovate with purpose, hold... ...community at a time. Concurrent Review Nurse (RN) 100% Remote | Monday–Friday, 8:00 AM–5:00 PM CST... ...Collaborate with hospitals, physicians, utilization review departments, and care teams to...
Remote work
Hourly pay
Full time
Temporary work
Work at office
Local area
Work from home
Monday to Friday
CVS Health
Austin, TX
3 days ago
Utilization Management Registered Nurse
...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented... ...transitions of care and ensuring patients receive... ...policies). This is a fully remote opportunity requiring... ...initiatives and process optimization. ~ Competitive compensation...
Remote work
Appworks
United States
5 days ago
Nurse Consultant
...Dickinson (US) LLP seeks a Nurse Consultant to join our team. The Nurse... ...outcomes. This role is performed utilizing firm-approved technology... ...position has been approved for remote work. RESPONSIBILITIES:... ...inconsistencies, causation, standards of care, and damages; document...
Remote work
Work at office
Womble Bond Dickinson LLP
Phoenix, AZ
2 days ago
MDS RN Nurse Consultant, Minnesota
...required). Ensure resident care plans and supporting documentation... ...OBRA documentation. Review nursing notes to ensure clarity,... ...care. Arrange assessments to optimize RUG/CMI scores. Manage Medicare... .... Hybrid schedule (remote and on-site). Supportive, collaborative...
Remote work
Full time
Contract work
AHI - Advanced Health Institute
Minneapolis, MN
15 minutes ago
Remote Utilization Management Nurse: Improve Care & Costs
...Health Solutions in Medford, OR is seeking an experienced Utilization Management Nurse to perform prospective, concurrent, and retrospective... ...criteria and collaborate with physician advisors to optimize member care and appropriate payments. The role requires an Associate...
Remote work
Cambia Health Solutions
Medford, OR
3 days ago
Appeals Nurse Consultant (Remote)
$66.58k - $142.58k
...Appeals Nurse Consultant We're building a world of health around every... ...by passionate colleagues who care deeply, innovate with... ...Nurse Consultant to join our remote team. In this role, you will... ...Appeals, Managed Care, or Utilization Review experience. Proficiency...
Remote work
Hourly pay
Full time
Temporary work
Local area
Monday to Friday
Shift work
Avery Healthcare Group Ltd.
United States
5 days ago
Sr. Utilization Management Nurse RN-Field Position
$72.8k - $130k
...organization that delivers care, aided by technology to help... ...you help us advance health optimization on a global scale. Join us to... ...occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional...
Remote work
Minimum wage
Full time
Work experience placement
Casual work
Live in
Work at office
Local area
Optum
Springfield, MA
17 hours ago
RN, Registered Nurse -Lactation Consultant
...Summary: The Registered Nurse Lactation Counselor... ...mothers and infants, utilizing the nursing process to... ...evaluate individualized care. This role involves providing in-person consultations, telephone follow-ups,... ...mothers and infants receive optimal care. The Lactation...
Full time
CHRISTUS Health
Boerne, TX
8 days ago
Concurrent Review UM Nurse Consultant - Louisiana Residence Preferred
$54.1k - $116.77k
..., you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable... ...person, one family and one community at a time. Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management Are...
Remote work
Hourly pay
Full time
Temporary work
Work at office
Local area
Work from home
CVS Health
Louisiana
4 days ago
Nurse Consultant 1 (PCN 064038M)
...inspections is to determine a health care providers ability to provide... ...-day activities could span remote villages in the Arctic... ...link and search for Nurse Consultant 1 : Qualifications Competency... ...requirements if applicable. If utilizing this education you must show...
Remote work
Full time
Contract work
Part time
Work experience placement
Flexible hours
State of Alaska
Anchorage, AK
6 days ago
Regional Nurse Consultant
...Regional Nurse Consultant (RNC)Sheridan Healthcare | Regional Corporate Clinical Role Shawnee... ...corporate clinical team, with a focus on Wound Care and Falls Monitoring across our... ...flexibility for documentation, follow-up, and remote facility support. Planned regional...
Remote work
Full time
Work from home
Shawnee Senior Living, LLC
Herrin, IL
3 days ago
Registered Nurse-Utilization Review
...Registered Nurse – Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS). Required Qualifications...
Remote work
3B Healthcare, Inc.
Torrance, CA
2 days ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote position. You will review medical necessity, facilitate discharge planning, and... ..., 2+ years acute hospital experience, UR/Managed Care experience, and an active RN license. The role involves...
Remote work
CVS Health
United States
17 hours ago
Registered Nurse:Utilization Review,16:00:00-04:30:00
$1,813 - $1,908 per week
...Registered Nurse:Utilization Review,16:00:00-04:30:00 Location: Torrance, California Type... ...Review* Admission Criteria Care coordination Concurrent Review Continued... ...National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/...
Remote work
B2B Staffing Services
Torrance, CA
2 days ago
Registered Nurse Utilization Review
...skilled and experienced Registered Nurse with specialties in Medical/... ...for providing skilled nursing care, case management, and hospice... ...: Experience in Utilization Review or case management roles... ...ability to work independently in remote settings. Must be able to...
Remote work
Flexible hours
vTech Solution
Santa Rosa, CA
3 days ago
Registered Nurse Consultant
$45 per hour
...seeking an experienced Registered Nurse (RN) to support our assisted living and memory care communities in Spooner, Wisconsin, as a contracted RN Consultant. This role focuses on clinical oversight... ...of on-site community visits and remote work based on community needs...
Remote work
Hourly pay
Part time
VitaCare Living Rice Lake I & Rice Lake II
Spooner, WI
3 days ago
RN - Utilization Review
...Remote Utilization Review Specialist In this remote role, you will conduct utilization reviews, ensuring that patient care meets the necessary standards. You will coordinate with healthcare teams for optimal patient outcomes while managing documentation and compliance...
Remote work
Weekly pay
Slate Healthcare
United States
5 days ago
Utilization Management Nurse
...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization... ...'s benefit coverage while working remotely. Primary Responsibilities:... ...ensure timely review of services and care. Provides referrals to Case management...
Remote work
Contract work
Work at office
MagnaCare
Chapel Hill, NC
1 day ago
Registered Nurse - Utilization Review (Nursing)
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U.... ...months RN experience in direct patient care • 12 consecutive months in Utilization...
Remote work
Contract work
Immediate start
Monday to Friday
J Edward Staffing LLC
Aurora, CO
2 days ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review... ...services, collaborate with providers to authorize care, and elevate cases when needed while maintaining thorough...
Remote work
Preferra Insurance
Phoenix, AZ
7 hours ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal for individuals who thrive... ...to make a clinical impact without direct patient care. Highlights include a remote role in VA with...
Remote work
CVS Health Corporation
Virginia, MN
7 hours ago
Registered Nurse - Utilization Review
$1,908 per month
...Travel Offering Nursing Profession Registered... ...Nurse Specialty Utilization Review Job ID 1778... ...* Admission Criteria Care coordination Concurrent Review... ...Additional Skills remote UR work CA and Medi-Cal experience...
Remote work
Weekly pay
Shift work
Night shift
Providence Little Company of Mary Medical Center Torrance
Torrance, CA
5 days ago
Utilization Management Registered Nurse (RN) - Remote
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities... ...of inpatient or outpatient services, Quality of care concerns. Interfacing routinely with ordering providers...
Remote work
Bi-weekly pay
Full time
Temporary work
For contractors
Local area
Work from home
Guidehealth
United States
5 days ago
Remote Utilization Management Nurse Consultant
...CVS Health Corporation in Springfield, IL is hiring a Utilization Management Nurse Consultant to assess and coordinate care, applying clinical criteria to determine coverage and benefits for members. This is a 24/7 operation with weekend, holiday and evening hours....
Remote work
Shift work
Weekend work
Afternoon shift
CVS Health
United States
4 days ago
Regional Nurse Consultant RN
...Regional Nurse Consultant RN StoneGate Senior Living in Tulsa, OK is hiring a Regional Nurse Consultant RN for our Tulsa, OK region. A rewarding... ...facility that specializes in long-term and rehabilitative care! If you are an experienced Regional Nurse Consultant RN, we...
Remote work
Work at office
Work from home
Flexible hours
StoneGate Senior Living
United States
1 day ago
Senior Consultant, Process Optimization & Agentic Operations
...Position SummaryThe Senior Consultant will combine... ...based approaches, process optimization expertise, and operational... ....For all virtual remote positions, in order to... ...expectation of family care being in place during... ...more than one person is utilizing the same internet connection...
Remote work
Full time
Second job
Ascensus
Tampa, FL
10 hours ago
Remote Utilization Management Nurse Consultant
...CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise documentation. The position...
Remote work
Flexible hours
Pennsylvania Psychological Association
Phoenix, AZ
7 hours ago
RN - Utilization Review
$2,158.8 per week
...Ref. 65547807 RN - Utilization Review $2,158.80 per... ...in Fort Myers, FL. This remote position requires expertise... ...opportunity for experienced nurses to work in a flexible virtual... ...healthcare providers to optimize patient care Manage electronic medical...
Remote work
Weekly pay
Work experience placement
Monday to Friday
Flexible hours
Shift work
Weekend work
Seven Healthcare
Fort Myers, FL
4 days ago
UTILIZATION MANAGEMENT NURSE
...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases... ...Management team on coordinating patient care to ensure patients can access the... ...'s home which may be in understaffed/remote areas, in the presence of pets or family...
Remote work
Full time
Work at office
North East Medical Services
Burlingame, CA
4 days ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking an experienced Utilization Management Nurse Consultant to apply clinical judgment and guidelines to determine appropriate benefits across the continuum of care. This full-time role supports a 24/7 operation, with scheduled weekends, holidays and...
Remote work
Full time
Weekend work
Afternoon shift
4062 Aetna Resources, LLC
United States
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Nurse Consultant - Care Optimization. Be the first to apply!