Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Utilization Management RN Consultant - Medicare

CVS Health

CVS Health is seeking an Utilization Management Nurse Consultant – Clinical Precertification RN for Medicare. This fully remote, full-time role supports the UM team to ensure appropriate care decisions across plans and providers.

You will review cases, collaborate with care teams, and contribute to quality outcomes while working standard business hours in your time zone. The position requires an active RN license, 3+ years of RN experience including medical-surgical exposure, and UM/CM

#J-18808-Ljbffr
Vacancy posted -53
Similar jobs that could be interesting for youBased on the Remote Utilization Management RN Consultant - Medicare in Florida vacancy
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant in the Baltimore area. The role leverages RN clinical expertise to assess care options, determine...  ...experience, and MS Office proficiency; remote work options with home setup... 
    Remote work
    Work from home

    CVS Health

    Baltimore, MD
    -53
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. The role supports coordination of care, uses clinical criteria to render coverage...  ...members. The position requires ~3+ years as an RN with active licensure, Med/Surg experience, and... 
    Remote work
    Work from home
    Monday to Friday
    Afternoon shift

    CVS Health

    Little Elm, TX
    -53
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. The role emphasizes...  ..., and effective utilization management. Strong RN background and licensure are required, with Med/... 
    Remote work
    Work at office
    Work from home
    Afternoon shift

    CVS Health

    Atlanta, GA
    -53
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and authorize appropriate healthcare services for members, coordinating with providers to ensure effective care and optimal utilization of benefits. The role requires... 
    Remote work

    CVS Health

    Wyoming, MI
    -53
  •  ...is seeking an experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on Medicare joint procedures. You will review clinical...  ...utilization. The position requires 3+ years RN experience, an active RN license, an associate degree... 
    Remote work

    CVS Health

    Guin, AL
    -53
  •  ...CVS Health is seeking a Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) to support treatment decisions remotely. You will collaborate with providers and apply clinical judgment for the right care at the right time. An active RN license... 
    Remote work
    Work at office

    CVS Health

    Crystal Bay, NV
    -53
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to join our team in a remote capacity. Schedule is Monday through Friday, 9:00am to 5:30pm in the candidate's time zone, with 24/7 utilization management coverage including holidays... 
    Remote job
    Monday to Friday
    Afternoon shift

    CVS Health

    Seattle, WA
    2 days ago
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations from a remote location. The role requires strong clinical judgment, collaboration with care teams, and a weekend-oriented schedule after training... 
    Remote job
    Full time
    Weekend work

    CVS Health

    Central City, CO
    2 days ago
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. Schedule is Monday-Friday, 9:00am-5:30pm in the candidate's time zone, with...  ...collaborating with providers. Ideal candidates hold ~3+ years RN experience, active RN license, and ~1+ years Med/... 
    Remote job
    Work at office
    Monday to Friday
    Afternoon shift

    CVS Health

    Annapolis, MD
    2 days ago
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations and care coordination. This remote, full-time role requires an active RN license and 3+ years of nursing experience, including Med/Surg. After... 
    Remote job
    Full time
    Work at office
    Shift work
    Weekend work
    Afternoon shift

    CVS Health

    Guin, AL
    2 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess, coordinate, and determine appropriate healthcare services for members...  ...practices. The position requires an active RN license, 3+ years of nursing experience, and comfortable... 
    Remote work
    Work at office

    CVS Health

    Kansas City, MO
    -53
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to work remotely on a full-time weekend schedule after training. This role focuses on ensuring members receive the right care at the right time by reviewing clinical information... 
    Remote job
    Full time
    Work at office
    Weekend work
    Day shift

    CVS Health

    Brooklyn, NY
    23 hours ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. The role involves applying clinical judgement...  ...with BSN preferred, and RN licensure must be active in the...  ...MedCompass experience is valued; remote work is available to qualified... 
    Remote work
    Afternoon shift

    CVS Health

    Missouri
    -53
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. The role requires 3+ years of RN experience, active RN licensure, and strong Med/Surg and...  ...appropriate care and benefits. This full-time remote position supports a 24/7 Utilization... 
    Remote work
    Full time
    Work at office
    Afternoon shift

    CVS Health

    Lansing, MI
    -53
  •  ...CVS Health in the United States is seeking an experienced RN to join the Medicare Utilisation Management team in a remote, full-time role. You will leverage clinical judgment to ensure appropriate care through precertification reviews for joint procedures. This position... 
    Remote work
    Full time
    Work from home

    CVS Health

    Utah
    -53
  •  ...CVS Health is seeking an experienced RN Utilisation Management Nurse Consultant (Medicare – Joint Procedures) to work remotely in a full-time role. You will review, adjudicate and coordinate care for Medicare beneficiaries, leveraging evidence-based criteria to ensure... 
    Remote work
    Full time

    CVS Health

    Williamstown, NJ
    -53
  •  ...CVS Health is seeking an Utilization Management Nurse Consultant to ensure Medicare members receive appropriate care. This is a remote, full-time role with a weekday schedule and a base hourly...  ...care teams. Ideal candidates hold an RN license, have 3+ years of RN experience... 
    Remote work
    Hourly pay
    Full time
    Weekday work

    CVS Health

    Iowa
    -53
  •  ...CVS Health is seeking an RN Utilisation Management Nurse Consultant (Medicare – Joint Procedures) for a remote, full-time role. You will review clinical data, apply criteria, and coordinate plans to ensure members receive appropriate care in a timely manner. Ideal candidates... 
    Remote work
    Full time

    CVS Health

    New Hampshire
    -53
  •  ...CVS Health is seeking a Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) for a remote, full-time role. You will review cases, coordinate care, and apply clinical judgment to support decisions, serving as a resource across stakeholders.... 
    Remote work
    Full time
    Weekday work

    CVS Health

    North Dakota
    -53
  •  ...CVS Health is seeking a seasoned RN in a remote, full-time role as Utilisation Management Nurse Consultant for Medicare joint procedures. You will assess clinical information, apply criteria, and coordinate treatment plans across care teams. Ideal candidates hold an... 
    Remote work
    Full time
    Work at office
    Afternoon shift
    Weekday work

    CVS Health

    Kentucky
    -53
  •  ...CVS Health in the United States seeks an RN Utilisation Management Nurse Consultant to support Medicare joint procedures in a remote, full-time role. Remote work with some evenings...  ...care with providers, and help optimise utilization while upholding safety and quality. #J-... 
    Remote work
    Full time
    Afternoon shift

    CVS Health

    Hydaburg, AK
    -53
  • CVS Health in West Virginia is seeking a Medicare Precertification Utilization Management Nurse Consultant to support a 24/7 operation and remote work from home. The role requires strong nursing credentials, Med/Surg exposure, and utilization management experience. You... 
    Remote job
    Work from home

    CVS Health

    Charleston, WV
    2 days ago
  • CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate member... 
    Remote job

    CVS Health

    Alton, IL
    2 days ago
  •  ...with providers to facilitate care and treatment. You will identify referral opportunities to integrate CVS Health products and programs and serve as a clinical resource to internal and external stakeholders in utilization/benefit management. #J-18808-Ljbffr CVS Health
    Remote job

    CVS Health

    Annapolis, MD
    23 hours ago
  • CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity, and apply clinical criteria to determine appropriate care while maintaining compliance with health plan requirements... 
    Remote job

    CVS Health

    Bastrop, LA
    23 hours ago
  • CVS Health is seeking an Utilization Management Nurse Consultant to review clinical cases and make coverage determinations for Medicare beneficiaries. This remote, full-time role follows a weekday schedule, leveraging your RN expertise to ensure appropriate care and outcomes... 
    Remote job
    Full time
    Weekday work

    CVS Health

    Heber City, UT
    2 days ago
  • CVS Health is seeking an experienced Registered Nurse for Utilization Management in a full-time, remote-capable role based in California. The position supports 24/7 operations including weekends and evenings, with a focus on coordinating care and benefits for members. Responsibilities... 
    Remote job
    Full time
    Afternoon shift

    4062 Aetna Resources, LLC

    Sacramento, CA
    1 day ago
  • CVS Health is seeking an Utilization Management Nurse Consultant for Medicare precertification, remotely accepting applications nationwide. The role emphasizes clinical judgment...  ...Health standards. The position requires an RN license, 3+ years of nursing experience (1+... 
    Remote job
    Work at office

    CVS Health

    Oklahoma City, OK
    2 days ago
  • CVS Health is seeking an experienced RN Utilisation Management Nurse Consultant (Medicare - Joint Procedures) to join our remote, full-time team. Bring your clinical expertise to ensure members receive appropriate care at the right time, shaping high-quality Medicare coverage... 
    Remote job
    Full time

    CVS Health

    New York, NY
    23 hours ago
  • CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant to join a 24/7 operation in a role requiring RN licensure and clinical collaboration. The position involves assessing care plans, applying clinical guidelines, communicating... 
    Remote job
    Work at office

    CVS Health

    Austin, TX
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Utilization Management RN Consultant - Medicare. Be the first to apply!