Remote Utilization Management Nurse Consultant
CVS Health
CVS Health in the United States is seeking an experienced Utilization Management Nurse Consultant (RN) to join our remote team. You will review prior authorization requests, evaluate medical necessity, and apply clinical criteria to support timely, cost-effective care across diverse specialties.
The role emphasizes collaboration with providers and care teams, adherence to regulatory standards, and high-volume caseload management.
#J-18808-Ljbffr- ...CVS Health is seeking an Utilization Management Nurse Consultant to assess and coordinate care for members across the continuum of care. This role requires... ..., and effective communication. A BSN is preferred; remote work is supported within the state(s) of residence....Remote work
- ...CVS Health is seeking a qualified Registered Nurse for Utilization Management to ensure appropriate healthcare services and benefits for members. This role supports a 24/7 operation, including weekends and evenings, and requires strong clinical judgment and collaboration...Remote workAfternoon shift
- ...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....Remote workWork from home
- ...CVS Health is seeking a Utilization Management Nurse Consultant (Remote) to support Florida Medicare home-care requests. You will review cases, determine coverage, and coordinate with providers to ensure timely, appropriate care. The role emphasizes clinical judgment,...Remote workFull time
- ...CVS Health is hiring a Registered Nurse for Utilization Management in California. This full-time role supports a 24/7 operation with weekend, holiday... ..., an active RN license, and strong communication. A remote work setup within the state is required, with equipment provided...Remote workFull timeWeekend workAfternoon shift
- ...CVS Health is seeking a Utilization Management Nurse Consultant (RN) to work remotely on prior authorization and utilization management. You will review requests, assess medical necessity, and apply clinical criteria to support decisions, collaborating with providers and...Remote work
- ...CVS Health is seeking an experienced Registered Nurse to join the Utilization Management team in a remote role. You will review clinical information, apply evidence-based criteria, and collaborate with providers to ensure appropriate, high-quality care and benefits for...Remote work
- ...CVS Health is seeking an Utilization Management Nurse Consultant to review clinical cases and make coverage decisions in a remote, full-time role. You will collaborate with providers and care teams, apply clinical judgment, and support utilization and benefit management...Remote workFull timeWork at office
- ...CVS Health is seeking a Registered Nurse for Utilization Management. This 24/7 role involves evaluating care options, gathering clinical information, and applying guidelines to support appropriate benefits for members. You will collaborate with providers and internal...Remote workWeekend workAfternoon shift
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant in Indiana. The role uses clinical expertise to assess and coordinate care, determining coverage decisions and communicating with providers to ensure appropriate services. Strong...Remote workAfternoon shift
- ...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 workFull timeWeekday work
- ...CVS Health is seeking a Registered Nurse for Utilization Management in a full-time role based in the United States. The position requires a current RN license, 2+ years in adult acute/critical care, and experience with utilization management processes. You will assess...Remote workFull timeAfternoon shift
$26.01 - $62.32 per hour
...bigger - helping to simplify health care one person, one family and one community at a time. RN Utilization Management Nurse Consultant (Medicare - Joint Procedures) Remote | Full-Time | Monday-Friday (9:00 am to 5:30 pm in your time zone, with occasional evenings/...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- ...CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity... ...Qualifications include an active RN license (multi-state preferred), 3+ years of nursing, 2+ years in UM/PriorJ-18808-Ljbffr...Remote work
$26.01 - $62.32 per hour
...– helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work$29.1 - $62.32 per hour
...determined in collaboration with management to ensure adequate weekend... .... Position Summary Utilize your clinical experience and... ...and benefit utilization. Consult and lend expertise to other internal... ...Registered Nurse Education: Diploma RN acceptable...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeShift workWeekend work- ...CVS Health is seeking an Utilization Management Nurse Consultant for Medicare precertification, remotely accepting applications nationwide. The role emphasizes clinical judgment and collaboration to ensure appropriate care timing and treatment, aligning with Medicare guidelines...Remote workWork at office
- ...CVS Health is seeking a Registered Nurse for Utilization Management. This remote, full-time role requires 2+ years in adult acute/critical care, an active RN license, and readiness for a 24/7 schedule including weekends and holidays. You will assess, plan, implement...Remote workFull time
- ...CVS Health is seeking a remote Utilization Management Nurse Consultant (Medicare) to apply clinical expertise beyond the bedside and ensure members receive the right care at the right time. You will review cases, collaborate with providers, and use evidence-based guidelines...Remote workFull timeLocal areaMonday to FridayAfternoon shift
$26.01 - $74.78 per hour
...one family and one community at a time. Registered Nurse (RN) - Utilization Management Location: Remote (Preference for candidates in CST or EST time zones... ...of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeWeekend workAfternoon shift- ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote role supporting EST/CST time zones. The position requires 2+ years of RN experience, current unrestricted RN licensure, and ability to work weekends/evenings as part of a 24/7 operation. The...Remote workWork at officeWeekend workAfternoon shift
$26.01 - $56.14 per hour
...CVS Health Utilization Management Position We're building a world of health... ...Schedule: 3-11 or 11-8 Location: Remote (Central Time)... ...and benefit utilization Consults and lends expertise to other... ...experience as a Registered Nurse in adult acute care/critical...Remote workHourly payFull timeTemporary workWork at officeLocal areaAfternoon shift$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$29.1 - $62.32 per hour
...About This Role The Utilization Management Nurse Consultant at CVS Health is responsible for assessing, planning, implementing, and coordinating healthcare... .... Highlights Pay: $29.10 - $62.32/hour Location: Remote, CO Schedule: Full-time, Monday through Friday, 9:00am...Remote workFull timeWork at officeMonday to Friday$29.1 - $62.32 per hour
...Utilization Management Nurse Consultant### Utilization Management Nurse ConsultantApply: Remote: NH - Work from home: Work At Home-Arkansas: Work At Home-Idaho: Work At Home-Ireland: Work At Home-Georgia: Full time: Posted Today: End Date: November 27, 2026 (28 days left...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$26.01 - $68.55 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ..., one family and one community at a time. Fully remote with requirement to work the following schedule:...Remote workHourly payFull timeTemporary workWork at officeMonday to FridayWeekend work$26.01 - $56.14 per hour
...8:00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American Health... ..., is a URAC-accredited medical management organization founded in 1993. We provide... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review,...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$26.01 - $74.78 per hour
...of something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Registered Nurse (RN) - Remote Make a meaningful impact on patient care from wherever you work. We are seeking an experienced...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$29.1 - $62.32 per hour
...listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Utilization Management Nurse Consultant based in Canada. We are seeking an experienced Registered Nurse to join a remote Utilization Management team in a non-...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$60.53k - $129.63k
...Health, is a URAC-accredited medical management organization founded in 1993. We... ...Position Summary Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment... ...information from providers. Remote Work Expectations This is a 10...Remote workHourly payFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift workWeekend work
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