Remote Utilization Management Nurse Consultant
CVS Health
CVS Health is seeking an RN Utilization Management Nurse Consultant specialized in Medical Review. This fully remote role (U.S. only) requires a valid RN license and clinical experience to ensure medically necessary care through thoughtful review and collaboration with providers. The position emphasizes precision, clear communication, and compassion in a desk-based environment. It offers a comprehensive benefits package and performance-based incentives. #J-18808-Ljbffr
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Consultant in Jefferson City, MO vacancy
- ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote role prioritizing Massachusetts residents. You will coordinate the utilization/benefit management program and ensure timely, appropriate care and location-specific turn-around times. Key duties...Remote work
Hispanic Alliance for Career Enhancement
Oklahoma City, OK4 hours ago - ...CVS Health is seeking a Utilization Management Nurse Consultant specializing in Medical Review. This fully remote role requires an active RN license, 3+ years clinical experience, and 1+ year in Utilization Review/Medical Management. You will apply criteria to determine...Remote work
4062 Aetna Resources, LLC
Kansas City, MO15 hours ago $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 hoursThe Muse
Albany, NY15 hours ago$26.01 - $62.32 per hour
...bigger - 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 ScheduleAre you a Registered Nurse ready to make an impact beyond the...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday workCVS Health
Mountain Iron, MN3 days ago$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 workWeekday workOak St. Health
United States3 days ago$26.01 - $56.14 per hour
...family and one community at a time. Utilization Management is a 24/7 operation and work schedules... ...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 officeLocal areaAfternoon shiftCVS Health
United States4 days ago$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... ...review and collaboration with providers. This fully remote position offers the opportunity to apply your clinical...Remote jobHourly payFull timeLocal areaFlexible hoursShift work- ...Research, Rehabilitation Therapy and Nursing. Job Description Location :... ...programs are comprised of network management, clinical coverage, and policies. · Utilizes clinical skills to coordinate,... ...Services and benefit utilization · Consults and lends expertise to other...Work at officeWeekend work
Integrated Resources
Downers Grove, IL4 days ago $29.1 - $62.32 per hour
...of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and...Hourly payFull timeTemporary workLocal areaAfternoon shiftCVS Health
Phoenix, AZ15 hours ago- ...Remote, RI Contract Job Description: Responsible for the review and evaluation of clinical information and documentation... ...with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST...Remote workContract work
US Tech Solutions
United States5 days ago - ...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
Santa Barbara Cottage Hospital
New York, NY4 days ago - ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...Observation (OBS). Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (...Remote work
3B Healthcare, Inc.
United States2 days ago - ...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
Bestica Healthcare
United States4 days ago - ...skilled and experienced Registered Nurse with specialties in Medical/... ...skilled nursing care, case management, and hospice care to... ...Certifications: Experience in Utilization Review or case management... ...to work independently in remote settings. Must be able to...Remote workFlexible hours
vTech Solution
Santa Rosa, CA15 hours ago $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 workkozmetickesluzby.vecnakraska.sk - Jobboard
Phoenix, AZ3 days ago$26.35 - $39.53 per hour
...NeueHealth is seeking a Concurrent Utilization Review Nurse responsible for real-time clinical reviews to ensure the medical necessity of healthcare services. The role includes conducting assessments, coordinating with providers, and collaborating with the Medical Director...Remote workHourly payNeueHealth
California, MO4 days ago- ...Utilization Management Nurse 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, and prefers working in a professional office...Remote workFull timeWork at office
HealthCheck360
Asbury, IA2 days ago - ...We ’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’... ...Advantage regulations (LCD/NCD policies) . This is a fully remote opportunity requiring discipline, accuracy, and...Remote work
Appworkshub
New York, NY3 days ago - ...Guidehealth leverages remotely‑embedded Healthguides™ and a centralized Managed Service Organization to... ...precise and timely Utilization Review. In this role,... ...timeframes. Clinical Consultation & Collaboration Partner... ...aligned with Illinois nursing regulations and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home
Guidehealth
Chicago, IL15 hours ago $65 per hour
...Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role As a Utilization Review Registered... ...policies. Job details $65.00 / hour Remote, California Profession: Registered Nurse Facility...Remote workTotalMed Staffing
United States3 days ago$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ..., 0730-1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~ U.S. Citizenship...Remote workContract workImmediate startMonday to FridayVarite
Aurora, CO2 days ago$80k - $95k
...risk adjustment, population health, and utilization management. IntusCare empowers teams to take... ...Overview The Utilization Management Nurse plays a critical role in ensuring high-... ...needs. Work location: This is a fully remote role based in the United States. Sponsorship...Remote workINTUS INC
United States1 day ago$84.06k - $118.67k
...Your future role at a glance Location: Remote Facility: Ascension Network Service Department: Utilization Management Schedule: Days l Full Time Salary... .../ Registration: ~ Licensed Registered Nurse credentialed from the Texas Board of Nursing...Remote workFull timeLocal areaAscension
Austin, TX15 hours ago$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination... ...or Interqual. Experience working in a fully remote, metrics-focused role Experience as an MDS Coordinator...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome officeHumana
Olympia, WA4 days ago$84.06k - $118.67k
...glance Location: Remote Facility: Ascension... ...Hospital Department: Utilization Review Schedule:... ...spiritual care and stress management resources Family... .... Manage and consult on high-acuity or complex... ...~ Licensed Registered Nurse credentialed from the...Remote workFull timeLocal areaAscension
Pensacola, FL6 days ago$81.12k - $115.94k
...Location: Partially Remote, with onsite coverage required... ...Agnes Hospital Department: Utilization Management Schedule: Day-Shift |... ...expert case management and consultation, providing a roadmap for high... ...: ~ Registered Nurse credentialed from the Maryland...Remote workFull timeLocal areaMonday to FridayWeekend workDay shiftAscension
Baltimore, MD4 days ago- ...Description: This is a remote position but will need onsite... ...Collaborate with physicians, nursing staff, and interdisciplinary... ...ensure appropriate resource utilization and care planning Review admissions... ...utilization review, case management, or payer review experience preferred...Remote workFull timePart timeReliefWork at officeLocal areaShift workRotating shiftDay shift
Trinity Health
Mishawaka, IN3 days ago $26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN California, United States Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible... ...Work Environment: Corporate office preferred / remote may be considered Collaborative environment requiring frequent...Remote workHourly payWork at officeNeueHealth
Encino, CA15 hours ago$46.79 - $72.52 per hour
***REMOTE*** Sr Risk Management Consultant (RN/Registered Nurse) - Sinai Hospital ~ Baltimore, MD ~ SINAI HOSPITAL ~ QUALITY LBH ~ Full-time w/Weekend Commitment... ...state and federal regulatory requirements. Utilize the domains of Enterprise Risk Management...Remote workFull timeTemporary workShift workWeekend workDay shift$26.35 - $39.53 per hour
...for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time... ...services provided to members under a managed care health plan. This role involves... ...Corporate office preferred / remote may be considered. Collaborative environment...Remote workHourly payWork at office
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