Remote RN UM Consultant - Medicare
CVS Health
CVS Health is seeking an experienced RN for an Utilisation Management Nurse Consultant role focused on Medicare joint procedures. This remote, full-time position emphasizes clinical expertise to ensure appropriate care while coordinating with providers and care teams.
The role requires an active RN license, 3+ years of RN experience (1+ year Med/Surg) and proficiency with Microsoft Office 365. Flexible schedule, with home-based work and a strong benefits package.
#J-18808-Ljbffr- ...CVS Health is seeking an experienced RN Utilisation Management Nurse Consultant (Medicare – Joint Procedures) for a remote, full-time role with a Monday–Friday schedule. You’ll review precertifications, apply criteria, and coordinate care to ensure members receive appropriate...Remote workFull timeWork at officeMonday to Friday
- ...Corporation is seeking a Utilization Management Nurse Consultant for Medicare Home Care. This remote, full-time role supports Florida members and partners with... ...hours as needed. Required: active, unrestricted RN license in your state, 2+ years RN experience (1+ year...Remote workFull timeAfternoon shift
$26.01 - $56.14 per hour
...About This Role The UM Nurse Consultant at CVS Health is a remote position ideal for experienced inpatient Registered Nurses looking to leverage their clinical... ...Residency: Must reside in Louisiana or have Compact RN licensure What You'll Do Conduct concurrent reviews for...Remote workFull timeMonday to Friday$26.01 - $56.14 per hour
...utilization management (UM) reviews and... ...of care. The UM Nurse Consultant evaluates medical necessity... ...unrestricted Registered Nurse (RN) license in the state... ...Experience in Medicaid, Medicare, or Commercial Health Plan... ...working in a remote environment.EducationAssociate...Remote workHourly payFull timeLocal area$29.1 - $62.32 per hour
...a time. Utilization Management Nurse Consultant, Specialty Spine Team (Remote) Schedule Monday-Friday, 8:00 AM-5:00... ...holiday coverage Are you an experienced RN with a passion for clinical review,... ...? Join our Utilization Management (UM) Spine Team and play a critical role...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to Friday$26.01 - $56.14 per hour
About This Role The Concurrent Review UM Nurse Consultant role at CVS Health is ideal for experienced... ...Pay: $26.01 - $56.14/hour Location: Remote, LA Residency: Louisiana residency preferred... ...: Active, unrestricted multi-state RN license in your state of residence, or the...Remote workFull time- ...CVS Health is seeking a licensed RN to join our Utilization Management team in a remote, full-time role focused on Medicare precertification. You will review cases, determine coverage, and collaborate with providers to ensure appropriate care. The role requires 3+...Remote workFull timeWork at officeMonday to FridayAfternoon shift
$26.01 - $56.14 per hour
...one community at a time. Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity... ...Qualifications BSN preferred Experience in Medicaid, Medicare, or Commercial Health Plan Utilization Management...Remote workHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home$26.01 - $56.14 per hour
...and one community at a time. Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management Are you an... ...BSN preferred Experience supporting Medicaid, Medicare, or Commercial Health Plan populations Utilization review...Remote workHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home- ...CVS Health is hiring an RN Utilization Management Nurse Consultant (Medicare - Joint Procedures) for remote, full-time work. You will review Medicare precertification data, apply criteria, and coordinate care plans to ensure appropriate treatment and utilization. The...Remote workFull timeWork at office
- ...CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote, full‑time team. The role focuses on ensuring appropriate care and coordinating with providers to optimize member outcomes, with a weekend‑heavy...Remote workFull timeWork at officeShift workWeekend work
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote team on weekends after training. You will review clinical information to support coverage determinations and collaborate with providers to coordinate care,...Remote workWork at officeWeekend work
$65k - $88.6k
...Licensed Registered Nurse ( RN ) – Multi-State Compact Master... ...troubleshoot and resolve within a remote environment Preferred Qualifications Behavioral Health UM experience, performing medical... ...of life for people with Medicare and Medicaid, families, individuals...Remote workFull timeTemporary workApprenticeshipWork from homeHome officeMonday to Friday- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) for a remote full-time role with weekend coverage. You will review clinical information to support coverage determinations, apply guidelines, and collaborate with care teams...Remote workFull timeWork at officeWeekend work
- ...Utilization Management (UM) Nurse, you are the... ...administrative compliance. Unlike remote roles, this position... ...is a Registered Nurse (RN) responsible for... ...Collaborationo Physician Consultation: Meet in person with attending... ...condition-code 44 or Medicare observation notices (...Remote workFull timeImmediate startShift work
$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Concurrent Review Nurse (RN) 100% Remote | Monday-Friday, 8:00 AM-5:00 PM CST Occasional Weekend & Holiday On-Call Coverage Are you an experienced inpatient...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to Friday- ...for oversight of staff UM RNs to ensure coordination... ...is expected that all RN Clinical Nurses are... ...administrative compliance. Unlike remote roles, this position... ...Physician Consultation: Meet in person with attending... ...as condition-code 44 or Medicare observation notices (MOON...Remote workFull timeImmediate startShift work
- ...Description $10,000 Sign On Bonus Position Overview The RN Clinical Management Specialist is a qualified professional responsible... ...and families every day. HHH As an employer accepting Medicare and Medicaid funds, employees must comply with all health-...Remote jobFull timeInterim roleWork at officeRelocation package
$53 per hour
...Job Description Job Description REMOTE RN OPPORTUNITY – GRIEVANCE & APPEALS / UTILIZATION... ...NY RN license Direct outpatient UM experience. Strong outpatient Utilization... ...Grievance & Appeals experience Managed care, Medicare/Medicaid experience Strong clinical...Remote jobLong term contractWork from homeMonday to FridayShift workWeekday work- ...CVS Health in Oklahoma is seeking an experienced Utilization Management Nurse Consultant (RN) for a 100% remote role based in Oklahoma. You will review medical necessity, coordinate care, support discharge planning and provide coverage recommendations, collaborating with...Remote work
- ...seeking an experienced Utilization Management Nurse Consultant to work remotely in the United States. The role supports Medicare precertification, assesses clinical information... ...teams. The position requires 3+ years of RN experience, an active RN license, and...Remote workWork at officeAfternoon shift
- ...VitaCare Living in Spooner, WI is seeking an experienced Registered Nurse (RN) Consultant to provide clinical oversight for our assisted living and memory care communities. You will guide practice, ensure regulatory compliance, and support staff with education and quality...Remote work
$45 per hour
...Wisconsin, is seeking an experienced Registered Nurse (RN) to serve as a contracted RN Consultant for assisted living and memory care communities. The role... ...hours/week) with a mix of on-site community visits and remote work, compensation at $45 per hour, and collaboration...Remote workHourly payPart time- ...Molina Healthcare seeks a Remote RN Care Review Clinician for UM/Discharge Planning in California. You will verify medical necessity, review services against guidelines, and coordinate care across the delivery continuum to achieve quality outcomes. The role requires...Remote workWork at office
- tango is a leader in home health management seeking a UM Clinical Support Specialist to join our growing team in Phoenix, AZ. The role focuses on data collection, analysis, reporting, and maintaining utilization and productivity logs to support decision making. You will...Remote job
- ...CVS Health seeks a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. You will apply clinical criteria and collaborate with providers to render coverage decisions along the continuum of care. The...Remote work
- ...)—a nationally respected leader in senior care consulting and management is seeking an experienced MDS Consultant – RN to support skilled nursing communities throughout... ...your MDS expertise is needed most—providing remote support, strengthening reimbursement and clinical...Remote workInterim roleImmediate start
- ...Mass General Brigham Health Plan is seeking an experienced RN for utilization management with a focus on processing and managing UM authorizations. The role supports collaboration between the UM department and external vendors to ensure efficient authorization processing...Remote work
- ...promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications At... ...combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice....Remote workWork at office
- ...with providers to facilitate treatment. The role emphasizes HIPAA-compliant care, collaboration, and efficient use of resources. Requires an active RN license, ADN (BSN preferred), and 2+ years in adult acute/critical care. Remote work within the U.S. #J-18808-Ljbffr...Remote work
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