Remote RN: Medicare Utilization Management Consultant
CVS Health
CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to join our team remotely in Trenton, New Jersey. This role demands a Registered Nurse (RN) with strong clinical judgment and over 3 years of experience to review clinical information and collaborate with providers. You will work Monday through Friday, and the position is eligible for a comprehensive benefits package including medical, dental, and vision coverage. Join CVS Health to contribute to simplifying healthcare for communities. #J-18808-Ljbffr
Vacancy posted 15 hours ago
Similar jobs that could be interesting for youBased on the Remote RN: Medicare Utilization Management Consultant in Ewing, NJ vacancy
$29.1 - $62.32 per hour
4062 Aetna Resources, LLC is seeking a Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) to support healthcare quality and care coordination. This full-time remote position requires an active RN license and at least 3 years of RN experience...Remote jobHourly payFull time$26.01 - $68.55 per hour
4062 Aetna Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant to work remotely. The role requires an active RN license and a minimum of 3 years of RN experience. Responsibilities include reviewing clinical information, making...Remote jobHourly payFull time$26.01 - $62.32 per hour
...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join their remote team. This full-time role involves reviewing clinical information to support patient care across the continuum. Candidates should have a valid RN license...Remote workHourly payFull timeWork at officeCVS Health
Austin, TX15 hours ago$26.01 - $68.55 per hour
Medicare Precertification Utilization Management Nurse Consultant (Remote) Schedule: Monday-Friday, 9:00AM - 6:00PM (local time); includes occasional evenings, holidays,... ...About the Role We’re seeking a Registered Nurse (RN) with strong clinical judgment to join our Utilization...Remote workHourly payFull timeWork at officeLocal areaMonday to FridayAfternoon shift$26.01 - $62.32 per hour
Utilization Management Nurse Consultant (Medicare / Spine) Remote | Full-Time | Mon‑Fri, 9:00 AM‑6:00 PM (local time) May include evenings, holidays, and occasional... ...What You Bring - REQUIRED Active, unrestricted RN license in the state of residence 3+ years of RN...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shift$29.1 - $62.32 per hour
...determined in collaboration with management to ensure adequate weekend coverage. Position Summary: Utilize your clinical experience and... ...and benefit utilization. Consult and lend expertise to other internal... ...Nurse Education: Diploma RN acceptable; Associate degree/...Remote workHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend workOak St. Health
United States2 days ago$32.01 - $68.55 per hour
...each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term... ...and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered... ...Knowledge of Medicaid and Medicare processes Education Bachelor's Degree in...Remote workHourly payFull timeLocal area10 hours per weekFlexible hoursThe Muse
Albany, NY4 days ago$26.01 - $62.32 per hour
...bigger – helping to simplify health care one person, one family and one community at a time. Medicare Precertification Utilization Management Nurse Consultant (RN) Remote | Full-Time | Weekends Are you a detail-oriented RN passionate about improving healthcare...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayShift workWeekend workAfternoon shiftCVS Health
Mountain Home, TX6 days ago$26.01 - $56.14 per hour
...Health, specific to ABA. Utilizes clinical experience and skills... ...and benefit utilization. Consults and lends expertise to other... ...administration of the utilization/benefit management function. Required... ...business needs ~ This is a remote position Preferred...Remote workHourly payFull timeTemporary workMonday to FridayOak St. Health
United States3 days ago- ...MVP Health Care is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team. In this remote role, you will conduct clinical reviews to ensure compliance with Medicare guidelines and support high-quality patient outcomes. The ideal candidate...Remote work
MVP Health Care
New York, NY4 days ago - ...Are you an experienced Registered Nurse (RN) – Utilization Management / Case Management (Medicare) with a desire to excel? If so, then Talent Software Services... ...site training required (1–6 weeks depending on role) Remote/hybrid flexibility available post-training based on...Remote workContract workLocal area
Talent Software Services
Columbia, SC5 days ago $34.98 - $42.85 per hour
...Remote in California only Are you ready to make... ...'s fastest-growing Medicare Advantage plans with an... ...The UM Nurse I - RN performs clinical review... ...policies. This role conducts utilization review activities... ...) year in utilization management or case management preferred...Remote workHourly payWork at officeClever Care Health Plan
Huntington Beach, CA3 days ago$26.01 - $62.32 per hour
...Hispanic Alliance for Career Enhancement is seeking a full-time Utilization Management Nurse Consultant to support Medicare precertification for complex spine cases. This remote position requires an active RN license and a minimum of 3 years' RN experience, with...Remote jobHourly payFull timeWork at office$116.3k - $264.6k
...: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work... ...and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management... ...with: Current unrestricted RN licensure in CA required...Remote workMonday to FridayFlexible hoursUCLA Health
Los Angeles, CA2 days ago- ...Utilization Management Program Manager-RN Summary Samaritan Health Plans (SHP) provides health insurance... ..., community employers, and Medicare and Medicaid members. SHP operates... ...Healthier Communities Together. This is a remote position in which we are able to...Remote work
Vivian Health
Salem, OR3 days ago - ...Truman Medical Centers is seeking a Utilization Management RN for a part-time position working from home. The role involves partnering with interdisciplinary teams to optimize patient care and resources, ensuring compliance with regulatory standards. Applicants should...Remote workPart timeWork from home
Truman Medical Centers
New York, NY4 days ago $35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance... ...and Description of Project: Managing a case load for healthcare members with... ...member contact and will include 80% travel. Remote role. Will require a driver’s license....Remote workHourly payFull timeContract workImmediate startShift work3 days per weekMindlance Health
Corpus Christi, TX10 days ago$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance... ...and Description of Project: Managing a case load for healthcare members with... ...member contact and will include 80% travel. Remote role. Will require a driver’s license....Remote workHourly payFull timeContract workImmediate startShift work3 days per weekTravelNurseSource
Corpus Christi, TX9 days ago- ...Job Description Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
Spectrum Healthcare Resources
Phoenix, AZ4 days ago - ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
Freelanceshop
New York, NY5 days ago - ...solutions company is seeking an experienced Utilization Review Nurse to improve patient care... ...authorization requests, ensuring compliance with Medicare guidelines, and collaborating with... ...utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Medix
New York, NY2 days ago - ...The Peer-to-Peer (P2P) Utilization Review Nurse is an integral member... ...the MGB Central Utilization Management team, specializing in identifying... ...(CONI) processes through RN-to-RN collaboration with payers... ...Schedule and Work Model ~ Remote / Work from Home. ~32...Remote workWork from home
Mass General Brigham (Enterprise Services)
Somerville, MA2 days ago - ...Services) is hiring a Peer-to-Peer Utilization Review Nurse who will manage complex cases with high autonomy. This... ...clinical discussions. A BSN and RN license are required, along with significant... ...experience. The position offers a remote work model with a 32-hour work week...Remote work
Mass General Brigham (Enterprise Services)
Somerville, MA2 days ago - ...Appworkshub is seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct... ...transitions of care, and ensure compliance with Medicare Advantage regulations. The ideal candidate will...Remote work
Appworkshub
New York, NY2 days ago - ...conduct reviews of medical documentation while working remotely. This role involves managing appeals and validating claims to ensure medical... ...years of clinical nursing experience, including utilization review, and a valid RN license in Florida or Kentucky. Strong analytical...Remote workFull time
Molina Healthcare
New York, NY2 days ago - ...A leading healthcare facility in the United States seeks a Clinical Product Consultant for Utilization Management. The role involves providing clinical insights, ensuring product accuracy, and managing implementation milestones. Candidates should have a BSN, extensive...Remote workFlexible hours
Santa Barbara Cottage Hospital
New York, NY2 days ago $34.98 - $42.85 per hour
...Clever Care is hiring a UM Nurse I - RN to conduct clinical reviews of authorization requests in California. The role... ...minimum of three years of clinical experience, preferably in utilization management. This remote position offers a wage range of $34.98 to $42.85 per hour...Remote workHourly paySanta Barbara Cottage Hospital
New York, NY2 days ago- ...A leading healthcare organization is seeking a remote RN to ensure appropriate administration of hospital resources and quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations. The ideal candidate...Remote work
BJC HealthCare
Saint Louis, MO4 days ago - ...A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
The Judge Group, LLC
New York, NY5 days ago - ...Phoebe Putney Memorial Hospital, Inc. is seeking a full-time RN UR Specialist in Albany, GA. Responsibilities include managing insurance notifications and certifications for Utilization Review, ensuring compliance with regulations while supporting patient care. Candidates...Remote workFull time
Phoebe Putney Memorial Hospital
Albany, GA4 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Medicare Utilization Management Consultant. Be the first to apply!
