Remote Utilization Management Nurse (RN)
4062 Aetna Resources, LLC
Topeka, KS
- Remote job
CVS Health is seeking a Utilization Management (UM) Nurse Consultant for a fully remote, full-time role open to CST zone candidates. You will coordinate, document, and communicate all aspects of utilization and benefit management, ensuring appropriate care levels within state and federal requirements and turnaround times. Responsibilities include reviewing medical necessity, collaborating with providers, and supporting cost-effective care. #J-18808-Ljbffr 4062 Aetna Resources, LLC
Vacancy posted 19 hours ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse (RN) in Topeka, KS vacancy
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports... ...management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities include...Remote jobWork from home
$70k - $75k
...analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build... ...Job Description The Utilization Management Registered Nurseis responsible... ...education consistent with current nursing practice standards and the...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from homeGuidehealth
United States1 day ago$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote jobWeekend work- ...RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide - California Job Description... ...Nurse (UMRN) . These will be completely remote positions, working entirely from the Nurse'...Remote workFull timeContract workWork at officeWork from homeMonday to Friday
Spectrum Healthcare Resources
Los Angeles, CA4 days ago - A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote workFlexible hoursWeekend workDay shift
The Judge Group, LLC
New York, NY2 days ago - ...Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...Remote work
Brighton Health Plan Solutions
Chapel Hill, NC1 day ago - ...SSM Health in the United States seeks a registered nurse for utilization management to evaluate medical necessity of hospital admissions and procedures... ...role supports day shift operations, requires two years of RN experience, and involves coordinating with payors,...Remote workDay shift
Socket
New York, NY19 hours ago - ...CVS Health is hiring a Utilization Management Nurse Consultant focused on Medical Review. This fully remote role supports timely, medically necessary care through expert clinical... .... The position requires an active RN license, 3+ years of clinical experience, and...Remote workFull time
Hispanic Alliance for Career Enhancement
Jefferson City, MO4 days ago - ...Job Description Job Description Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like... ...candidates will have strong multitasking skills, RN and clinical experience, preferably in ER,...Remote workFull timeWork at office
Cottingham & Butler
Davenport, IA14 days ago - ...Seeking a California Licensed UM Nurse for a full-time remote position, who will review... ...expertise is needed Utilize CMS guidelines and Milliman... ...service UM experience in a managed care environment Active, valid... ..., and unrestricted LVN or RN license in California...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
Appworks
United States3 days ago - ...Working remotely, the full-time RN Utilization Management will review and document member case histories and prior authorization requests, utilizing clinical judgment to determine coverage eligibility while ensuring compliance with policies and procedures. Key Responsibilities...Remote workFull timeWork experience placement
Virtual Vocations Inc
United States4 days ago - A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management... ...discharge planning. Candidates must have an active RN license in New Jersey, strong analytical skills, and...Remote workContract work
Rangam
Pennington, NJ3 days ago - ...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
Hispanic Alliance for Career Enhancement
Wausau, WI4 days ago $1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military... ...weekends, no holidays, no telehealth/remote work Minimum Qualifications U... ..., full, active, and unrestricted RN license Certifications: BLS...Remote workContract workImmediate startMonday to FridayJ Edward Staffing LLC
Aurora, CO19 hours ago- ...growing healthcare team, the full-time California Licensed Utilization Management LVN will manage authorization processes, perform utilization... ...with healthcare providers and insurance representatives in a remote setting. Key responsibilities Interface with external agencies...Remote workFull time
Virtual Vocations Inc
United States4 days ago - 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 to...Remote job
- ...Job Title Utilization Review/Case Management – Nurse Department Case Management (Quality) Hours & Shift Requirements Full time position. Hybrid (combination of in person and remote considered) General Summary The Utilization Review/Case Management Nurse is directly responsible...Remote workFull timeShift work
Gibson Area Hospital
Gibson City, IL4 days ago - CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to coordinate, document, and... ...management process. This 100% remote role supports members to receive appropriate... .... The position requires an active RN license, 2+ years in acute hospital care...Remote job
- ...applicable patients as stated in system utilization management plan. Oversees Clinical Review... ...first week. This role will be remote BUT regular meetings/trainings require... ...Qualifications ~ Bachelor of Science in Nursing ~ Previous experience with MCG and/...Remote workReliefShift workWeekend work3 days per week
Children's Healthcare of Atlanta
Brookhaven, GA1 hour ago - ...Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in the tri-state area (PA, DE, NJ) M... ...equipment Must have an active PA license or a Nurse Licensure Compact to include PA. **...Remote workImmediate startDay shift
The Judge Group, LLC
New York, NY2 days ago - CVS Health is hiring a Utilization Management Nurse Consultant for a 100% remote role focused on the EST zone. You will review medical necessity, coordinate care,... ...while meeting regulatory timelines. Required: active RN license and 2+ years of acute hospital experience,...Remote job
- CVS Health in the United States is seeking a Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role available to candidates in EST or CST zones. You will apply clinical expertise to ensure members receive safe, effective care at the right time and...Remote jobFull time
- CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote position in the EST zone. The role focuses on coordinating, documenting... ...timelines. Minimum requirements include an active RN license and 2+ years of acute hospital experience....Remote job
- 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... ...-effective care. The position requires an active RN license, 2+ years hospital experience, strong...Remote job
$32 - $48 per hour
...RN-Utilization Review/Case Manage Nurse - RFT Hot Job Gibson City, IL 60936 Overview Salary Range $32.00 - $48.00 Hourly Position Type Full... ...time position. Hybrid (combination of in person and remote considered) GENERAL SUMMARY The Utilization Review...Remote workHourly payFull timeWork at officeRelocation packageShift workGibson Area Hospital
Gibson City, IL19 hours ago- ...Alliance for Career Enhancement is seeking an experienced Utilization Management Nurse - Precertification RN whose primary focus is ensuring appropriate, high-quality care through the precertification process. This remote, full-time role emphasizes evidence-based decision-...Remote jobFull time
- 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...Remote jobFull time
$71.1k - $97.8k
Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...Licensed Registered Nurse (RN) with at least 3 years prior clinical... ...information. Travel: While this is a remote position, occasional travel to Humana'...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayShift work- 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
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Nurse (RN). Be the first to apply!
Related searches