Remote Utilization Management Nurse
IntelliResume
Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care decisions. This full-time, remote position offers a competitive salary and comprehensive benefits, with duties including interpreting criteria, coordinating with providers and members, and following established guidelines. #J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse in Brooklyn, NY vacancy
$60.15 - $85.81 per day
...Utilization Management NurseThe Utilization Management Nurse supports the case management department by providing a variety of utilization management functions... ...rotating weekend coverageHybrid Position – Primarily remote/work-from-home, with an expectation to be on-site...Remote workFull timeWork experience placementWork from homeShift workCredenza Health
Madera, CA9 hours ago$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation... ...center or triage experience Additional Information Remote to work the eastern or central time zone Work at Home...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeHumana
Columbia, SC2 days ago- ...Cambia Health Solutions, Inc. is seeking a Utilization Management Nurse to join our Clinical Services team. This remote role supports members in Oregon, Washington, Idaho or Utah, conducting prospective, concurrent and retrospective reviews to ensure medical necessity...Remote work
Cambia Health Solutions
United States1 day ago - ...CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal for individuals who thrive in a fast-paced environment and are looking to make a clinical impact without direct patient care....Remote work
CVS Health
United States3 days ago - Mass General Brigham Health Plan Holding Company, Inc. seeks a Nurse for utilization review to assess medical necessity and benefit coverage for ACO/HMO/EPO members. Remote with occasional on-site team meetings in Somerville, MA. Strong InterQual/Milliman experience and...Remote work
Mass General Brigham
Somerville, MA1 day ago - ...Humana is seeking a Utilization Management Nurse to leverage clinical nursing skills in coordinating, documenting, and communicating medical service determinations. The role requires independent interpretation and decision making within established guidelines, with collaboration...Remote work
Humana
United States3 days 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
United States3 days ago- ...CVS Health Corporation is seeking a Nurse Consultant to join our Utilization Management team. The role focuses on applying clinical judgment and evidence-based criteria to review inpatient and outpatient services, authorizing care, and escalating cases when needed....Remote work
CVS Health
United States1 day ago - ...CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote position. You will review medical necessity, facilitate discharge planning, and collaborate with providers to support members with complex needs. Qualifications include ADN required,...Remote work
CVS Health
United States21 hours ago - ...CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise documentation. The position...Remote workFlexible hours
Pennsylvania Psychological Association
Phoenix, AZ1 day ago - ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
Appworks
United States21 hours ago - ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant in the United States to apply clinical judgment and coordinate care across the continuum for members. This role supports a 24/7 operation with weekend and evening hours and requires strong communication...Remote workWeekend workAfternoon shift
CVS Health
Little Rock, AR3 days ago $1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,60... ...Friday, 0730–1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications U.S. Citizenship (required...Remote workContract workImmediate startMonday to FridayJ Edward Staffing LLC
Aurora, CO2 days ago$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States21 hours ago$26.01 - $56.14 per hour
...something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | 24/7 Operations Are you an experienced Registered Nurse looking to apply your clinical...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftCVS Health
Home, KS1 day ago- ...CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborate with providers to authorize care, and elevate cases when needed...Remote work
Preferra Insurance
Phoenix, AZ-130 - ...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities. The... ...organizations, or patient's home which may be in understaffed/remote areas, in the presence of pets or family members that are...Remote workFull timeWork at office
North East Medical Services
Burlingame, CA4 days ago $36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will be given to current employees and candidates who reside in Idaho and Utah. Build a career with purpose. Join our Cause to create a person-focused and economically...Remote workFull timeWork at officeImmediate startWork from homeFlexible hoursCambia Health Solutions
United States1 day ago$26.01 - $56.14 per hour
...of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant (RN) - Remote Must Reside in Oklahoma. Join a collaborative team dedicated to helping members receive the right care,...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayCVS Health
United States2 days ago- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant to apply clinical judgment and guidelines to determine appropriate benefits across the continuum of care. This full-time role supports a 24/7 operation, with scheduled weekends, holidays and...Remote workFull timeWeekend workAfternoon shift
4062 Aetna Resources, LLC
United States1 day ago $26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | Central Time Zone Preferred Are you an experienced Registered Nurse looking to expand your...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftCVS Health
Topeka, KS2 days ago- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant (RN) to perform concurrent reviews for acute inpatient admissions,... ...discharge planners, and support timely transitions of care. This full-time remote role is based in Louisiana. #J-18808-LjbffrRemote workFull time
CVS Health Corporation
Louisiana-130 - ...Utilization Management Department (Fully Remote) Provides health care services regarding admissions, case management, discharge planning and utilization review. Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective...Remote work
$60k
...a LPN/LVN experienced in the managed care payor environment to perform... ...pre-service and post-service utilization reviews and appeals for... ...KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include... ...opportunities Remote Opportunities We are actively...Remote workTemporary workLocal areaIntegra Partners
Troy, MI3 days ago$72.8k - $130k
...and projects. We have collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Springfield MA Regional Area, the role centers on ensuring the accuracy of medical record...Remote workMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaOptum
Charlton, MA2 days ago$29.1 - $62.32 per hour
...simplify health care one person, one family and one community at a time. Position Summary This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayCVS Health
Richmond, VA1 day ago$29.1 - $62.32 per hour
...Utilization Management Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse Consultant, you will utilize...Remote workHourly payFull timeTemporary workWork at officeMonday to FridayCVS Corporation
United States2 days ago$45 - $51 per hour
...Pay: $45.00 - $51.00 per hour Job description: Position Details Position: RN Utilization Management / Utilization Review Setting: 100% Remote Schedule: 5x8-hour days Hours: 8:00 AM 4:30 PM or 9:00 AM 5:30 PM Pacific Time...Remote workHourly payWeekend workHanker Systems
California1 day ago- ...Associate's degree ~ Unrestricted Registered Nurse License in your state of residence ~3+ years of Managed Care and/or Clinical experience Preferred Qualifications... ...experience Pre-authorization experience Utilization Management experience Case Management...Remote jobHourly payMinimum wageFull timeWork experience placementLocal area
- ...Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the... ...in initial clinical review. NOTE: This is a Part-Time REMOTE position for 4 Hours on Friday Evening and 4 Hours each on...Remote jobPart timeWeekend workAfternoon shift
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