Remote RN: Utilization Management & Prior Authorization
CVS Health
CVS Health Corporation is seeking a Utilization Management Nurse Consultant (RN) for remote work supporting prior authorization and utilization management. You will review requests, evaluate medical necessity, and collaborate with care teams to ensure timely, cost-effective care.
Requires multi-state RN license and 3+ years of nursing with UM/PA experience. Your role includes applying clinical criteria, coordinating with providers, and ensuring compliance with policies and standards while
#J-18808-LjbffrVacancy posted 4 days ago
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Guin, AL3 days ago $72.8k - $130k
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United States5 days ago $26.01 - $62.32 per hour
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King, WI1 day ago$26.01 - $62.32 per hour
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Wilmot, SD3 days ago$26.01 - $62.32 per hour
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Midway City, CA1 hour ago$32.01 - $68.55 per hour
...every day. Position Summary This Utilization Manager position is with Aetna's Long-Term... ...Supports (LTSS) team and is a fully remote role. Candidates must hold a New York... ...Care experience Experience with Prior Authorizations Knowledge of Medicaid and Medicare...Remote workHourly payFull timeLocal area10 hours per weekFlexible hoursThe Muse
Albany, NY14 hours ago$90k - $107k
...package. The UMCM will utilize clinical knowledge to... ...candidate will have prior authorization (outpatient review) experience in a managed care setting with commercial... ...Registered Nurse (RN) license required Experience... ...hire. This is a remote role with occasional...Remote workFlexible hoursShift workMass General Brigham Health Plan Holding Company, Inc.
Somerville, MA16 hours ago$69.8k - $125.9k
...for ensuring compliance with Utilization Management (UM) and Quality Review (QR... ...~ Registered Nurse (RN) with an unrestricted license... ...clinical review role. ~ Strong prior authorization experience within a... ...not available This is a remote role Pay Transparency Statement...Remote workNight shiftHealth Care Service Corporation
United States4 days ago- ...Area Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA) Company... ...non-licensed denial unit staff, managing daily tasks, performance reviews... ...Registered Nursing Program; RN preferred.Minimum of five years in prior-authorization, appeals & grievance, or health...Remote workPermanent employmentTemporary work
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Phoenix, AZ3 days ago$26.01 - $68.55 per hour
## Utilization Management Nurse ConsultantApply: Remote: IL - Work from home: Work At Home-Idaho: Work At Home-Arkansas... ...active current and unrestricted RN licensure in state of residence*... ...) **Preferred Qualifications*** Prior Authorization or Utilization Management...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shift- ...Arkansas Blue Cross and Blue Shield is seeking an RN Utilization Management Nurse to perform clinical reviews for medical necessity across various services. The role involves weekend coverage and work from home within Arkansas and several western states. The ideal candidate...Remote workWork from homeWeekend work
Arkansas Blue Cross
United States5 days ago
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