Remote Utilization Management Nurse Consultant
CVS Health
- Remote job
CVS Health is seeking an experienced Registered Nurse for Utilization Management in a full-time, work-from-home role within the United States. The position requires 2+ years of adult acute/critical care nursing, an active RN license, and the ability to work a 24/7 schedule including evenings, weekends, and holidays. The role involves applying clinical criteria to determine coverage, coordinating with providers, and collaborating with internal teams to optimize care and benefit utilization. #J-18808-Ljbffr CVS Health
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports utilization management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities...Remote workWork from home
- ...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...Remote workFull timeWork from home
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving candidates in the EST or CST zones. You will coordinate, document, and communicate utilization and benefit management activities to ensure appropriate...Remote workFull time
- ...CVS Health is seeking an Utilization Management Nurse Consultant (Clinical Precertification RN) for Medicare, remotely. This full-time role asks for an active RN license and several years of experience to evaluate care and determine coverage using evidence-based guidelines...Remote workFull timeAfternoon shiftWeekday work
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to EST residents across the U.S. You will apply clinical expertise to ensure members receive safe, appropriate and cost-effective care. Schedule: Monday...Remote workFull timeMonday to FridayWeekend work
$32.01 - $68.55 per hour
..., 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
...person, one family and one community at a time. Fully remote with requirement to work the following schedule:... ...-Friday 8:00am-4:30pm EST. Position Summary As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayWeekend work$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...Remote workHourly payFull timeTemporary workLocal areaWeekday work$26.01 - $56.14 per hour
...00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American... ...Health, is a URAC-accredited medical management organization founded in 1993. We... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work- ...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
- CVS Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The role focuses on assessment, coordination... .... Shifts include evenings/holidays after training; remote work is allowed with required home setup. #J-18808-Ljbffr...Remote jobShift workAfternoon shift
$26.01 - $56.14 per hour
...one person, one family and one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home | Full-Time | Open to EST residents... ...UM) Nurse Consultant to join our team. This is a fully remote role available to candidates in any U.S. state in the...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayShift workWeekend 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
$26.01 - $56.14 per hour
...Position SummaryUtilization management is a 24/7 operation and work... ...holidays, and evening hours. Utilizes clinical experience and skills... ...services and benefit utilization. Consults and lends expertise to other... ...experience as a registered nurse in adult acute care/critical...Hourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$32.01 - $68.55 per hour
...CVS Health Utilization Management PositionWe're building a world of health around every individual — shaping a more connected, convenient and... ...writtenRequired Qualifications- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting- Must have active...Hourly payFull timeTemporary workWork at officeAfternoon shift- ...Utilization Management Nurse ConsultantIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected... ...of Healthcare Services and benefit utilization· Consults and lends expertise to other internal and external constituents...Work at officeWeekend work
- 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
$60.52k - $129.62k
...alignment with relevant project plans. ~ Manages and coordinates specific workplans for... ..., 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 placementLocal areaMonday to Friday$32.01 - $68.55 per hour
Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends... ...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...Hourly payFull timeTemporary workWork at officeLocal areaAfternoon shift- ...Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments...Remote workWork from home
- ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
- ...Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments...Remote work
- IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical... .... This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-LjbffrRemote work
- ...Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective... ...with CMS, URAC, and other regulators. This fully remote role requires a US-based location, strong nursing background...Remote work
- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within...Remote workFull time
- A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote work
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical... ...decision-making to provide appropriate care for members. This remote, patient-facing position may require occasional travel to...Remote work
$71.1k - $97.8k
...live safely and independently in their communities? As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well... ...in Illinois, Wisconsin, or Indiana. Workstyle: This is a remote position supporting members and providers throughout...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...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
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