Remote Utilization Management RN Consultant
CVS Health
- Remote job
CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote role. You will apply clinical judgment to determine coverage, coordinate care, and collaborate with providers. The position schedules Tue-Sat 9:30am-6:00pm and may include evenings, weekends, and holidays. The role requires 3+ years of Med/Surg RN experience, active RN license, and ability to work across multiple IT platforms. Strong knowledge of Medicare/Medicaid and managed care is preferred. #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... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include...Remote jobWork from home
$29.1 - $62.32 per hour
...family and one community at a time. Utilization Management is a 24/7 operation and work... ...holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule : Monday-Friday 10... ...years of Med Surg experience as an RN in the hospital setting -...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will leverage...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced, collaborative Utilization Management team? Join us in helping ensure...Remote workHourly payFull timeTemporary workWeekend workAfternoon shift$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...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$29.1 - $62.32 per hour
...and one community at a time.Utilization Management is a 24/7 operation and work... ...hours. UM Nurse ConsultantFully Remote- WFHSchedule : Tuesday-... ...evening hours.The UM Nurse Consultant Utilizes clinical experience... ...of Med Surg experience as an RN in the hospital setting- Active...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$26.01 - $56.14 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual — shaping a... ...8:00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American... ...Qualifications ~ Active, unrestricted RN license in your state of residence...Remote workHourly payFull timeMonday to FridayFlexible hoursShift work$32.01 - $68.55 per hour
...Utilization Management Position We're building a world of health around every individual — shaping... ...Healthcare Services and benefit utilization Consults and lends expertise to other internal... ...have active current and unrestricted RN licensure in state of residence -...Remote workHourly payFull timeTemporary workWork at officeAfternoon shift- 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...Remote jobFull timeWork from home
- CVS Health seeks a Utilization Management Nurse Consultant to support a 24/7 operation. In this role you will assess, plan, implement, coordinate, monitor... ...care teams to facilitate treatment decisions. Required RN experience and active license; Associates degree...Remote job
- 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 jobFull time
- CVS Health is seeking a Utilization Management (UM) Nurse Consultant to join our team. This is a 100% remote, full‑time role available to MST/PST residents. You will apply clinical... ..., cost‑effective manner. Required: active RN license and 2+ years of acute hospital...Remote jobFull time
- 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... ...-5:00 PM EST, with some weekend/holiday coverage. RN license active, 2+ years acute hospital experience...Remote jobFull timeMonday to FridayWeekend work
- 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 jobFull timeAfternoon shiftWeekday work
- ...Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The role... ...Associates degree (BSN preferred), active RN license, 3+ years RN, 1+ year Med/... ...evenings/holidays after training; remote work is allowed with required home...Remote jobShift workAfternoon shift
$32.01 - $68.55 per hour
...compassionate. And we do it all 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...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$29.1 - $62.32 per hour
...family and one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home | Full-Time |... ...to join our team. This is a fully remote role available to candidates in any... ...Qualifications Active, unrestricted RN license 2+ years of acute hospital...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayShift workWeekend work- ...an experienced Organizational Change Management Consultant to support a late-stage technology deployment... ...supporting field operations, utility operations, inspection teams, asset management... ...: August 2026 through March 2027 Remote or hybrid arrangement may be considered...Remote workFull timeContract work
- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients... ...schedule of 8 hours per day, requiring an RN with a Bachelor's degree, state licensure, and...Remote jobWork from homeMonday to Friday
- ...Work The purpose of Dignity Health Management Services Organization (Dignity Health... ...Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will... ...and organizational resources. As a remote employee, we will provide you with the...Remote workLocal areaWork from homeShift workWeekend work
- Humana is seeking an experienced Utilization Management Nurse 2 to support medical necessity reviews,... ...with providers and members. The role is remote/work-from-home with weekend shifts and... ...few times annually; requires Kentucky RN license, 2+ years clinical experience,...Remote jobWork at officeWork from homeShift work
- ...and authorization of services utilizing established mental health and... ...retrospective utilization management review of inpatient, residential... ...position is full-time, fully remote (work from home) and requires... ...Michigan clinical license (RN, LMSW, LP, LPC, or LLP) required...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...experience with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills:... ...6 months of Prior Authorization. Education: ~ RN with current unrestricted state licensure About...Remote work
$65 per hour
...RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:... ...? No Locals accepted? No. Pending License accepted: No Fully Remote Position RTO Restrictions: Please include all RTO at the time...Remote workHourly payLocal areaImmediate startMonday to FridayShift workWeekend work- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
$100k
...Work Experience 1-3 years Salary $100,000 Remote Job Job Description This is a remote position. The Utilization Management (UM) Nurse is responsible for conducting... ...maintain an active, unrestricted Registered Nurse (RN) license in the applicable state or possess a...Remote workContract workWork experience placement- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established criteria. The role requires adept EMR review, strong clinical judgment, and collaboration with ED physicians...Remote job
- Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This role emphasizes OASIS review, coding accuracy, QA, and remote documentation audits. The ideal candidate holds an active Florida RN license, OASIS certification...Remote job
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