Remote Utilization Nurse Consultant, 24/7 Coverage
CVS Health Corporation
- Remote job
CVS Health Corporation is seeking a full-time Kansas Licensed Utilization Nurse Consultant to support a 24/7 Utilization Management operation. This remote position requires assessment, planning, implementation, and evaluation of healthcare services for members while managing communication with providers. The ideal candidate will have 2+ years of experience as a Registered Nurse in acute care settings and must hold an active RN license. Availability on weekends and holidays is essential. #J-18808-Ljbffr CVS Health Corporation
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
$29.1 - $62.32 per hour
...UM Nurse Consultant Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. Fully Remote- WFH Schedule: Tuesday-Saturday 9:30am-6:00pm... ...clinical judgment to render coverage determination/recommendation...Remote workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$26.01 - $62.32 per hour
The 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 responsibilities...Remote jobHourly payFull timeWork at office$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management (24/7 Operations) Leverage your clinical expertise to make a broader impact. Join our Utilization Management... ...clinical documentation and apply criteria to support coverage determinations Collaborate with providers and care...Remote workHourly payFull timeLocal areaAfternoon shift$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management... ...clinical information and apply guidelines to support coverage decisions Collaborate with providers and care teams...Remote workHourly payFull timeTemporary workAfternoon shift- ...Institute is offering a Telehealth role for a National On Call advanced practice clinician (APC) to provide 24/7 telephonic coverage and care. This position allows for remote work, ensuring a balanced work-life experience. The role involves managing care coordination for...Remote job
$32.01 - $68.55 per hour
...CVS Health Utilization Management Position We're building... ...Management is a 24/7 operation and work schedules... ...judgment to render coverage determination/recommendation... ...utilization. Consults and lends expertise to... ...experience as a Registered Nurse in adult acute care/critical...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shift$26.01 - $56.14 per hour
...Utilization Management Nurse (RN) – 24/7 Operations Location: Remote (Preference for CST/MT time zones) Schedule: Includes evenings, weekends, and holidays... ...clinical information and apply guidelines to make coverage determinations across the care continuum Collaborate...Remote workHourly payFull timeTemporary workAfternoon shift- 4004 Aetna Medicaid Administrators is seeking a Utilization Management Nurse Consultant for a crucial role in a 24/7 operation based in Florida. This position works... ...service. Benefits include comprehensive medical coverage, paid time off, and wellness programs among other...Remote workWork from home
$71.1k - $97.8k
...health insurance company is seeking a Utilization Management Registered Nurse to leverage clinical skills in... ...medical services for members. This remote role emphasizes compassionate care,... ...including medical, dental, and vision coverage, is offered alongside a competitive...Remote work- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...Beneficiary Notices (ABNs) Hospital-Issued Notices of Noncoverage (HINNs) Medicare Coverage Status Notices (MCSNs)...Remote work
- A healthcare company is seeking a Utilization Management Registered Nurse to utilize nursing skills for coordinating... ...and facilitating care. This remote role requires an RN license and clinical... ...a competitive salary, medical coverage, and work-from-home options, ensuring...Remote jobWork from home
- ...(Days) Overview: Sentara Health Plansis hiring an Utilization Review Nurse/RN- Remote in Virginia Status: Full-time,permanent position (40... ...skills. Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a...Remote workPermanent employmentFull timeTemporary workShift work
$71.1k - $97.8k
...leading health services organization is seeking a Utilization Management Registered Nurse in Austin, Texas. This remote position involves using clinical nursing skills... ...plan and comprehensive benefits including medical, dental, and vision coverage. #J-18808-Ljbffr...Remote work- ...Regional MDS / PDPM / CMI / RAI Consultant Are you ready to make a... .../ RAI Consultant to provide remote reimbursement, MDS, PDPM, Case... ...our long-term care and skilled nursing facilities. This position... ...A documentation and skilled coverage support Assist with Triple...Remote workHourly payNight shift
- ...62 Aetna Resources, LLC is looking for a Utilization Management Nurse Consultant Clinical Precertification RN to work full-time remotely. This role requires a Registered Nurse with... ...RN license. Benefits include medical coverage, paid time off, and wellness programs. #J...Remote workFull time
- Summit BHC is seeking a Utilization Assistant for The Pavilion at Williamsburg Place in Virginia. This role involves supporting utilization review activities to ensure accurate reimbursement and coverage for patients while coordinating with insurance providers. The ideal...
- ...Medicaid, and OBRA documentation. Review nursing notes to ensure clarity, accuracy, and alignment... ...optimize RUG/CMI scores. Manage Medicare coverage reviews, denials, and communication with... ...travel opportunities. Hybrid schedule (remote and on-site). Supportive, collaborative...Remote workFull timeContract work
$46 per hour
...Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role... ...solid understanding of medical guidelines and coverage policies. Job details $46.00 / hour Remote, California Profession: Registered Nurse...Remote work$54.1k - $142.58k
...practices and promote patient safety and satisfaction. The QM Nurse Consultant (Nurse Navigator) role strengthens WV Medicaid's ability to... ...for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs...Remote workHourly payFull timeTemporary workWork experience placement$86k - $105k
...Pre-Payment Review Nurse Consultant- Wisconsin It takes great medical minds to create powerful... ...and reports related to health service utilization patterns. Knowledge of laws, statutes,... ...in the state of Wisconsin. Role is 100% remote. Employees may be required to travel to...Remote workFull timeWork at officeFlexible hours- ...Primary ResponsibilitiesThe Utilization Management Nurse will determine the medical appropriateness of... ...include after-hours, holiday and weekend coverage.Collaborate with staff, physicians,... .../families.LocationThis position is remote, but requires the employee to live within...Remote workWork at officeWeekend work
$110k - $120k
...Regional Nurse Consultant (RN) - Skilled Nursing Americare Senior Living is seeking an experienced Regional Nurse Consultant (RN)... ...requirements, and quality initiatives Support implementation and utilization of INTERACT standards and processes Assist with policy...Remote workHome officeMonday to FridayNight shift- ...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs... ..., contractual requirements, and a member's benefit coverage while working remotely. Primary Responsibilities: Performs...Remote workContract workWork at office
$60k
...service and post-service utilization reviews and appeals... ...cases to independent consultants or IROs, when necessary... ..., Licensed Vocational Nurse, or Licensed Practical... ...short term disability coverage (location restrictions... ...development opportunities Remote Opportunities We are...Remote workTemporary work$100.2k - $164.1k
...SpearTip, the cybersecurity consulting segment within Zurich... ...75% billable utilization while delivering exceptional... ...incidents. Provide 24/7 on‑call emergency response... ...to client sites or remotely connecting to contain... ...years of expertise and coverage across 25+ industries,...Remote workFull timeTemporary workApprenticeshipLocal areaVisa sponsorshipFlexible hours$35.29 - $54.71 per hour
...does not offer a hybrid or remote option Minimum Requirements... ...or state board of nursing approved Registered/Professional... ...practice in direct patient care utilizing the nursing process... ...Medical, dental and vision coverage. Access to 24/7 mental health and well-being...Remote workTemporary workReliefLocal areaFlexible hoursShift work- ...independently. 3 years of clinical experience required. Must have experience with Medcompass. Must have prior authorization utilization experience. Managed Care/Medicare experience preferred. MUST HAVE MEDCOMPASS or ASSURECARE exp. MUST HAVE MANAGED CARE...Remote work
- Concentric Energy Advisors, Inc. is seeking a Principal Consultant - Utility Revenue Requirements Specialist to prepare and defend regulatory... ...based in Marlborough, MA or Washington, DC, and is also open to remote candidates. The ideal candidate will have over 5 years of...Remote job
$35.29 - $54.71 per hour
...does not offer a hybrid or remote option Minimum Requirements... ...or state board of nursing approved Registered/Professional... ...practice in direct patient care utilizing the nursing process... ...Medical, dental and vision coverage. Access to 24/7 mental health and well-being...Remote workTemporary workReliefLocal areaFlexible hoursShift work
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