Remote Utilization Management Nurse Consultant
CVS Health
- Remote job
CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to CST-zone residents. You will apply clinical expertise to ensure safe, effective, and appropriate care, coordinating utilization and benefits while meeting state and federal requirements. Responsibilities include reviewing documentation, collaborating with providers, and supporting cost-effective, high-quality care. #J-18808-Ljbffr CVS Health
- ...CVS Health is seeking a Utilization Management Nurse - Precertification RN to support remote precertification processes. The role requires an active RN license and 3+ years of clinical nursing experience, with strong decision-making using evidence-based criteria. You...Remote work
- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant for a fully remote role. You will assess and coordinate care options, apply clinical criteria to determine coverage, and communicate with providers to ensure appropriate services for members....Remote workWork at office
- ...CVS Health is seeking an experienced Utilization Management Nurse - Precertification RN to work remotely on a full-time, weekday schedule. You will review clinical information, apply criteria, and authorize services while collaborating with providers to support timely...Remote workFull timeWeekday work
- ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote role prioritizing Massachusetts residents. You will coordinate the utilization/benefit management program and ensure timely, appropriate care and location-specific turn-around times. Key duties...Remote work
- ...CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, 100% work-from-home role available to candidates in the EST Zone. You will review medical necessity, coordinate care, and document UM processes to ensure safe, cost-effective care...Remote workWork from home
- ...CVS Health is hiring a Utilization Management Nurse for precertification. This full-time, remote role involves reviewing clinical data, applying evidence-based criteria, and authorizing services within guidelines. You will work with providers and internal teams to ensure...Remote workFull time
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to coordinate, document, and communicate all aspects of the utilization and benefit management process. This 100% remote role supports members to receive appropriate care while meeting state...Remote work
$32.01 - $68.55 per hour
..., each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...Remote workHourly payFull timeLocal area10 hours per weekFlexible hours- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% remote role open to EST residents. You will coordinate, document, and communicate UM processes, ensuring timely and appropriate care while complying with state and federal requirements...Remote work
- ...Alliance for Career Enhancement is seeking an experienced Utilization Management Nurse - Precertification RN whose primary focus is ensuring appropriate... ...-quality care through the precertification process. This remote, full-time role emphasizes evidence-based decision-making...Remote workFull time
$29.1 - $62.32 per hour
## Utilization Management Nurse ConsultantApplyremote type: Remotelocations: MI - Work from home: MS - Work from home: PA - Work from home... ...weekends, holidays, and evening hours.* **UM Nurse Consultant**Fully Remote- WFH**Schedule : Tuesday-Saturday 9:30am-6:00pm****Position...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift- ...CVS Health is seeking a Utilization Management Nurse Consultant specializing in Medical Review. This fully remote role requires an active RN license, 3+ years clinical experience, and 1+ year in Utilization Review/Medical Management. You will apply criteria to determine...Remote work
$26.01 - $68.55 per hour
...of something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and...Remote workHourly payFull timeTemporary workLocal areaWeekday work- ...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
$26.01 - $68.55 per hour
...Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring...Remote workHourly payFull timeTemporary workWeekday work$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse (RN) - 24/7 Operations Location: Remote (Preference for CST/MT time zones) Schedule: 8:00 am to 5:00 pm Includes evenings, weekends,...Remote workHourly payFull timeTemporary workLocal areaAfternoon shift$26.01 - $56.14 per hour
...00am-5:00pm EST Location: 100% Remote (U.S. only) About Us American... ..., is a URAC-accredited medical management organization founded in 1993. We provide... ...complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review,...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$32.01 - $68.55 per hour
...Utilization Management Position We're building a world of health around every individual — shaping... ...Services and benefit utilization Consults and lends expertise to other internal... ...+ years of experience as a Registered Nurse in adult acute care/critical care setting...Remote workHourly payFull timeTemporary workWork at officeAfternoon shift- CVS Health is seeking an RN Utilization Management Nurse Consultant specialized in Medical Review. This fully remote role (U.S. only) requires a valid RN license and clinical experience to ensure medically necessary care through thoughtful review and collaboration with...Remote job
- CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full‑time role open to CST zone residents. You’ll coordinate, document, and communicate all aspects of utilization and benefit management, ensuring safe, effective care and adherence...Remote jobFull time
- ...Remote, RI Contract Job Description: Responsible for the review and evaluation of clinical information and documentation... ...with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST...Remote workContract work
- ...Research, Rehabilitation Therapy and Nursing. Job Description Location :... ...programs are comprised of network management, clinical coverage, and policies. · Utilizes clinical skills to coordinate,... ...Services and benefit utilization · Consults and lends expertise to other...Work at officeWeekend work
$26.01 - $74.78 per hour
...do it all with heart, each and every day. Position Summary CVS Health Aetna has an opportunity for a full‑time Utilization Management (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate...Hourly payFull timeTemporary workWork at officeLocal areaFlexible hours- ...ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers... ...care quality. Qualifications include a NLN-accredited nursing program, at least 3 years acute care nursing, and an...Remote workPart timeWork from home
- ...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
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing... ...This position offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...Akron Children’s Hospital is seeking a Utilization Management Nurse to lead medical necessity reviews, assuring appropriate use of hospital resources... ...with physicians and care teams. The role offers a remote work option, standard daytime schedule, and 40 hours per week...Remote work
- ...provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license... ...providers. This position offers the flexibility of remote work while supporting professional growth and a...Remote work
- ...Registered Nurse - Utilization Review About Company Bestica We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
- 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
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