Remote Utilization Management Nurse Consultant (RN)
CVS Health
CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity, and apply clinical criteria to determine appropriate care while maintaining compliance with health plan requirements. The role supports providers, care managers, and interdisciplinary teams to ensure timely, cost-effective services. Qualifications include an active RN license (multi-state preferred), 3+ years of nursing, 2+ years in UM/Prior
#J-18808-LjbffrVacancy posted 1 hour ago
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Hydaburg, AK20 hours ago - ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to work remotely on a full-time weekend schedule after training. This role focuses on ensuring members receive the right care at the right time by reviewing clinical information...Remote workFull timeWork at officeWeekend workDay shift
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Guin, AL3 days ago $29.1 - $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 | Monday-Friday Are you a Registered Nurse looking to leverage your...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift$26.01 - $56.14 per hour
...:00pm EST Location: 100% Remote (U.S. only) About Us American... ...URAC-accredited medical management organization founded in 1... ...medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical... ...Qualifications Active, unrestricted RN license in your state of...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work- ...CVS Health is seeking a qualified Registered Nurse for Utilization Management to ensure appropriate healthcare services and benefits for members. This role supports a 24/7 operation, including weekends and evenings, and requires strong clinical judgment and collaboration...Remote workAfternoon shift
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Sacramento, CA3 days ago - ...CVS Health is seeking a Registered Nurse for Utilization Management in a fully remote role. You will review clinical information, coordinate with care teams,... ...coverage and care plans from home. Requires an active RN license and 2+ years in adult acute, critical care or...Remote work
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New York, NY2 days 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... ...thorough documentation. The position requires active RN licensure, 3+ years of acute behavioral health or...Remote work
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New York, NY4 days ago - ...CVS Health is seeking a Remote Utilization Management Nurse Consultant (RN) to review and determine appropriate coverage, applying policies and clinical guidelines. The role collaborates with care teams to coordinate treatment and improve member outcomes in a 4-day weekend...Remote workWeekend work
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Lincoln, NE20 hours ago - ...CVS Health Corporation is seeking an experienced Utilization Management Nurse Consultant (RN) to support remote concurrent review. You will review authorization requests, determine medical necessity, and apply clinical criteria to inform denials or approvals while collaborating...Remote work
CVS Health
Austin, TX4 days ago - ...CVS Health Corporation in Springfield, IL is hiring a Utilization Management Nurse Consultant to assess and coordinate care, applying clinical criteria... ...and evening hours. Requirements include 2+ years of RN clinical experience in adult acute/critical care, active...Remote workShift workWeekend workAfternoon shift
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Phoenix, AZ4 days ago - ...CVS Health is seeking a Registered Nurse for Utilization Management. This 24/7 role involves evaluating care options, gathering clinical information... ...coordinate care and referrals. The position requires an active RN license and 2+ years of adult acute/critical care...Remote workWeekend workAfternoon shift
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United States4 days ago - ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote role supporting EST/CST time zones. The position requires 2+ years of RN experience, current unrestricted RN licensure, and ability to work weekends/evenings as part of a 24/7 operation. The...Remote workWork at officeWeekend workAfternoon shift
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Austin, TX4 days ago - ...CVS Health is seeking a Utilization Management Nurse Consultant (Clinical Precertification RN) for Medicare on a remote, full-time basis. You will review clinical cases, determine coverage, coordinate care, and support decision-making for member outcomes. The role requires...Remote workFull timeMonday to FridayAfternoon shift
CVS Health
United States4 days ago
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