Remote Utilization Management Nurse
Vālenz Health
Valenz Health is seeking a Utilization Management Nurse to oversee and manage the UM process, ensuring the delivery of high-quality, cost-effective care for plan participants. You will review prospective, concurrent, and retrospective UM activities and collaborate with internal teams and healthcare professionals to ensure compliance with CMS, URAC, and other regulators. This fully remote role requires a US-based location, strong nursing background, and ability to work in a fast-paced environment #J-18808-Ljbffr
Vacancy posted 10 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse in Brooklyn, NY vacancy
- ...Humana is seeking a Manager, Utilization Management Nursing to lead coordination and interpretation of medical services and benefit determinations in a remote, home‑based role. You will apply advanced nursing knowledge, guide teams, and collaborate across departments...Remote workWork from home
Humana
Frankfort, KY1 day ago - ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
SHR (Spectrum Healthcare Resources)
Honolulu, HI3 days ago - ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports utilization management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities...Remote workWork from home
CVS Health
New York, NY1 day ago - ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate...Remote workFull timeWork from home
CVS Health
United States3 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 - IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical... .... This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-LjbffrRemote work
IntePros
New York, NY4 days ago - ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within...Remote workFull time
4062 Aetna Resources, LLC
Topeka, KS14 hours ago - A healthcare staffing agency seeks a Utilization Management RN to evaluate clinical conditions through medical record reviews. The position is remote, requiring candidates to reside in PA, DE, or NJ. Key duties involve applying criteria for medical necessity, collaborating...Remote work
The Judge Group, LLC
New York, NY4 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
Phoenix, AZ4 days ago- ...Humana Inc. is seeking an Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical... ...decision-making to provide appropriate care for members. This remote, patient-facing position may require occasional travel to...Remote work
Humana
Brooklyn, NY1 day ago $71.1k - $97.8k
...live safely and independently in their communities? As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well... ...in Illinois, Wisconsin, or Indiana. Workstyle: This is a remote position supporting members and providers throughout...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayHumana
Springfield, IL3 days ago$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation... ...member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift workHumana
Florida, NY4 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, NY4 days ago - ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving candidates in the EST or CST zones. You will coordinate, document, and communicate utilization and benefit management activities to ensure appropriate...Remote workFull time
Santa Barbara Cottage Hospital
New York, NY14 hours ago - ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to EST residents across the U.S. You will apply clinical expertise to ensure members receive safe, appropriate and cost-effective care. Schedule: Monday...Remote workFull timeMonday to FridayWeekend work
CVS Health
Raleigh, NC3 days ago $70k - $75k
...analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build... ...Job Description The Utilization Management Registered Nurseis responsible... ...education consistent with current nursing practice standards and the...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States1 day ago- ...CVS Health is seeking an Utilization Management Nurse Consultant (Clinical Precertification RN) for Medicare, remotely. This full-time role asks for an active RN license and several years of experience to evaluate care and determine coverage using evidence-based guidelines...Remote workFull timeAfternoon shiftWeekday work
Hispanic Alliance for Career Enhancement
Wausau, WI4 days ago $26.01 - $68.55 per hour
...UM Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends,...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftOak St. Health
United States1 day ago$32.01 - $68.55 per hour
...UM Nurse Consultant We're building a world of health around every individual — shaping... ...family and one community at a time. Utilization Management is a 24/7 operation and work schedule... ...holidays, and evening hours. Fully Remote- WFH Schedule - M-F 10:30A-7:30P...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shiftAvery Healthcare Group Ltd.
United States1 day ago$58.66k - $142.45k
...Peer-to-Peer Utilization Review Nurse Mass General Brigham relies on a wide range of professionals... ...of the MGB Central Utilization Management team, specializing in identifying, preparing... .... Schedule and Work Model ~ Remote / Work from Home. ~32 hours per week...Remote workWork from homeShift work$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, CO3 days ago- ...Utilization Management Specialist Shift: Monday through Friday 8:00 AM to 4:30 PM, with every fifth... ...~ Must be computer literate and have remote working experience. Compliance... ...City Fort Myers State FL TLC Nursing Associates, Inc. is an equal-opportunity...Remote workContract workWork experience placementLocal areaMonday to FridayShift workWeekend work
Lee Health-Corporate Center
Fort Myers, FL1 day ago - Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters according to process instructions. You will extract pertinent details, reference clinical guidelines, and ensure compliance with HIPAA and policies. Position...Remote job
- IntusCare is seeking a Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. You will review... ...with care plans and PACE regulations. This is a fully remote US-based position. #J-18808-Ljbffr Santa Barbara Cottage...Remote job
- UnitedHealth Group's Optum is seeking a Utilization Management Nurse to review patient records and craft defensible appeal letters in accordance with OPAS guidelines. This role supports 40 hours per week, Monday-Friday, with telecommuting flexibility across the U.S. and...Remote jobMonday to Friday
$71.1k - $97.8k
Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation... ...member PHI / HIPAA information. Travel While this is a remote position, occasional travel to Humana's offices for training...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office$42 per hour
IntusCare is seeking a Contract Utilization Management Nurse to ensure high-quality, cost-effective, and compliant care for PACE participants. The... ...transitions across care settings. The position is fully remote within the United States and offers a 1-year contract with...Remote jobHourly payContract work- Mass General Brigham Health Plan Holding Company, Inc. is seeking an RN-based Utilization Management Nurse to support network adequacy reviews and authorization decisions for ACO, HMO, and EPO products. The role emphasizes medical necessity assessment and robust payer...Remote job
- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications...Remote jobWork at office
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and compliance. You will support OPAS and enterprise goals while collaborating across teams to deliver high-quality reviews. Requirements...Remote jobWork at officeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse. Be the first to apply!
Related searches
- software engineering manager remote Brooklyn, NY
- system engineer remote Brooklyn, NY
- remote technical project manager Brooklyn, NY
- remote recruitment consultant Brooklyn, NY
- remote property manager Brooklyn, NY
- remote reviewer Brooklyn, NY
- remote insurance agent Brooklyn, NY
- remote no experience Brooklyn, NY
- remote life underwriter Brooklyn, NY
- remote medical coding supervisor Brooklyn, NY