Remote Utilization Management Nurse Consultant
4062 Aetna Resources, LLC
- Remote job
CVS Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The role focuses on assessment, coordination of care, and collaboration with providers to optimize benefits for members. Requires Associates degree (BSN preferred), active RN license, 3+ years RN, 1+ year Med/Surg, and MS Office proficiency. Shifts include evenings/holidays after training; remote work is allowed with required home setup. #J-18808-Ljbffr 4062 Aetna Resources, LLC
$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-Friday 10:30AM- 7:30PM...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 your...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 members...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 will...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$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 ConsultantFully Remote- WFHSchedule : Tuesday-Saturday 9:... ...holidays and evening hours.The UM Nurse Consultant Utilizes clinical experience and...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 more connected, convenient and compassionate... ...: Monday–Friday 8:00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American Health Holding, Inc...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... ...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 officeAfternoon shift- 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 jobWork 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 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 and evaluate healthcare options for members, using clinical guidelines to render coverage determinations. You will...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 expertise to review medical necessity, coordinate care, document outcomes, and ensure members...Remote jobFull 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 jobFull 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 jobFull timeMonday to FridayWeekend work
$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$29.1 - $62.32 per hour
...care one person, one family and one community at a time. Utilization Management (UM) Nurse Consultant 100% Work‑From‑Home | Full-Time | Open to MST/PST... ...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 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...Remote jobAfternoon shift
- ...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
- ...years of clinical experience required. ~ Must have experience with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST HAVE MEDCOMPASS or ASSURECARE exp. MUST HAVE...Remote work
$29.1 - $62.32 per hour
...UM Nurse Consultant We're building a world of health around every individual shaping a more connected, convenient and compassionate... ...one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include...Hourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$68.43k - $125.17k
Summary The Registered Nurse (RN) - Quality Management (QM) Consultant functions as a clinical expert and executes position... ...not REAL ID compliant cannot be utilized as an acceptable form of... ...site options Telework eligible No Remote job No Relocation expenses reimbursed...Remote workPermanent employmentFull timeTemporary workPart timeSeasonal workImmediate startRelocationRelocation packageMonday to Friday- ...Job Description Job Description Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients...Remote workFull timeWork at office
- ...intensity of service, the part-time Registered Nurse Utilization Review will liaise with external review... ...from established pathways in a remote setting. Key responsibilities: Collect... ...Experience in hospital nursing, hospital case management, insurance case management, or...Remote workPart time
- ...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
- ...Seeking a California Licensed UM Nurse for a full-time remote position, who will review prior authorization... ...when additional expertise is needed Utilize CMS guidelines and Milliman Care... ...year of pre-service UM experience in a managed care environment Active, valid, and...Remote workFull time
- 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 to...Remote job
- ...Alliance for Health in California is seeking a Registered Nurse for a temporary Utilization Management role. You will ensure prior authorizations comply with... ...paths may substitute for experience. Hybrid work and remote- interview options are offered. #J-18808-Ljbffr...Remote jobTemporary 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 job
- Valenz, a remote-first health services platform in the United States, seeks a Utilization Management Nurse to oversee the UM process for plan participants, ensuring appropriate, necessary, and cost-effective care. You will review prospective, concurrent, and retrospective...Remote job
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