Remote Utilization Management Nurse Consultant
CVS Health
- Remote job
CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate care for members. In this role you will review medical necessity, collaborate with providers, and support cost-effective care while meeting state and federal requirements. Strong clinical judgment and communication are essential. #J-18808-Ljbffr CVS Health
$29.1 - $62.32 per hour
...Join Our Utilization Management Team We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose...Remote workFull timeShift workAfternoon shift$29.1 - $62.32 per hour
...bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Commercial) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$29.1 - $62.32 per hour
...care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule: Monday, Tuesday, Thursday, Friday and Saturday...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$29.1 - $62.32 per hour
...determined in collaboration with management to ensure adequate weekend... .... Position Summary Utilize your clinical experience and... ...and benefit utilization. Consult and lend expertise to other internal... ...Registered Nurse Education: Diploma RN acceptable...Remote workHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend work- CVS Health is seeking a Registered Nurse for Utilization Management on a work-from-home schedule with weekend coverage. You will assess, plan, implement, coordinate, monitor, and evaluate options to facilitate healthcare services and member benefits. Responsibilities include...Remote jobWork from home
$26.01 - $62.32 per hour
...Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) We're building a world of health around every individual — shaping... ...one person, one family and one community at a time. Remote | Full-Time | Weekday Schedule Are you a Registered...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work$32.01 - $68.55 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual... ...Services and benefit utilization Consults and lends expertise to other internal... ...+ years of experience as a Registered Nurse in adult acute care/critical care setting...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shift- CVS Health is seeking a Nurse Consultant to assess and coordinate healthcare services for members in a fully remote role. You will apply clinical criteria, gather information... ...Office/IT systems. Outpatient or utilization management experience is a plus; BSN preferred....Remote jobWork at office
- ...Health Corporation is seeking an experienced Registered Nurse for Utilization Management. The role examines and coordinates care options, applying... ...a 24/7 environment with weekends, holidays and evenings. Remote work is supported for colleagues who live in-state, with...Remote jobLive inHome officeWeekend workAfternoon shift
$32.01 - $68.55 per hour
...with heart, 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$26.01 - $68.55 per hour
Utilization Management Nurse - Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring members...Remote workHourly payFull timeTemporary workLocal areaWeekday work- CVS Health is seeking a Utilization Management Clinical Consultant to work remotely from home, primarily serving Louisiana. The role focuses on examining medical necessity, applying clinical guidelines, and guiding providers in utilization management processes. The position...Remote jobWork from home
- Blue Cypress Consulting is seeking a Senior Utility Management Services (UMS) Consultant to support current projects and facilitate the expansion of our utility... ...of this job. This is a hybrid position (in office/remote). We offer a telecommute option to work once a week...Remote workFor contractorsWork at officeLocal areaWork from homeWork visa1 day per week
- ...Utilization Management Nurse Consultant Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in...Work at officeWeekend work
$66.58k - $142.58k
...alignment with relevant project plans. Manages and coordinates specific workplans for... ...publications, and/or facilitating research utilization to improve clinical care and outcomes.... ...technical writing skills ~ Registered Nurse (RN) required. Adept at problem solving...Remote workHourly payFull timeTemporary workWork experience placementWork from homeMonday to Friday$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 will...Hourly payFull timeTemporary workAfternoon shift- CVS Health seeks a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations through clinical review, care coordination, and evidence-based decision-making. This remote role requires an active RN license, NICU nursing experience, and familiarity...Remote jobWork from home
- ...Registered Nurse - Utilization Review About Company Bestica: We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...Observation (OBS). Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (...Remote work
- ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in... ...and a member’s benefit coverage while working remotely. Primary Responsibilities • Performs...Remote workContract workWork at office
- Senior Utility Process Consultant – Electric Distribution Patrol & Inspection Location: Remote (Work from home eligible) Position Overview Celerity is seeking a Senior Business... ..., engineering, vegetation, asset management, and compliance Document current-state...Remote workFull timeTemporary workWork from homeWork visaFlexible hours
- ...skilled and experienced Registered Nurse with specialties in Medical/... ...skilled nursing care, case management, and hospice care to... ...Certifications: Experience in Utilization Review or case management... ...to work independently in remote settings. Must be able to...Remote workFlexible hours
- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
- Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization requests. The role requires documentation of... ...criteria, and coordinating with Medical Directors. Remote options are available for eligible candidates. The position...Remote job
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$71.1k - $97.8k
...caring community The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing skills to support the coordination... ...role includes a required holiday rotation. This is a remote position. This role is responsible for overseeing...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work$58.66k - $142.45k
...Utilization Management Clinical Reviewer Mass General Brigham Health Plan is an exciting place... ...Education ~ Associate's Degree Nursing required or Bachelor's Degree Nursing... ...Approximately 6 months after hire. This is a remote role with occasional onsite team...Remote workWork at officeFlexible hours$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ..., 0730-1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~ U.S. Citizenship...Remote workContract workImmediate startMonday to Friday- Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters according to process instructions. You will extract pertinent details, reference clinical guidelines, and ensure compliance with HIPAA and policies. Position...Remote job
- UnitedHealth Group's Optum is seeking a Utilization Management Nurse to review patient records and craft defensible appeal letters in accordance with OPAS guidelines. This role supports 40 hours per week, Monday-Friday, with telecommuting flexibility across the U.S. and...Remote jobMonday to Friday
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