RN Utilization Management Specialist — Medicare
CVS Health
CVS Health is hiring a Medicare Clinical Predetermination Nurse in Colorado. This full-time role requires 3+ years of RN experience, an active RN license, and at least 1 year in Med/Surg. The position supports Utilization Management with M-F, 9:00am–5:30pm ET/CST, and includes holiday rotations. You will assess and coordinate care, apply clinical criteria for coverage decisions, communicate with providers, and participate in ongoing quality initiatives. Benefits included. #J-18808-Ljbffr CVS Health
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Management Specialist — Medicare in Central City, CO vacancy
- ...Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow support to Utilization Review (UR) Nurses to ensure timely, accurate, and...SuggestedRemote work
Cedars-Sinai
Central City, CO2 days ago - CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations from a remote location. The role requires strong clinical judgment, collaboration with care teams, and a weekend-oriented schedule after training...SuggestedRemote jobFull timeWeekend work
$71.1k - $97.8k
...a part of our caring community The Utilization Management Registered Nurse uses clinical nursing... ...Must hold Compact Registered Nurse (RN) license in your state of residence... ...care setting Experience as an RN for a Medicare Certified Home Health agency Health...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome office$60k
...is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual... ...care, payor environment Experience with Medicare and Medicaid (not required, but highly...SuggestedTemporary workLocal areaRemote workIntegra Partners
Central City, CO2 days ago- CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. This position emphasizes clinical decision... ...behavioral health license in their state (LPC/LMHC/LCMHC or RN) and have 3+ years of post-licensure experience with mental...SuggestedRemote job
$26.01 - $62.32 per hour
...of something 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...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shiftWeekday work$26.01 - $68.55 per hour
...:30pm in the candidate's time zone. Utilization Management is a 24/7 operation and work schedules... ...include holidays and evening hours. Medicare Precertification Utilization Management... ...Must have active current and unrestricted RN licensure in state of residence ~1+...Hourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$26.01 - $62.32 per hour
...something 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...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayShift workWeekend workAfternoon shift$29.1 - $62.32 per hour
...one family and one community at a time. Medicare Clinical Predetermination Nurse Must be... ...CST with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules... ...have active current and unrestricted RN licensure in state of residence. 1+ years...Hourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shift- ...launched its first solution, a suite of special needs and behavior management offerings, to support K-12 education. Over time, we expanded... ...of something exciting. Job Summary The Reconciliation Specialist is responsible for supporting our billing teams by working...Hourly payFull timeWork at officeRemote workWorldwideMonday to Friday
Rethink First
Central City, CO1 day ago $65k
Description JOB SUMMARY The Production Management Associate is a leadership development role designed to immerse early-career professionals... ...of their professional role or work environment. Together, we utilize our diverse skills and experiences to drive our company and...Hourly payFull timeTemporary workWork experience placementWorldwideFlexible hoursShift work- ...providers, reviewing CMS alerts, as well as keeping up-to-date and managing compliance risks that impact our business and the DMEPOS... ...about Integra’s business, our policies and procedures, learn how Medicare and Medicaid guidelines impact our business, how we run our compliance...Temporary workLocal areaRemote work
$27.02 per hour
...beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills... ...Coder (CPC) Certified Risk Coder (CRC) Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) Preferred...Full timeFor contractorsWork at officeLocal areaRemote workFlexible hours- ...Purpose of the Role The Processing Specialist is responsible for reviewing and processing... ...additional tasks as assigned by management. General Knowledge & Skills Basic... ...skills. Confidence in learning and utilizing various online tools, systems, and programs...Full timeWork at officeLocal area
$24.52 - $28.32 per hour
Boulder Care is hiring a Peer Recovery Specialist for a 100% remote, full-time position.... ...Coordinate effectively with clinical, care management, and community partners Assist... ...with diverse populations and individuals utilizing non-traditional pathways to recovery Demonstrated...Hourly payFull timeTemporary workRemote workMonday to Friday- ...Saratoga Casino Black Hawk in Black Hawk, CO is hiring a Main Banker to manage the main bank, cash handling, and related duties under the Cage Manager. The role requires accuracy, adherence to regulations, and teamwork to deliver excellent guest service. Full-time,...Full timeFlexible hoursWeekend work
Saratoga Casino Black Hawk
Black Hawk, CO4 days ago - ...Clinical Social Worker), provides integrated and coordinated case management services for the complex, high-risk and high-utilizer... ...medicine settings. Responsible for managing facets of care and utilization for identified complex psychiatric, mental health, and addiction...Local areaShift work
- ...assisting clients who reside all over the world and have helped bring over 2,000 babies into this world. We are looking for a Donor Specialist to join our team. This is a full-time position, and as a Donor Specialist, you’ll be a part of the Donor Services Team and will...Full timeWork at officeRemote workFlexible hours
$66.58k - $142.58k
...alignment with relevant project plans. • Manages and coordinates specific workplans for... ...publications, and/or facilitating research utilization to improve clinical care and outcomes.... ...technical writing skills • Registered Nurse (RN) required. Adept at problem solving and...Hourly payFull timeTemporary workWork experience placementLocal areaWork from homeMonday to Friday- ...Vail Health Hospital is seeking an organized scheduling professional to manage outpatient imaging and cardiopulmonary appointments in our Colorado facility. You will verify patient demographics, insurance, and orders to ensure accurate scheduling and pre-registration...
Vail Health Hospital
Central City, CO3 days ago - USPS in the United States is actively accepting applications for Mail Handler Assistants nationwide. This entry-level role offers comprehensive training and the chance to work with a diverse team to ensure efficient mail handling and distribution. Starting pay is $0.47...Hourly payFull time
Postal Job resource
Idaho Springs, CO8 hours ago $25 - $27 per hour
...and paid on-the-job training As an Airside Experience Specialist , you are the face of our private aviation terminal,... ...reputation if the work continues. Report concerns to the appropriate manager and cooperate in addressing the unsafe act or condition. Follow...Hourly payFull timeSeasonal workLocal areaImmediate startWorldwideRelocation packageShift workNight shiftSignature Aviation
Idaho Springs, CO4 days ago- ...Connections Health Solutions in the United States is seeking an Accounts Resolution Specialist to ensure accurate billing and reimbursement. You will follow up on accounts, review denials, and submit appeals while collaborating with care teams to resolve claims efficiently...Remote work
Connections Health Solutions
Central City, CO3 days ago $65k - $75k
...Join 829’s thriving Paid Media team as a Senior Paid Social Specialist. Continue your agency journey as you further develop your understanding... ...driving a successful campaign and client relationship. You’ll manage a portfolio of clients, executing campaigns and coordinating...Full timeTemporary workSummer workWork at officeLocal areaRemote work$15.16 - $22 per hour
...premiums may apply if applicable criteria are met. The Delivery Specialist will maintain and operate store vehicles to deliver parts and/... ...a safe and efficient manner. Ability to use delivery fleet management hand-held devices to process deliveries, capture customer...Hourly payMinimum wageFull timeLocal areaImmediate startFlexible hours$145.92k - $218.88k
...use cases, and product innovations. Capture competitive intelligence and field feedback and provide structured input to Product Management and Engineering regarding customer requirements, market trends, product gaps, and competitive capabilities. Develop reusable...Full timeLocal area$15.16 - $22 per hour
...premiums may apply if applicable criteria are met. The Delivery Specialist will maintain and operate store vehicles to deliver parts and/... ...a safe and efficient manner. Ability to use delivery fleet management hand-held devices to process deliveries, capture customer...Hourly payMinimum wageFull timeLocal areaImmediate startFlexible hours- Boulder Care is seeking a Peer Recovery Specialist for a fully remote, Colorado-based, full-time role. You will provide recovery-focused support, leveraging lived experience to empower patients and connect them with resources, while maintaining professional boundaries....Remote jobFull timeMonday to Friday
- Highmark Health is seeking an experienced HCC Coder to support Medicare Advantage, ACA, and ESRD projects. You will code using CMS guidelines, with focus on HCC categories and RPM initiatives, collaborating with physicians and cross-functional teams to ensure accuracy...Remote job
- Thimble Alterations is looking for skilled wedding dress specialists to join our network of independent alteration professionals. If you have a passion for precision tailoring on bridal gowns and a steady hand for delicate fabrics, we want to hear from you. Responsibilities...Flexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Management Specialist — Medicare. Be the first to apply!
Related searches
- public health registered nurse Central City, CO
- temporary rn Central City, CO
- nicu registered nurse Central City, CO
- rn urgent care Central City, CO
- rn skilled nursing facility Central City, CO
- labor delivery registered nurse Central City, CO
- pcu rn Central City, CO
- united nations registered nurse rn Central City, CO
- call center rn Central City, CO
- registered nurse Central City, CO