RN Utilization Manager — Remote Care Optimization
CVS Health
- Remote job
CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management. In this role you will review clinical information to support coverage determinations, apply guidelines, and coordinate care to ensure appropriate, high-quality outcomes. This full-time, remote position requires an active RN license, 2+ years in adult acute or critical care, and strong communication. Associates degree in nursing is required, with preferred Med-Surg or utilization management experience. #J-18808-Ljbffr CVS Health
$113.73k - $170.46k
...patients receive high-quality care while efficiently utilizing medical resources. Reviews... ...patient outcomes and optimizing resource allocation. Utilizes... ...~ Registered Nurse (RN) licensure in the state of... ...variances to the on-site care management teams when appropriate. Reviews...Remote workFull timeWork experience placement- ...seeking an experienced Registered Nurse (RN) to join our Utilization Management team, helping ensure members receive appropriate care at the right time through evidence-based clinical... ...promoting care management initiatives to optimize health outcomes. A flexible schedule...Remote jobFlexible hours
- ...on behalf of a partner company, is seeking a Case Manager - Utilization Review Specialist for a remote US role. You will oversee admission and... ...managers, and payer representatives to protect patient care and optimize reimbursement outcomes. The ideal candidate has 5...Remote job
- INTEGRIS Health is seeking a remote RN Case Manager - Utilization Review for a full-time days position in Oklahoma... ...plans to ensure high-quality care. The role requires a BSN, Oklahoma RN... ...with physicians and hospital staff to optimize resource utilization and discharge...Remote jobFull timeWeekend work
- ...Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote, part-time role. The position covers enterprise-wide shifts with on-call and weekend rotations, requiring RN licensure with a compact license within the service area. Responsibilities...Remote workPart timeShift workWeekend work
- ...Behavioral Health Utilization ManagerBehavioral Health Utilization Manager will perform concurrent and discharge reviews on... ...stay in the appropriate level of care. Notifies Medical Director regarding... ...telephone systems Work Schedule: Remote Other Requirements: Able to work...Remote workContract workWork experience placement
- ...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know... ...timely transfers to appropriate levels of care as indicated by clinical needs and...Remote workFull timeWork at officeWeekend work
- CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team. You will review clinical information, apply guidelines, and coordinate care to ensure members receive the right care at the right time. The role requires an active RN license...Remote jobShift work
- Intermountain Health seeks an RN Utilization Review Care Management I for a fully remote, part-time role. You will use clinical expertise to perform utilization review screenings, assessments, and evaluations, developing plans that promote cost-effective, high-quality...Remote jobPart time
- Intermountain Health is seeking an RN Utilization Review Care Management I for St. Marys Regional Hospital in a fully remote, part-time role. The position emphasizes utilization review screenings, assessments, and coordinating with patients, providers, and payers to ensure...Remote jobPart time
- Intermountain Health is seeking an RN Utilization Review Care Management I for remote work. The role focuses on screenings, assessments, and evaluations to ensure cost-effective, high-quality care while coordinating with patients, families, providers, and payers. This...Remote jobPart timeShift work
- Intermountain Health seeks an RN Utilization Review Care Management I to perform utilization review screenings, assessments, and evaluations with a focus on cost-effective, high-quality care. The role involves collaboration with patients, families, providers, and insurers...Remote jobFlexible hoursShift work
- Intermountain Health is seeking an RN Utilization Review Care Management I to perform utilization review screenings, assessments, and evaluations with a focus on cost-effective, high-quality care. The role collaborates with patients, families, providers, insurers, and stakeholders...Remote jobPart time
- Intermountain Health is seeking an RN Utilization Review Care Management I to perform utilization review, screenings, assessments, and evaluations. The role focuses on responsible resource stewardship, cost-effective, high-quality care, and collaboration with patients,...Remote jobFlexible hoursShift workWeekend work
- Intermountain Health is seeking an RN for Utilization Review Care Management I to perform screenings, assessments, and evaluations focused on cost-effective, high-quality care. Remote-friendly role with enterprise-wide shift coverage and weekend rotation; requires RN license...Remote jobShift workWeekend work
- Intermountain Health is seeking an RN Utilization Review Care Management I for St. Marys Regional Hospital. This fully remote role involves coordinating utilization reviews, applying evidence-based guidelines, and ensuring compliant, cost-effective care. Flexible options...Remote jobPart timeFlexible hoursWeekend work2 days per week
- Intermountain Health is seeking an RN Utilization Review Care Management I for enterprise-wide utilization review work in a fully remote role. The position involves reviewing medical records, applying clinical guidelines, and coordinating authorizations to promote cost-...Remote jobShift workWeekend work
- Intermountain Health is seeking an RN Utilization Review Care Management I for flexible, enterprise-wide coverage, including shifts across Peaks/Canyons/Desert regions. The role emphasizes utilization review, clinical decision-making, and collaboration with providers and...Remote jobPart timeFlexible hoursShift workWeekend work2 days per week
- UnitedHealth Group seeks an Inpatient Care Management Nurse to ensure proper utilization of health services. You will assess member needs, identify solutions... ...support appropriate levels of care. This role offers remote work flexibility with standard hours of 8:00 a.m. to...Remote jobLocal area
- ...behalf of a partner company, is seeking a Case Manager - Utilization Review Specialist based in the United States. This remote role oversees admission and concurrent reviews... ...case managers to support appropriate patient care and financial performance. You will apply clinical...Remote job
- Cambia Health is seeking an Utilization Management Nurse to support care decisions from a home-based setup across several states, including Washington, Oregon, Idaho and Utah. The role emphasizes clinical judgment, cost-effective care, and policy-based reviews. The nurse...Remote jobWork from home
- A leading staffing firm is seeking a TEMP-TO-PERM Care Manager RN to oversee the continuum of care for mental health and substance abuse... ...license, with 2-3 years of experience in Behavioral Health and Utilization Management. Responsibilities include reviewing service...Remote jobPermanent employmentTemporary work
$82.29 - $129.92 per hour
...and patient‑centered care? Do you bring both operational... ..., Surgical Services RN serves in a dual role... ...practice. Utilize staffing management principles to ensure... ...families to promote optimal care and service excellence... ...onsite, two days remote and live within a...Remote workMinimum wageFull timeSeasonal workLive inLocal areaShift work- Humana is seeking a Utilization Management Nurse 2 to support coordination, documentation, and communication of medical services and benefit determinations... ...The position operates Monday-Friday, 8:00am-5:00pm ET, with remote/work-from-home options and occasional travel to Humana...Remote jobWork from homeMonday to Friday
- Highmark Inc. is seeking a full-time remote Care Manager responsible for utilization management, reviewing care appropriateness, and identifying opportunities for Health Coaching interventions. The role involves utilizing data to improve member and provider outcomes and...Remote jobFull timeWeekend work
- Highmark Inc. is seeking a full-time remote Care Management professional available on weekends and... ...appropriateness of health care services, applying utilization criteria, and identifying referrals to... .../case management. The job requires RN licensure and clinical experience,...Remote jobFull timeWeekend workWeekday work
- Highmark Inc. is seeking a remote RN Case Manager to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) in addition to three weekdays, with duties spanning review of services, adherence to policies, and proactive...Remote jobWeekend workWeekday work
- Highmark Health is seeking a full-time RN Care Manager for a REMOTE role requiring weekend availability (Saturday and Sunday) and three weekdays. This position centers on utilization management, applying criteria, and coordinating with Health Coach/case management to improve...Remote jobFull timeWeekend workWeekday work
$41.2 - $62.17 per hour
Job Description:The RN Utilization Review Care Management I leverages clinical expertise and critical thinking to perform utilization review care management... ....Experience working successfully working in a remote environment or using Advanced Microsoft Suite, including...Remote workHourly payReliefWork at officeFlexible hoursShift workWeekend work2 days per week- University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient outcomes. The position emphasizes...Remote job
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