Remote Utilization Nurse Consultant - Medicare/Home Health
CVS Health Corporation
CVS Health is seeking a Utilization Management Nurse Consultant for a remote Florida-based role focused on Medicare members. The position emphasizes clinical review, collaboration with home care teams, and evidence-based determinations to optimize care and efficiency.
Required RN licensure with 2+ years of experience, including Med/Surg and utilization management exposure. Benefits include medical/dental/vision, PTO, and retirement options, with a weekday full-time schedule.
#J-18808-Ljbffr$29.1 - $62.32 per hour
## Utilization Management Nurse Consultant - Behavioral Health (Remote)Apply: Remote/Hybrid: AZ - Work from home: Full time: Posted Today: End Date: October 28, 2026 (20 days left to apply): R1051758We’re building a world of health around every individual — shaping a more...Remote jobWork from homeHourly payFull timeTemporary workWork experience placementMonday to FridayFlexible hoursShift workWeekend work- CVS Health Corporation invites an experienced Utilization Management Nurse Consultant to join the Spine Team in a remote, full-time capacity. You will review spine-related prior authorizations, apply evidence-based criteria, and collaborate with providers and Medical Directors...Remote jobFull time
$71.1k - $97.8k
...seeking a Behavioral Health Prior Authorization Nurse to join the... ...necessity and other Medicare and Medicaid criteria... ...year of experience in Utilization Management Two (2... ...discharge planning and/or home health or rehab.... ...workstyle is defined as remote but will use Humana...Remote workWork from homeFull timeTemporary workApprenticeshipHome officeMonday to Friday- ...CVS Health Corporation is seeking an Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. You will review information, apply... ...operations, including weekends and evenings, from a home-based setting. The ideal candidate holds an RN...Remote workWork from homeAfternoon shift
- ...Representative to support members, providers, and patients with their health plan information. You will handle inquiries in Member Services, Medicare, and Billing, and document interactions with accuracy. This remote, home-based role emphasizes HIPAA compliance, privacy, and high-...Remote jobWork from home
$54.1k - $116.77k
...re building a world of health around every individual... ...RN Concurrent Review | Remote Join our team as an RN Concurrent Review Nurse , where you’ll use your... ...Location Work from home Monday–Friday, 8:00... ...and improved healthcare utilization Support timely, effective...Remote workWork from homeHourly payFull timeTemporary workWork at officeLocal areaMonday to Friday$54.1k - $116.77k
...’re building a world of health around every individual... ...one community at a time. Utilization Management Nurse Consultant (RN) Remote | Prior Authorization |... ...Experience supporting Medicaid, Medicare, or Commercial Health... ...preferred Work from Home Requirements: You...Remote workWork from homeHourly payFull timeTemporary workWork at officeLocal area$54.1k - $116.77k
...building a world of health around every individual... ...at a time. Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization... ...Experience in Medicaid, Medicare, or Commercial Health... ...today! Work from Home Requirements: You...Remote workWork from homeHourly payFull timeTemporary workWork experience placementWork at officeLocal area$29.1 - $62.32 per hour
...We’re building a world of health around every individual — shaping a... ...and one community at a time. Utilization Management Nurse Consultant, Specialty Spine Team (Remote) Schedule: Monday-Friday, 8:00... ...members' care journeys. Work from Home Requirements You must have...Remote workWork from homeHourly payFull timeTemporary workWork experience placementWork at officeLocal areaMonday to Friday$60.15 - $85.81 per day
...Utilization Management NurseThe Utilization Management Nurse supports the case management department by providing a variety... ...Position – Primarily remote/work-from-home, with an expectation to be on-... ...ability to work with a variety of health care professionals. Ability to...Remote workWork from homeFull timeWork experience placementShift work- ...professional responsible for collaboration with Home Health and Hospice leadership in planning,... ...rehired/promoted Clinical Managers and Nurses Serve as interim Clinical Manager... ...day. HHH As an employer accepting Medicare and Medicaid funds, employees must comply...Remote jobFull timeInterim roleWork at officeRelocation package
$7.72k - $11.98k
...Public Health Nurse (PHN) I FLSA DESIGNATION:... ...use a smartphone. Ability to utilize phone and computer applications. Ability to use remote meeting technology. Ability... ...motor vehicle to visit work sites, home visits, and/or attend meetings;...Remote workWork from homeFull timeInternshipWork at officeLocal area- ...Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and... ...necessity and coordinate in-home and community-based care for... ...The position emphasizes utilization review, documentation, and collaboration...Remote workWork from home
- CVS Health Corporation is seeking a Utilization Management Nurse Consultant to review inpatient and outpatient services remotely. You will apply evidence-based criteria, collaborate with providers, and authorize care while maintaining documentation. A mandatory training...Remote job
- ...Home Health Registered Nurse Are you a compassionate, dedicated Registered Nurse looking for an opportunity to make a meaningful impact on patients... ...Requirements: Ability to visually assess patients and to utilize sight to implement and evaluate plan of care (changing...Remote workWork from homeTemporary workMonday to FridayFlexible hoursWeekend work
$29.1 - $62.32 per hour
...We're building a world of health around every individual - shaping a more... .... Position Summary Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment... ...information from providers. Remote Work Expectations This is a 100...Remote workHourly payFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...Job Description Valcore Health • Growing Rural... ...Approved E.1 Position MA / nurse - addiction and psychiatric... ...demand; MIH, mobile, home-, community-, partner-site-, telehealth-, and remote-patient-monitoring-... ...supported by the Centers for Medicare & Medicaid Services (...Remote workWork from homeContract workImmediate start
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing... ...disease management or population health programs to support continuity and... ...to you include: Work from Home: Guidehealth is a fully remote...Remote workWork from homeBi-weekly payFull timeTemporary workFor contractorsLocal area$36.8 - $49.8 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah. Preference will be given... ...focused and economically sustainable health care system. Who We Are Looking... ...to make determinations and consults with physician advisors as needed....Remote workWork from homeFull timeWork at officeImmediate startFlexible hours$26.01 - $56.14 per hour
...CVS Health Utilization Management Position We're building a world of health... ...and benefit utilization Consults and lends expertise to other... ...experience as a Registered Nurse in adult acute care/critical... ...BSN preferred Work from Home Requirements: • You must have...Remote workWork from homeHourly payFull timeTemporary workWork at officeAfternoon shift$65k - $88.6k
...The Licensed Behavioral Health Utilization Management... ...Licensed Registered Nurse (RN) - Multi-State Compact... ...and resolve within a remote environment Preferred... ...remote position Work at Home Requirements: To ensure... ...life for people with Medicare and Medicaid, families...Remote workWork from homeFull timeTemporary workApprenticeshipHome officeMonday to Friday- ...national model for improving health. Today, we're focused on... ...innovative culture that allows nurses to grow their skillsets, develop... ...: This role does allow for remote work from home. Travel: Less than 25%-... ...patient satisfaction while utilizing service recovery techniques....Remote workWork from homeFull timeTemporary workPart timeShift workNight shiftWeekend work
- ...Regional Nurse Consultant RN StoneGate Senior Living in Tulsa, OK is hiring a Regional Nurse... ...Nurse Consultant. This position will be home based in Tulsa, OK and will provide consulting... .... We offer competitive compensation, health, dental, and vision insurance, company...Remote workWork from homeWork at officeFlexible hours
- ...national model for improving health. Today, we're focused on... ...innovative culture that allows nurses to grow their skillsets, develop... ...: This role does allow for remote work from home. Travel: Less than 25%-... ...patient satisfaction while utilizing service recovery techniques....Remote workWork from homeFull timeTemporary workPart timeWork at officeLocal areaShift workNight shiftWeekend work
- ...Firstsource is seeking a Work From Home Customer Service Call Center Representative to handle member inquiries, document interactions and resolve complex issues related to health plan benefits. You will respond empathetically, coordinate with providers as needed, maintain...Remote workWork from home
$42.3 per hour
...accessibility! As a Registered Nurse, you will work closely... ...submit required public health reporting... ...diagnosis Continually utilizes the nursing process to... ...Requirements: Reliable at home internet with a... ...locations where we hire remote, hybrid, or onsite employees...Remote workWork from homeHourly payImmediate start$17 per hour
...VIMO INC is hiring Remote Customer Service Representatives in California, offering a full-time, work-from-home position. The role emphasizes delivering exceptional customer experiences and assisting with health insurance enrollment. Key responsibilities include managing...Remote workWork from homeHourly payFull time- About Discovery At Home Discovery At Home is part of the Discovery... ...2012 with the creation of a Medicare-certified agency in Southwest... ...clinical operations of a home health agency. This position provides... ...Primarily office-based (onsite or remote depending on agency)....Remote workWork at office
- ...with clients virtually, identify needs, and explain life, accident, and supplemental health insurance options in a clear and professional manner. This role offers a supportive work-from-home environment with training, mentorship, and income growth potential. #J-18808-...Remote jobWork from home
$17 - $19 per hour
...Vimo is hiring Remote Customer Service Representatives to join our elite teams. This full-time/seasonal role offers... ...with performance incentives, and the chance to work from home while helping people enroll in health insurance. Training is provided, and employees enjoy benefits...Remote workWork from homeHourly payFull timeSeasonal work
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